10 Keys to Recovery from Schizophrenia
Factors identified as keys to recovery from schizophrenia included:
1. Family relationships: Family stress is a powerful predictor of relapse, while family education and emotional support decrease the rate of relapse. Among study participants, 70 percent reported good or very good family relationships.
2. Substance abuse: National Institute of Mental Health research estimates the prevalence of lifetime substance abuse among schizophrenia patients at 47 percent, well above the overall rate. Though three-quarters of the study participants reported substance abuse prior to treatment, just 17.4 percent reported abuse after the onset of schizophrenia. None reported illicit drug use in the past year, and just two reported occasional alcohol consumption.
3. Duration of untreated psychosis: Longer duration of symptoms prior to treatment correlates directly with greater time to remission and a lesser degree of remission. Among study participants, only 13 percent reported a delay of more than a year between the onset of symptoms and treatment.
4. Initial response to medication: Improvement of symptoms within days of receiving antipsychotic drugs significantly predicts long-term results of treatment. Among the study group, 87 percent reported effective control of symptoms with their first antipsychotic medication.
5. Adherence to treatment: Failure to take antipsychotic medication as prescribed hampers both short-term and long-term recovery. All study participants reported adherence to psychiatric care and medication regimens.
6. Supportive therapy: Positive relationships with psychiatrists, therapists and/or treatment teams engender hope and are essential to improvement. Among study participants, 91 percent reported ongoing psychotherapy, and 78 percent reported that accessible and supportive psychiatrists and therapists contributed to their recovery.
7. Cognitive abilities: Neurocognitive factors such as working memory, sustained attention and efficient visual perception are strong predictors of recovery. Among study participants, all showed normal or near normal functioning on tests of flexibility in solving problems, verbal working memory and perceptual skills.
8. Social skills: Negative symptoms, or poor interpersonal skills relative to social expectations, correlate with the degree of disability caused by schizophrenia. No study participants showed more than very mild negative symptoms.
9. Personal history: Premorbid factors, or those in place prior to the onset of the disease, that affect treatment outcome include education and IQ, age of onset, rapidity of onset, work history, and social skills. Among study participants, level of education was used as a measure of premorbid history. A total of 70 percent graduated from college before becoming ill, and an additional 13 percent completed two years of college. Three of the remaining four subjects worked full time before their illness began.
10. Access to care: Continuous, comprehensive, consumer-oriented and coordinated treatment is crucial to recovery. Among study participants, 91 percent reported receiving antipsychotic medication and psychotherapy, 47.8 percent social skills training, 56.5 percent family participation, 26 percent vocational rehabilitation, and 61 percent benefits from self-help groups
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"I kept hearing the neighbours banging on the walls trying to play on my nerves (or so I thought). My response was to run not just out of the house, but to get as far away as possible"
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