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Remission and recovery

How are remission and recovery defined? 

Remission has been defined as a level of symptomology that does not interfere with an individual’s behaviour, and is also below that required for a diagnosis of schizophrenia. Symptom improvements should last for a minimum of six months in order for remission to be reached. Recovery is less precisely defined. In addition to the symptom improvements required for remission, improvements in social and functional dimensions are required. These domains usually include, but are not restricted to; functional independence, maintaining satisfying relationships, being productive, having a sense of empowerment, and overcoming feelings of internalised stigma. Improvements in either clinical or functional domains need to be seen for at least two years.

What is the evidence for rates of remission and recovery in schizophrenia?

Moderate quality evidence suggests rates of remission of schizophrenia are around 36%. Moderate to low quality evidence suggests rates of recovery in schizophrenia are around 13% to 16%, with annual rates around 1.4%. Recovery rates are highest in low or low-medium income countries (36.4%) and lowest in high (13%) or high-medium income countries (12.1%). Rates do not vary according to sex, year of study, diagnostic method, chronicity of illness, origin of the sample, duration of follow-up, study quality, or definition of recovery. Rates of recovery and remission increase over time, from around 13% of patients at 5 years after first diagnosis to around 68% of patients by 32 years after first diagnosis. Rates also vary considerably in the developing world, with long-term (around 25 years) remission rates ranging from 31% in Colombia to 77% in India.

 

April 2016

Page last updated: 3:48  20 August 2017

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