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Am J Psychiatry 110:888-896, June 1954
doi: 10.1176/appi.ajp.110.12.888
© 1954 American Psychiatric Association
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COMMUNITY CONDITIONS AND PSYCHOSES OF THE ELDERLY

ERNEST M. GRUENBERG M. D.1

1 Executive Director, New York State Mental Health Commission, Dept. of Mental Hygiene.

Our evidence indicates that there is in the center of the city an area characterized by high first mental hospital admission rates for cerebral arteriosclerotic and senile psychosis, by high first mental hospital admission rates for all the other psychoses taken as a group, by high concentrations of multiple family dwellings, and by high percentages of people living alone.

POINTS FOR FURTHER INVESTIGATION

The foregoing findings indicate a need for studies in the following directions:

1. Determination of whether a disproportionate number of the hospital patients tend [SEE SOURCE PDF FOR TABLES 2,3,4,5] to have been living alone prior to hospitalization. Gerard's(4) study of schizophrenia and Sainsbury's studies of suicides as reported by Aubrey Lewis(5) suggest that this may be true.

2. Determination of whether the cases come disporportionately from multiple family dwellings. This is a much harder question to answer and no simple method for doing so has yet been found.

3. Determination of whether those first admissions who were not living alone at the time of admission were undergoing a process of social isolation without physical isolation.

4. Determination of whether isolation is an early Symptom of psychosis formation, is causative of psychosis, or both.

5. If physical or social isolation are found to be causative, determination of methods by which such isolation may be prevented and by which it can be arrested and reversed once begun.




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