Application of Token Economy in the Management of Chronic Schizophrenia: A Case Report

Abstract

A case of chronic schizophrenia with “inability to walk” in the absence of a neurological basis is presented. Patient responded to antipsychotic medications in terms of improvement in the symptoms of schizophrenia but “inability to walk” persisted necessitating the introduction of graded tokens / incentives to the treatment regimen. The patient regained the use of his leg and sustained improvements in mental state at discharge. Voluntary ambulation was sustained for three months after discharge before patient was lost to follow-up. Token economy may be very useful in rehabilitation of chronic psychotic illness as this case illustrates. This treatment approach may be essential in a developing country like Nigeria where socio-economic deprivations may modify the presentation of chronic schizophrenia symptoms.

Key Words: chronic schizophrenia, inability to walk, token economy.