Whether schizophrenia affects you or a loved one, you want to know how long it will last, and when things will get better. So, it must be frustrating to be answered along the lines of, ‘it depends', or, ‘there are a lot of things to consider', or, ‘we really can't say for sure.' What people really want to know is whether they, or their loved one, can ever return to being the person they were before schizophrenia entered their life. In this Sharepost I attempt to explain why recovery from schizophrenia often has to be thought of as a relative concept.
Clinical recovery, refers to the fact that the symptoms of a disease are no longer present. Unlike most diseases, where clinical recovery usually signals the start of a return to normal life, recovery from schizophrenia involves more than one process. Social recovery is one such process. It refers to a point where the person can return to or gain employment and function effectively in social situations. Psychological recovery is yet another process and is often the most problematic. Psychological recovery can be thought of as the ability to make necessary adjustments following a period of psychosis. This can relate to the trauma of the experience, through to anxiety, depression and fears about the future.
Schizophrenia is described as ‘heterogeneous', which means it can have a variety of outcomes. At one extreme, a person may experience a single episode, followed by a full social and psychological recovery. Alternatively, a person may experience many and ever worsening episodes, from which they will never recover. Between these extremes the course of schizophrenia varies, as does the extent to which a person may experience residual symptoms.
Despite a few fairly extensive and complex studies looking at the long-term outcomes for schizophrenia, the fact remains that outcome is complex, and is governed by biological, social and psychological factors. There are however a few lines of research that may help to shed a little light on prospects for recovery.
There was a time when the outcome for schizophrenia was perceived in an entirely pessimistic fashion. We now have evidence that points towards a general improvement of symptoms in people with schizophrenia as they age. The importance of social and psychological factors is highlighted when we compare outcomes across different cultures. Developing nations would appear to do far better in terms of recovery rates that developed nations. The social structures of developing nations appear quite different in terms of their beliefs about mental illness, and the willingness to provide social support and work, all in a climate of minimal stigma.
In a previous post I wrote about women having more favorable outcomes than men. But in the case of both men and women it does appear that their personality prior to the onset of schizophrenia is a significant predictor of how well they will recover. These factors, coupled with good levels of social support and lack of post-psychosis psychological problems, are all positive predictors for recovery.
Published On: November 27, 2008