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Clinically Distinct Recovery Styles From Schizophrenia

Thomas H. McGlashan, MD; Steven T. Levy, MD; William T. Carpenter, Jr., MD

Arch Gen Psychiatry. 1975;32(10):1269-1272.

Abstract
Concepts of integration and sealing over are common clinical psychiatric parlance. Our experience studying and treating acute schizophrenic patients, primarily with psychosocial techniques, has emphasized the meaningfulness of these concepts. By studying the recovered patient's attitude toward his psychotic experiences, we have obtained material from which to formulate definitions of these concepts.

Integrators tend to be curious about their symptoms, regard them as part of their life's pattern, and gain information from them, resulting in a more flexible and variable attitude toward illness than patients who seal over. The latter have rather fixed, usually negative, views of their illness, and tend not to strive to understand their psychotic symptoms nor to place their psychotic experiences in perspective with their lives before and after psychosis.

Author Affiliations
From the Clinical Research Unit, Psychiatric Assessment Section, National Institute of Mental Health, Bethesda, Md (Drs. McGlashan and Carpenter); and the Department of Psychiatry, Emory University School of Medicine, Atlanta (Dr. Levy).

Footnotes
Accepted for publication Aug 18, 1974

Reprint requests to the Clinical Research Unit, Psychiatric Assessment Section, Adult Psychiatry Branch, National Institute of Mental Health, 9000 Rockville Pike, Bldg 10, Rm 4N214, Bethesda, MD 20014 (Dr. McGlashan).

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