Hospital at war: treatment changes in mental patients

The implications of the chemical war threat and the missile attacks during the Gulf War for a medium-sized psychiatric community are analyzed in terms of psychiatric care and management. Changes in medication, physical restraint, and ward transfer were observed for schizophrenic patients in active psychotic phase (n=50), in residual post-active phase (n=37), and patients with long-term residual type (n=167). The variables for the first week of the war (n=250) were compared to those the same week 1 year before (n=254). Patients in active phase and patients in residual phase received more supplementary treatment and radical changes in treatment; patients in active phase received more treatment reinforcement, as well as physical restraint, compared to patients in residual phase and residual type patients. Residual type patients remained unchanged on all variables. Residual type patients remained mostly indifferent, while many severely disturbed psychotics needed restraining and less severely disturbed patients residing in open wards required only minor tranquilizers. Patients in active phase tended to behave very erratically while denying being affected by the war, and patients in residual phase overtly expressed their anxiety and remained in control.