Institutionalisation and schizophrenia in Japan: social environments and negative symptoms: Nationwide survey of in-patients.

Background: The number of psychiatric beds per capita in Japan is the highest in the world, and a replication of earlier British research is needed to identify possible means of improving the mental health system. Aims To describe the current situation of psychiatric hospitals in Japan and to examine the relationship between negative symptoms of schizophrenia and social environments.

Method: In-patients with schizophrenia were randomly selected from 139 hospitals. Data were obtained for 2758 participants using several scales, including the Manchester Scale and social environment scales.

Results: Negative symptom scales showed a significant correlation with understimulating social environments in hospitals.

Conclusions: This study confirms the results from the UK and provides evidence for the importance of community-based care and for providing more-stimulating rehabilitation environments.