Commonality of factors in the personal histories of severely disabled schizophrenia and bipolar disorder/major depression clients

The files of 87 severely disabled clients diagnosed with schizophrenia or bipolar disorder/major depression were examined for identification of personal history events which were held in common by the clients. The files of all persons in a case management program of a community mental health facility during a three month period who had one of the required diagnoses and whose files were complete were included. Factors identified in the files were sexual abuse, physical abuse, substance abuse, gender, diagnosis, age, age at the beginning of treatment, marital status, race/ethnicity, educational level achieved and employment status. Factors were examined for interrelatedness and prevalence in each diagnostic category. Results of crosstabulations and oneway analysis of variance showed that those diagnosed with schizophrenia had significantly higher levels of sexual abuse and substance abuse histories than did those diagnosed with bipolar disorder/major depression. Sexual abuse was recorded in the histories of 60.5% of those diagnosed with schizophrenia, and in 27.3% of those diagnosed with bipolar disorder/major depression. Females diagnosed with schizophrenia had a prevalence of 83.3% for sexual abuse compared to 36.0% for those diagnosed with bipolar disorder/major depression. Males diagnosed with schizophrenia had a prevalence of 44.0% for sexual abuse compared to 15.8% for those diagnosed with bipolar disorder/major depression. Females were more likely to have sexual abuse histories than were males as has been reported in previous studies. Those of both genders experiencing sexual abuse more often also had physical abuse; those who had physical abuse were more likely to abuse substances; however, little relationship was shown between those with sexual abuse and subsequent substance abuse. Males were more likely to have substance abuse histories than were females (70.5% of males and 27.9% of females). Among those diagnosed with schizophrenia, 60.5% had substance abuse histories; among those diagnosed with bipolar disorder/major depression, the rate was 27.9%.