The main purpose of this study was to follow up a group of persons who, fifteen years ago were considered to be fully recovered from schizophrenia, in order to examine how many have sustained their recovery and to investigate the role of resilience in recovery. A semi-structured interview was designed for this 15-year follow-up study based on previous research related to the course and prognosis of schizophrenia. In addition to the interview, measures of psychosocial functioning and the degree of positive and negative symptoms were used. Remission and recovery were evaluated by consensus-based criteria. The Connor-Davidson Resilience Scale was chosen to assess resilience. The results show a significant correlation between resilience and present psychosocial functioning. There is also a significant difference between fully recovered subjects and those in remission regarding their resilience score. These results show that the majority of the subjects had maintained their recovery, and that subjects who are still fully recovered have not used medication for seventeen years and are more resilient. Thus, a sustained, full recovery without medication seems possible for a subgroup of schizophrenia patients characterized by high resilience.
Although cognitive impairments are consistently linked to functional outcome in chronic schizophrenia, the relationship remains unclear for patients with first-episode schizophrenia. The objective of this present study was to determine whether there are distinct developmental trajectories for functional outcome in patients with different levels of baseline cognition. The present study has a multi-follow-up design, and includes data from six follow-ups over four years. Assessments were conducted yearly, apart from the first year where assessments were conducted every six months. A total of 28 patients with first-episode schizophrenia participated in the study, with 79% of patients retained at the 4-year follow-up. Cognition was assessed with MATRICS Consensus Cognitive Battery. Functional outcomes were obtained through Global functioning: Social and Global functioning: Role. Data were analyzed with linear multilevel models. Results suggest steady improvements in social and role functioning among the patients across the four year period. Baseline attention, verbal learning, and verbal working memory were significantly associated with social outcome. Role functioning was significantly associated with attention, verbal working memory, and reasoning/problem solving. Furthermore, the rate of change in social outcome varies among patients depending on their baseline level of attention and verbal working memory, with the lowest scoring group showing the least improvement over the years. The subgroup of patients with the largest cognitive impairments at the onset of the disorder shows limited improvements in social functioning compared to higher functioning groups.
The present study reports longitudinal data on individuals who 20-years ago were fully recovered from previously diagnosed schizophrenia. Four subjects from the original sample consented and were interviewed at the present follow-up; data on two more subjects were secured elsewhere. A semistructured interview, the Positive and Negative Symptom Scale (PANSS) and Connor and Davidsons Resilience Scale (CD-RISC) were used to examine the psychosocial functioning and resilience of the subjects in the follow-up period. Out of the six subjects with a confirmed diagnosis of schizophrenia, two subjects were still fully recovered, one was recovered, one was in remission, one had a deteriorating course of illness, and one was deceased. The results indicate that full recovery was maintained for nearly half of the reexamined subjects when a criterion-based definition of full recovery is used. Good personality and attitudinal approaches (resilience) seem to play a role in sustaining recovery.
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