Recovery and remission in schizophrenia. Results from a naturalistic 2-year follow-up inpatient study

Background: Remission in schizophrenia is defined as a period of at least 6 months in which symptom reduction occurs. In comparison, the term recovery is defined to include not only long-term symptomatic improvement but also good psychosocial functioning and improved quality of life. The aim of this naturalistic study is to prospectively investigate all these variables and their interrelationship in a sample of subjects with schizophrenia over a period of two years.

Methods: Seventy-seven subjects were included into the analysis. Criteria of remission for each domain were assessed using the BPRS (brief psychiatric rating scale, symptomatic remission), GAF (global assessment of functioning, functional remission) and the SWN-K (subjective well-being under neuroleptics, remission of subjective well-being). Subjects were considered to have "recovered" if they remitted in all three domains at discharge (t0), one (t1) and two-year (t2) follow-up assessments.

Results: Symptomatic and functional remissions were rare and occurred only in 10 % of the subjects at t0, t1 and t2. Approximately one-third of the individuals had remission with a stable quality of life. Correlations between quality of life and functional and symptomatic remissions were weak. None of the subjects met the criteria for recovery.

Conclusions: Compared to previous studies, the rates of remission and recovery in the current sample were quite low. The contrasting results may be due to the naturalistic characteristics of this sample of initially inpatient subjects while previous studies investigated selected samples of schizophrenic individuals. However, despite their functional and symptomatic impairments, the results also indicate that the schizophrenic subjects have a largely satisfying quality of life.