Schizophrenia and Prognosis for Recovery
As I await copyright clearance for the DSM-IV content, I will end this month with a detailed focus on schizophrenia and recovery outcomes.
First of all, a number of factors determine the level of recovery for an individual. For some, with effective medication and support, the symptoms stop completely. Others have residual or breakthrough symptoms even though they take medication. Some of us take the SZ drugs and continue to have persistent symptoms every day.
My psychiatrist told me that the routine course of the illness is that most people have periodic episodes. This would strengthen the idea that a lot of us have episodes or are hospitalized, yet can function well between episodes. Ten percent of the people diagnosed with schizophrenia commit suicide.
How do we know who will succeed? It comes down to whether a person will commit to taking the medication. Xavier Amador, PhD in his book I Am Not Sick, I Don't Need Help, quotes one of his own studies. According to Amador, "Poor adherence (i.e. both complete and partial non-adherence) has been found to be associated with relapse, increased involuntary admissions, poorer course of illness, and increased incidence of violence and suicide (Amador and David 2004).
In 2000, a study by Oehl indicated, "Only about one-third reliably take antipsychotic medication as prescribed."
It would appear the issue in recovery is not the lack of treatment but the refusal to accept the treatment that is available, as outlined in my Schizophrenia and Anosognosia SharePost earlier this month. Amador's LEAP technique improved compliance, motivation for change, insight and attitudes towards treatment.
As well, a study published in 2010 in the British Journal of Psychiatry found cognitive behavioral therapy or CBT: "was superior at reducing incidents of aggression-in patients with a history of aggression and violence-and was superior at reducing delusion severity and decreasing risk management."
Amador also quotes a recent national study of violent behavior in persons with schizophrenia: It concluded "symptoms of losing contact with reality, such as delusions and hallucinations increased the odds of serious violence by nearly three times the normal rate."
Amador observed this in his own work on more than 30 death penalty cases involving persons with schizophrenia. Paranoid and/or grandiose, the individuals acted on their delusions, often in a form of twisted self-defense because they believed their thoughts. This could cause a person to want to save the earth from attack by killing a radio talk show host who broadcast the aliens' signals.
Again: to have schizophrenia and have symptoms, and not have treatment available or to refuse treatment, is the deciding factor in whether a person has a chance to recover and to what degree they will.
I read in my Google Alerts for schizophrenia every day newspaper reports about people with this illness that commit crimes. The media frenzy to repeatedly report only the worst outcomes for individuals with schizophrenia will most likely not abate. I've also been reading various Huffington Post accounts that hint at what we can do yet do not provide detailed analysis like the one I've given you today.
It is no mystery that treatment more often than not works when it is given. Community members at this Web site are living proof that you can have a good life and you can recover and be in recovery and do well. We are the silent majority that nobody interviews or champions. I suppose there's nothing sensational about our stories that would agitate readers enough to buy newspapers.
I submit to you my own story: my mother drove me to the hospital within 24 hours of my breakdown, I was placed on Stelazine and within three weeks I was released from the ward because the positive symptoms disappeared. I went on one three-month failed drug holiday in 1992 and since then I've been in remission 19 years because I take the medication every day as prescribed.
I obtained a Masters in Library and Information Science and have been employed for over 20 years in professional jobs.
This is the real story and it's the only story I have to give people. Vantage Point Press will publish my memoir, Left of the Dial, in 2012. You might think I'm nuts to publicly disclose. I will be the first person to tell you I'm nuts. I don't care what other people think of me.
The only thing that matters is the truth:
In all five long-term studies of people diagnosed with schizophrenia: upwards of 60 percent completely recovered or significantly improved, and among those who did less well good improvement was possible.
The first SharePost in July will detail the stages of recovery and focus on achieving positive recovery outcomes and how to do this.
Believe me the reality is far rosier for most people diagnosed with schizophrenia.