July 31, 2005

Hope for recovery

Do Patients with Schizophrenia Ever Show Periods of Recovery? A 15-Year Multi-Follow-up Study
Harrow M, Grossman LS, Jobe TH, Herbener ES.

In this study, the researchers did a 15 year prospective (future-based) long term study where they followed people with schizophrenia and those with other types of psychotic and non-psychotic illnesses over a long time period. This was based on the Chicago Followup Study. They used a good sized sample of 274 patients from private and public hospitals who were studied prospectively at hospitalization and then followed up multiple times over a 15-year period. They included 64 people with schizophrenia, 12 with schizophreniform, 81 other psychotic patients, and 117 nonpsychotic patients. They gave interviews and questionnaires to evaluate symptoms. Since they were most interested in recovery rates, they defined “recovery” based on:

1) not showing major symptoms throughout the follow-up year (i.e. no psychotic activity or negative symptoms)
2) good psychosocial functioning – including working or volunteering half-time or more during the follow-up year and good social activity level
3)no psychiatric re-hospitalizations during the follow-up year.

Overall, their results were encouraging. On the negative side, there were a number of those with schizophrenia who showed relatively poor outcomes – that were worse than other types of psychotic disorders over 15 years. But on the positive side, they found that a larger percent of those with schizophrenia than expected showed the potential for intervals of recovery at some point. Even though there was a poorer course for those with schizophrenia, there seems to be a greater chance of recovery periods as people got older. This is in contrast to some of the old, traditional views that people with schizophrenia never completely recover.

So, even though there may be a lower rate of recovery than for other psychiatric groups, this study showed that 19% or more of those with schizophrenia seem to show adequate work performance and stay in a period of recovery from major symptoms. More importantly, overall, at 1 or more points over the 15-year period, slightly over 40% of those with schizophrenia showed a period of recovery lasting 1 or more years. For many this period of recovery lasted for at least a few years, even though for over 60% it was eventually followed over the next 5 to 8 years by symptoms and/or other adjustment difficulties. The researchers suggest that over 50% of those with schizophrenia in their study did not have a disorder that was chronic and continuous. Rather, the disorder was episodic, although for many more vulnerable and less resilient (meaning: able to bounce back) schizophrenia patients the episodes were more frequent and severe, with slower

To summarize their results:
Do people with schizophrenia show periods of recovery? YES
Do those with schizophreniform disorders (early stages of schizophrenia) show better outcomes than those with schizophrenia? YES
Is schizophrenia associated with slower recovery than other psychotic disorders? YES

Overall, this data on recovery for schizophrenia offers hope. It shows that a number of those with schizophrenia show the potential for recovery for 1 or more periods of time. This can help doctors and families by providing better data about recovery. ‘‘Expectations can be so powerful a factor in recovery, patients, families, and clinicians need to hear this.’’ It is also helpful because ‘‘if you don’t know where you should try to go [recovery], you may never get there.’’

Click here to find this article on PubMed


This doesn't say if they were on medications. That would be useful to know. I presume that they were.

Posted by: Arlene at August 1, 2005 04:28 AM

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