Keys to Recovery from Schizophrenia

Dec. 6, 2002 -- We saw it in the movie, A Beautiful Mind -- some people seem to recover from schizophrenia. Now specialists at UCLA have outlined what they say are factors that can aid virtually anyone in recovering from this often-misunderstood disorder.

Schizophrenia is a severe brain disorder that causes long-term and often disabling mental health problems -- including hallucinations and false beliefs. In the early days of psychiatry, doctors held little hope that schizophrenics could be productively involved in society.

Because of this fatalistic view, the disorder continues to be severely stigmatized, writes Robert P. Liberman, MD, research scientist at the UCLA Neuropsychiatric Institute.

Patients often deny their illness and avoid effective treatments, Liberman adds. Furthermore, doctors tend to limit the time they spend with schizophrenics -- so these patients often receive "the lowest common denominator of treatment, a five- or 15-minute medication management session once a month."

His most recent study appears in the November issue of the International Review of Psychiatry.

He studied existing research on schizophrenia as well as 23 schizophrenia patients who successfully returned to work or school with their symptoms under control.

"Our findings join a growing body of research that flies in the face of the long-held notion that individuals diagnosed with schizophrenia are doomed to a life of disability with little expectation for productive involvement in society, a fatalistic view that in itself is damaging to prospects for recovery," Liberman says in a news release.

"By understanding the dynamics of recovery, we can design more effective courses of treatment and combat the pessimism held by many doctors, patients, and families struggling to cope with this debilitating disease," he adds.

His findings shed light on factors that can be key to recovery from schizophrenia:

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% reported good or very good family relationships.

2. Substance abuse - Studies from the National Institute of Mental Health estimate that schizophrenics are 47% more likely to engage in illegal substances, well above the norm.

3. Duration of untreated psychosis - When treatment is delayed after schizophrenia is diagnosed, it's much more difficult to gain remission. Only 13% of those who had their symptoms under control reported a delay of more than a year between onset of symptoms and treatment.

4. Initial response to medication - Symptom improvement within days of receiving antipsychotic drugs significantly predicts long-term results of treatment. Among the study group, 87% 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.

6. Supportive therapy - Positive relationships with psychiatrists, therapists, and other treatment teams create hope and are essential to improvement; 91% reported ongoing psychotherapy and 78% said that accessible and supportive psychiatrists and therapists contributed to their recovery.