This large prospective observational study followed 1,635 chronically ill patients with schizophrenia for a 3 year period. The aim was to identify the best baseline predictors of recovery.
Sixty-two factors were assessed as possible prognostic variables, including patient-reported variables, clinician-rated variables and medical record based resource utilisation.
Here’s what they found:
The likelihood of a sustained favourable long-term outcome was associated with:
- Being employed (OR 1.98, 95% CI 1.34 to 2.91)
- The ability to shop independently (OR 1.76, 95% CI 1.19 to 2.59)
- The ability to undertake independent leisure activities (OR 1.75, 95% CI 1.10 to 2.79)
- Experiencing clearer thoughts from medications (OR 1.21, 95% CI 1.04 to 1.40)
- Better quality of life (OR 1.64, 95% CI 1.32 to 2.03)
- Better global functioning (OR 1.04, 95% CI 1.02 to 1.06)
- More daily activities (OR 1.27, 95% CI 1.06 to 1.52)
The likelihood of experiencing a sustained favourable long-term outcome was lower in:
- Those who had received individual therapy (OR 0.47, 95% CI 0.25 to 0.88)
- Or who had been a victim of crime (OR 0.38, 95% CI 0.17 to 0.85)
The authors concluded:
Only a small percentage of patients achieved sustained favourable long-term outcome in this study, suggesting there continues to be a great need for improvement in the treatment of schizophrenia. Findings suggest that clinicians could make early projections of health states and identify those patients more likely to achieve favourable long-term outcomes enabling early therapeutic interventions to enhance benefits for patients.
Cuyún Carter GB, Milton DR, Ascher-Svanum H, Faries DE. Sustained favorable long-term outcome in the treatment of schizophrenia: a 3-year prospective observational study. BMC Psychiatry. 2011 Aug 26;11:143.
This is a USA study; Individual therapy will not be CBT for Psychosis. evidenced by NICE giudance recommended in the UK
Furthermore there were some methodological issues that the authors recognise
“Our findings may reflect a somewhat conservative definition of “favorable and sustained long-term outcome,” considering we required patients to be closest to the best baseline health status cluster in each of the 2 years following the initial cluster assignment baseline assessment. Therefore, there is the possibility that more than 10% of patients have improved, just not to the degree defined in this study as “sustained favorable long-term outcome.”
Fascinating information.
can we have a job focused for people with mental illness. E.G. rather than focussing on what’s wrong with us, we could be focussing on what we can contribute to society. Therefore making us more productive. Also i’d like to know what’s a good job with Schizophrenia.