A new study examining recovery after first-episode psychosis found that based on a standard definition of recovery, 32% of people are in clinical recovery, including 50% of those with bipolar disorder and 23% of those with schizophrenia spectrum disorders (Asbo et al., 2022). The study authors also found that, “as most of our participants were in psychotic symptom remission, psychosis appears well managed for most.”

Psychotic disorders, such as schizophrenia, “continue to be viewed as chronic, although it has been firmly established that many will fully recover,” the researchers note. They looked at measures of clinical recovery 10 years after the participants had first been treated using a standard definition: full psychotic symptom remission and adequate functioning for a minimum of one year in people with schizophrenia and bipolar spectrum disorders.

The data on the number of people recovering is influenced by how recovery is defined. Part of the underlying purpose of the study, by Carmen Sorensen, Ph.D., with Oslo University Hospital, and colleagues, was to gain evidence to support a consensus definition of recovery from psychosis. At the present time, there is no agreed-upon definition of recovery.

A definition is not only important for research and treatment, but also for personal recovery.  They urge clinicians to “communicate this to service users receiving a psychosis diagnosis as it can contribute to increased hope of recovery and reduced pessimism and stigma, ultimately promoting chances of recovery.”

Sorenson and colleagues looked at how a control group of healthy individuals met the criteria for recovery compared to the study group of individuals with bipolar disorder and schizophrenia. Nearly one in five (18.8%) of healthy controls did not meet the criteria for adequate functioning, “suggesting that these criteria are too strict.”  Among the study group, not gaining full-time employment was the largest barrier to meeting the recovery criteria. Not meeting the social functioning criteria was the largest barrier for the healthy control group. People with psychotic disorders and other mental illnesses often face stigma and discrimination in employment.

SAMHSA’s New Office of Recovery and Challenge Awards

The Substance Abuse and Mental Health Services Administration recently established a new Office of Recovery to support the growth and expansion of recovery support services across the country. SAMHSA defines recovery as “a process of change through which individuals improve their health and wellness, live self-directed lives and strive to reach their full potential.” SAMHSA also identifies four major dimensions of recovery:

1. Health: overcoming or managing one’s disease(s) or symptoms, and making informed, healthy choices that support physical and emotional well-being.
2. Home: having a stable and safe place to live.
3. Purpose: conducting meaningful daily activities, such as a job, school volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society.
4. Community: having relationships and social networks that provide support, friendship, love, and hope.

A new Recovery Innovation Challenge will offer up to 10 awards for innovative practices in behavioral health that advance recovery in the community. Applications are due by July 15, 2022.

More information:

• Early and First Episode Psychosis (.pdf), NAMI
• Facts about psychosis, National Institute of Mental Health

Finding Help

• SAMHSA Behavioral Health Treatment Services Locator
• SAMHSA National Helpline, 1-800-662-HELP (4357).

Reference

Asbo, G., et al. (2022). The Time is Ripe for a Consensus Definition of Clinical Recovery in First-episode Psychosis: Suggestions Based on a 10-Year Follow-up Study. Schizophrenia Bulletin. https://doi.org/10.1093/schbul/sbac035