Schizophrenia in Navarra. An historical perspective

Abstract

Following a brief outline of data relating to the care of the ímadî in the XIX century in Navarra, this study focuses on the ideas and contributions made by psychiatrists over the course of the XX century and especially those of the Psychiatric Hospital, the only care resource until well after the first half of the century. An analysis is made of the factors that are usually considered to have influenced the notable reduction in the rate of first-time hospitalisations for schizophrenia: progressive longevity; change of diagnostic criteria; increase of suicides in young people; reduction of perinatal infections. We conclude that the latter, although certainly limited, is the only factor of objective value. In general, the procedure based on first-time hospitalisations cannot be considered as a valid indicator of the real decline in morbidity, since it is highly influenced by the changes of criteria deriving from the greater wealth of therapeutic possibilities. Sociological, evolutionary and therapeutic aspects of schizophrenic patients interned in the Navarra Psychiatric Hospital are shown. A study is made of the association between drug addiction and schizophrenia, and we reach the conclusion that this does not increase its incidence but that it does accelerate the first onset. Finally, we consider the need for imaginatively filling the gap created by the "bipartisanship"in mental health between the hospitalisation of acute cases in general hospitals and the support of social care.