Expert: Libby Bonner - 3/31/2006

Question
Hello there,

I have read that people personality disorders should not be institutionalized for many years in a mental hosptial with other mentally ill persons with illnesses such as schizophrenia. is that true?

yet a couple days ago i found a bipolor in a mental hosptial i visited here in egypt.  they say one of her symptoms is "sexual deviation" (probably in her manic phase).  what do you think of this? should she be in an psychiatric hospital at all or is this wrong?  

could any bipolars fit the criteria for "harm to self or others" which allows for their involantry committment to a mental hospital?

I met another girl who is schizo-affective who also has a symptom of "sexual deviation"! they say that she is especially resistant to treatment so the doctor says that she will probably stay in the hospital forever!

please let me know what you think of all this! thanks

Nada

Answer
There are many questions here, some of them perhaps cultural.  I am speaking from a USA perspective.

Schizophrenia, bipolar disorder [formerly, manic depression], and major depression, plus a couple more non-personality disorders, are considered to be "serious and  persisting mental illnesses" characterized by their 'relapsing/remitting' nature.

All of these have pharmaceutical agents available for effective treatment, or at least for symptom reduction - some reducing symptoms in as many as 80% of pts.  It is very usual for pts to take combinations of meds.  Meds, and med dosages, often need to be adjusted from time to time if effectiveness diminishes.

Hospitalizations here tend to be only long enough to get a pt stabilized [or, restabilized] on meds, and then pt would be seen by a doc fairly frequently post-hosp until it was judged that all med adjustments were working and that relative stability was being maintained.  Then the pt would be seen perhaps every couple months; sooner if syptoms flared.

The longer that a pt is untreated, or treated ineffectively, the less likely one is to have good results once effective treatment is begun.

Harm to self or others is likeliest to result during the  time any pt is severely depressed/suicidal or is hallucinating and/or psychotic.    Simply having a diagnosis of a serious mental illness does not, in itself, offer any info about potential for harm.

For more info on mental illnesses, see www.nami.org or www.mentalhealth.com

This is an international org that possibly has connections in your part of the world - check to see if they could help.  World Fellowship for Schizophrenia and Allied Disorders, www.world-schizophrenia.org

Good luck.  I am so glad that you wrote.