Few individuals with schizophrenia or other psychotic disorders were in remission or recovery 25 years after diagnosis, according to a report in AJP in Advance today. For individuals with schizophrenia spectrum disorders (schizophrenia, schizoaffective, and schizophreniform disorders), almost none experienced stable remission or recovery across 25 years.
The “stability of symptoms across the follow-up period indicates that more effective treatments are needed to influence the course of remission and recovery for individuals with schizophrenia spectrum disorders and illuminates the need for sustained intervention and support for this population,” wrote Sara Tramazzo and Wenxuan Lian, M.S., of Stony Brook University, and colleagues.
The authors analyzed recovery and remission data from 591 individuals with schizophrenia spectrum disorders or other psychotic disorders (bipolar disorder with psychosis, major depression with psychosis, drug-induced psychotic disorders) enrolled in the Suffolk County Mental Health Project.
Participants were recruited between 1989 to 1995 following their first hospital admission for psychosis. This was before the development of coordinated specialty care, which has proven effective in the treatment of first-episode psychosis.
In-person follow-up interviews were conducted at six months, 24 months, 48 months, 10 years, 20 years, and 25 years to assess participants’ remission (minimal or no symptoms) or recovery (moderate symptom but good functioning) status.
Among individuals with schizophrenia spectrum disorders, just 14.2% were in recovery at the 25-year follow-up, and only 7.4% were in remission. Among individuals with other psychotic disorders, 28.1% were in recovery and 20.0% were in remission at the 25-year follow-up.
Across all assessments, individuals with schizophrenia spectrum disorders were most likely to experience a trajectory of no remission or no recovery at any time point. Zero individuals with schizophrenia spectrum disorders experienced stable remission across all time points, and just 0.6% experienced stable recovery.
Individuals with other psychotic disorders were most likely to experience intermittent remission or recovery, transitioning in and out of these states over 25 years. Among this population, 15.1% and 21.1% experienced stable remission or recovery, respectively.
“Our findings highlight the often chronic or recurring course of psychosis and highlight outstanding questions beyond the peri-onset period,” the researchers wrote. “Treatment disengagement is common among individuals with psychotic disorders. Over the course of illness, social function declines, weakening ties that facilitate continued treatment engagement. Research on moderators of treatment engagement could provide valuable targets for improving long-term physical and mental health.”
For related information, see the Psychiatric News article, “More Data on Duration of Untreated Psychosis Needed.”
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