Identifying Life Stressors of Patients With Schizophrenia at Hospital Discharge
Abstract
--> To the Editor: The period after discharge from a psychiatric hospital represents a critical time in the course of illness for individuals with schizophrenia. The transition from the hospital to another setting has been found to be associated with increased levels of stress and, perhaps as a consequence, with exacerbation of psychiatric symptoms, noncompliance with medication, substance abuse, and suicide attempts (1,2). In particular, the link between discharge, stress, and suicide may be important, because 20 to 40 percent of suicides among persons with schizophrenia occur within three months of discharge (3), with the risk particularly high during the first five days after discharge. Although most studies of stress and schizophrenia focus on major life events, it has been suggested that it is more the demands of everyday life that lead to stress (4) and that daily hassles are better predictors of subjective stress than major life events (5). Schizophrenia is characterized by repeated hospitalizations and discharges. Even though it is recognized that the days after discharge are a high-stress period, there is a lack of information about the stressors that individuals with schizophrenia experience during this period. The aim of this study was to enumerate these