Schizophrenia.com

Long term recovery psychosis: the iHOPE-20 study

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About half of the original group was available for the 20 year follow up. 11% were dead. We don’t know what happened with the others, but:

Using the PANSS criteria for measuring symptoms, 65% of the sample were in remission at 20-year-follow-up and 35.2% of the sample were considered in Fully Functional Recovery (FFR). Over 50% of participants described themselves as fully recovered

And

Longer DUP* was associated with lower scores on both resilience as well as recovery at 20-year-follow-up. Older people had higher resilience scores and having an affective disorder decreased recovery rates.

*DUP is duration of untreated psychosis.

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I would be wary of self reports of full recovery .

They describe the differences between the (somewhat) objective measurements and personal subjective recovery.

Using the PANSS criteria for measuring symptoms, 65% of the sample were in remission at 20-year-follow-up and 35.2% of the sample were considered in Fully Functional Recovery (FFR). Over 50% of participants described themselves as fully recovered and the average Recovery Assessment Score (RAS) was= 97.7.

So 35% (of the sample) were considered in “fully functional recovery” but 50% describe themselves as fully recovered. Since 65% were in symptomatic recovery, the “fully functional” probably just depends on their personal expectations about what recovery is.

In the full paper, they define what “Fully Function Recovery” as assessed by the authors means:

We classified clinical recovery as ‘Full Functional Recovery’ (FFR) (Alvarez-Jimenez et al., 2012); a construct defined by combining remission status (from PANSS scores) with functional and vocational recovery status evaluated by the Quality of Life Scale (QLS) (Heinrichs et al., 1984). Functional and vocational status recovery was defined as a score of ⩾4 on 4 QLS questions: appropriate interpersonal relationships with people outside of family; adequate vocational functioning (being in paid employment, attending school or performing homemaker role effectively); adequate achievement in role adopted and basic living task engagement.

I’d be more concerned about the other ~40% that was not available for follow up. (11% were dead). No way to know whether the same rates of recovery applied to them.

There is a similar study from Norway that has much lower drop-out rates and similar (but I think somewhat lower) numbers. It was posted here half a year ago, I think. It doesn’t have as many participants, but still is convincing evidence that recovery rates are much higher than previously assumed, at least assuming the treatment is adequate.

I can find it for you if you don’t remember it or didn’t see it.

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I want to say that had a shorter follow up time - maybe more will get better later.

I think the sample used was a first episode psychosis group rather than chronic patients, so the numbers will get pulled up somewhat by those who have one episode and then get better.

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Yes, 10 years, I think. And yes, it was first-episode psychosis. You have an impressive memory.

Nah I just have an extensive list of bookmarks on my browser :slight_smile:

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