The concepts of remission and recovery in schizophrenia

Abstract

Objective: To examine the past and current research into the concepts of remission and recovery in schizophrenia.

Data sources: An electronic literature search of studies published between January 1990-April 2005 examining the concepts of remission and recovery in schizophrenia and the treatment of schizophrenia with antipsychotic agents was performed using Medline and EMBASE. Primary research parameters were 'schizophrenia', 'remission', 'recovery', 'meta-analysis', 'antipsychotics', 'atypicals', 'conventional', 'cognition', 'function' and 'quality of life'.

Study selection: English language articles, original research articles, reviews and other articles of interest were reviewed.

Data extraction: Data quality was determined by publication in the peer-reviewed literature and the most important information was identified.

Data synthesis: A number of different definitions of remission and recovery have been previously used, which has made comparison of study results problematic. Recently, the first operational definition of remission, based on Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria (DSM-IV) for schizophrenia, was developed. It is hoped that this will provide a standard tool for assessing the effectiveness of treatments for schizophrenia. Recovery, which encompasses both symptom remission and more functional aspects of patient's well being, such as cognition, social functionality and quality of life, is still to be satisfactorily defined. Although recent studies on new generation antipsychotics have examined some proxy outcomes related to recovery, further research is required.

Conclusions: Until the definition for 'recovery' is further elucidated, factors such as symptom control and remission, and functional aspects of recovery such as improvements in cognition and social functioning, which are quantifiable, should be used as measures of treatment outcome and markers of recovery.