Hope for People With Schizophrenia

Source: Unsplash/Dim Hou

Thinking you might have schizophrenia can sometimes feel like a death sentence. After all, media portrayals rarely depict people with schizophrenia who thrive and live a whole life.

However, the stereotype just simply isn’t true. There may be a higher percentage of fulfilled people living with schizophrenia than there are within the general culture, and there are actions that patients can take that can minimize their time in psychosis if they want to live their lives.

In a meta-analysis published in May 2024, researchers investigated the factors associated with positive and sustainable recovery in patients with schizophrenia and related disorders.

Types of Recovery

The researchers assessed clinical recovery, an objective measure of one’s health after a psychotic break defined by a sustained improvement in symptoms and a person’s functioning six months to two years after onset. The fact that this is a measurable outcome at all indicates that the medical community believes that patients do recover from schizophrenia.

There is also a more subjective research interest in personal recovery, which focuses on connectedness, hope, identity, meaning, and empowerment. This explores the relationship between the patient and their own symptoms. Sometimes clinical recovery and personal recovery are related to each other; if one is high, then the other is likely possible as well.

Social, occupational, and symptom remission were also all studied.

To investigate the different types of recovery and measure the weight of factors that might influence those types, the authors of the study turned to a meta-analysis. Some of their search terms while looking for articles to include in the analysis included psychosis, schizophrenia, and schizoaffective disorder. They excluded studies on at-risk populations (people who have yet to experience a psychotic break but may in the future), drug treatments and recovery, and quality of life (which is a related but separate topic). In total, 14 meta-analyses were selected for the study.

The Results

One of the biggest factors of predicting symptom remission is reducing the amount of time spent in psychosis through proactive treatment either through medications or social resources. Patients who had shorter time periods of untreated psychosis — three to nine months — were found to have better long-term recovery outcomes.

Exercise was also found to be associated with better symptom recovery outcomes. The authors hypothesized that this may be related to how exercise fosters neuroplasticity and an increased hippocampus size, which affects symptoms.

Unsurpisingly, psychological therapy interventions also revealed promising recovery outcomes — especially psychological therapies combined with drug treatments, which fare better than simply drug treatments alone.

The authors also looked for factors related to occupational functioning. Among the factors that indicated such were better attention and cognitive capacity. The authors hypothesized that cognitive interventions and treatments could help schizophrenia patients integrate back into school or the workforce.

Better social functioning outcomes were most related to physical exercise. Physical interventions encourage patients to participate in social and group activities, like team sports. Social adjustment in the period leading up to the first episode of psychosis — the prodromal period — was an indicator of how the patient would fare long-term after diagnosis.

Personal recovery was predicted by the levels of hope and empowerment; lower levels of both indicated less success in personal recovery. Symptoms related to mood in psychotic disorders might be a focus to target higher success with personal recovery outcomes.

The factors studied were more strongly related to personal recovery than they were to clinical recovery, which indicates that personal recovery might be beneficial to include in treatment plans, as opposed to targeting only clinical recovery. A main takeaway was that negative emotions heavily influenced the likelihood of recovery, which indicates that treatment plans should target issues like low self-esteem, depressed mood, and feelings related to the ideas of schizophrenia as well as ideas about the self.

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The authors suggested that recovery can occur even while symptoms exist, which drills home the point that the illness doesn’t have to go away in order for patients to experience positive life outcomes.

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