Keep in mind when reading about this that it varies by how recovery is defined, by how populations are sampled, and by which populations are studied (including different countries).
It’s true that there are no clear metrics to define recovery:
[ The precise proportion of cases that have favorable outcomes is less clearly understood. To a large degree, this relates to uncertainty about how to measure multifaceted outcomes such as “recovery.” Considering how much research attention has been allocated to exploring the onset of psychosis (eg, prodrome and early psychosis), it is appropriate that a comparable degree of research scrutiny also be accorded to the recovery of psychosis.1 With respect to the remission of clinical symptoms, operationalizable criteria are now available.2–4 However, symptom profiles are only one component of the many facets of recovery. Many consumer-based groups conceptualize recovery as a personal journey (ie, a subjectively evaluated process dealing with symptoms over time) rather than a defined point outcome (completely recovered vs persistent illness).5 In contrast to most clinical symptoms, outcomes related to recovery do not lend themselves to simple, reliable metrics.6,7]
They say their criteria is that the person needs to have persistence of good outcome in two different dimensions for at least 2 years:
Clinical remission;
Broader social functioning.
I think clinical remission means that the person is not hospitalized for 2 years at least. But I didn’t get what broader social functioning means. Is it the idea that the person is employed or active? What does it really mean?
I was at a lecture in a hospital two days ago about recovery and work in bipolar and psychosis, and one of the researchers had an interesting categorization of definitions of recovery. She divided it into three concepts which were (roughly):
Clinical recovery - improvement of symptoms beyond a threshold
Functional recovery - not necessarily marked improvement in symptoms, but improvement in function
Well-being - being happy and content with your life
She said research had traditionally focused on the first one, and somewhat the second one, and that patients and their families had stressed the importance of using other, more inclusive definitions of recovery in future research.
PS: I would by many of the clinical definitions on recovery not be recovered, even though I’m functioning pretty much like non-sz people and am very happy with my life. Many definitions on recovery are unnecessarily strict.
I’d describe occupational recovery as doing paid/voluntary work or going to college . Social recovery as having a social circle and a good measure of community involvement . Functional recovery- no or minimal symptoms and able to live independently with the level of support(none of us are islands) that people without a mental diagnosis would have.
All I can find for “broader social functioning” is having economic and residential independence and low social disruption (doing well in everyday situations).
A few questions I’ll ask. Who should define recovery the clinician or patient? Are we always good at telling how well we are doing? How much should the input of friends and family count in assessing recovery ?
