Assessment Of Recovery In Patients With Schizophrenia: A One Year Cross Sectional Hospital Based Study

Abstract

Introduction Schizophrenia has long been viewed by consumers and clinicians alike to be a chronic illness with poor prognostic outcomes. After various attempts of operationalizing definitions of recovery, numerous studies have shown significant proportion of patients showing recovery. Our study was taken up with the following objectives Primary objective 1. To determine the point prevalence of recovery in schizophrenia Secondary objectives 1. To assess factors associated with recovery in schizophrenia 2. To assess the stigma perceived by individuals who recovered from the illness. Methods Patients with established ICD-10 DCR diagnoses of schizophrenia were sampled from the OPD at a General Hospital Psychiatry Unit in India, and informed consent was taken. The patients and the caregivers were interviewed to determine whether the patients meet criteria for point symptomatic remission, complete remission, functional remission and recovery. The said entities were defined based on the operationalized definitions given by The Remission in Schizophrenia Working group. Tools used for assessment were the Brief Psychiatric Rating Scale (for assessment of symptom severity) and the Personal and Social Performance (for assessment of level of functioning). Subsequently, patients meeting criteria for recovery were then evaluated for perceived stigma using the Discrimination and Stigma Scale -12 Results Out of the total patients sampled, 42% showed point-symptomatic remission, with 31% showing complete remission, 41% with functional remission and 25% meeting criteria for recovery. Being married and being on treatment with Clozapine was found to be associated with higher recovery rates. Every recovered patient of schizophrenia reported to have experienced stigma and discrimination is at least one area of life. Of these, the areas of life with highest rates of discrimination included in the neighbourhood (96%), marriage (76.47%), role as a parent (68.75%), finding a job (54.54%), pregnancy (53.84%), making/keeping friends (52%) and religious practices (52%). 93.75% admitted attempting concealment of their illness, and 76% reported being avoided by others. Conclusion The prevalence of recovery in schizophrenia occurs in a quarter of the cases and hence is probably not as morbid a diagnosis as previously believed to be. All the recovered patients of schizophrenia reported facing discrimination in their lives.