The process of recovery from schizophrenia

Spaniol, LeRoy; Wewiorski, Nancy J.; Gagne, Cheryl; Anthony, William A.

doi:10.1080/0954026021000016978

Cited by 209 publications

(242 citation statements)

References 20 publications

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“…Glover (2002) has stated that a desire to "model" recovery will be one of the major threats to creating an authentic recovery-based framework. Other researchers hold open the possibility that one day we may arrive at a shared meaning of recovery, with room for various combinations of dimensions (Davidson et al 2005, Spaniol et al 2002. However, as a result of biomedical orthodoxy also influencing psychiatric nursing, for example during recommendations about comprehensive assessment systems and the development of differential diagnoses (Barker et al 1998), it is a possibility that a positivist research approach, studying recovery independent of the subject, could lead to the development of an evidence based recovery manual.…”

Section: The Content Of Recoverymentioning

confidence: 99%

“…The fact that people are able to recover from serious mental illness has been established through numerous studies (Adams & Partee 1998, Glass & Arnkoff 2000, Mead & Copeland 2000, Spaniol et al 2002, Topor 2004, Davidson et al 2005, Hopper et al 2007, Borg 2007, Till 2007, Brown & Kandirikirira 2007, Helm 2009, Schön et al 2009, Song 2009 ) and has resulted in an increased focus on recovery as a focus in mental health care. However definitions of recovery have remained diverse (Anthony 2000, Kristiansen 2003, Onken et al 2007); The implications for practice as well as professional understanding are therefore still unclear.…”

Section: Introductionmentioning

confidence: 99%

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In defence of a humanistic approach to mental health care: recovery processes investigated with the help of clients' narratives on turning points and processes of gradual change

Kogstad¹,

Ekeland

Hummelvoll³

2011

Journal of Psychiatric and Mental Health Nursing

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Several studies in recent years have shown that recovery factors as experienced by clients are not always compatible with professional approaches. For example, clients often emphasise the importance of relationships and the satisfaction of universal human needs. The aim of the study has been to explore clients" descriptions of beneficial factors and to discuss the implications of those factors for the delivery of mental health services. Method has been qualitative content analysis of 347 user narratives. The study confirms findings in earlier recovery studies, but also demonstrates that the investigation of clients" stories leads to a range of existential dilemmas. Fundamental beliefs about what constitutes effective and necessary treatment are challenged. Recovery is a fundamentally personal process that involves finding a new sense of self and feeling of hope. Furthermore it is not only an internal process; it also requires external conditions that facilitate a positive culture of healing.

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Section: The Content Of Recoverymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

In defence of a humanistic approach to mental health care: recovery processes investigated with the help of clients' narratives on turning points and processes of gradual change

Kogstad¹,

Ekeland

Hummelvoll³

2011

Journal of Psychiatric and Mental Health Nursing

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“…Consistent with this focus, most existing models have been developed as part of treatment programs (Ahern & Fisher, 1999;Anthony & Liberman, 1986;Spaniol, Koehler, & Hutchinson, 1994;Townsend, Boyd, Griffin, & Hicks, 1999), concentrating little on aspects of recovery outside the immediate realm of mental health services. Broader models are now under development (Ralph et al, 2000), however, and reports addressing both the recovery process and wholeperson outcomes are becoming available (Harrison et al, 2001;Liberman et al, 2002;Onken, Dumont, Ridgway, Dornan, & Ralph, 2003;Spaniol, Wewiorski, Gagne, & Anthony, 2002;Torgalsboen & Rund, 2002). That is, we have begun to take on the difficult task of understanding recovery in the global sense, examining the production of recovered lives, and the definitions, meanings, and adaptations constructed by individuals for whom one of life's critical tasks has become making sense of what it means to be affected by a serious mental disorder.…”

Section: Conceptualizing the Recovery Processmentioning

confidence: 99%

Fostering Recovery from Life-transforming Mental Health Disorders: A Synthesis and Model

Green

2004

Soc Theory Health

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In the past, "recovery" from serious mental health problems has been variously defined and generally considered rare. Current evidence suggests that some form of recovery is both possible and common, yet we know little about the processes that differentiate those who recover from those who do not. This paper discusses approaches to defining recovery, proposes a model for fostering, understanding, and studying recovery, and suggests questions for clinicians, researchers, and policy makers. The proposed model is a synthesis of work from the field of mental health as well as from other disciplines. Environment, resources, and strains, provide the backdrop for recovery; core recovery processes include development, learning, healing, and their primary behavioral manifestation, adaptation. Components facilitating recovery include sources of motivation (hope, optimism, and meaning), prerequisites for action (agency, control, and autonomy), and capacity (competence and dysfunction). Attending to these aspects of the recovery process could help shape clinical practice, and systems that provide and finance mental health care, in ways that promote recovery.

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“…61 Otros autores consideran a la remisión de síntomas, a la cognición, al funcionamiento y a la calidad de vida como componentes del espectro de recuperación funcional. 28,36,46,50,62 Respecto a las consideraciones para evaluar la recuperación funcional, se han propuesto los criterios siguientes: 1) un diagnóstico confiable de esquizofrenia al inicio temprano de la enfermedad, 2) que no se cumplan con los criterios diagnósticos de esquizofrenia al momento actual de la evaluación, 3) que el paciente no hubiera sido hospitalizado por lo menos durante cinco años, 4) el funcionamiento psicosocial debe estar en un "rango de lo normal", con un puntaje >65 de acuerdo a la EEAG-GAF y 5) que no se encuentre tomando medicamentos antipsicóticos, o si es así, que sea en dosis muy bajas (menos de la mitad de lo que se considera como una dosis diaria). 58 También se pueden considerar los siguientes criterios: 1) presencia moderada de síntomas psicóticos de acuerdo a las escalas que evalúan los síntomas positivos y negativos, 2) tener vida independiente, 3) estar trabajando o estudiando por lo menos medio tiempo y 4) participar en actividades sociales y recreativas.…”

Section: Remisiónunclassified

“…Sin embargo, los avances en los últimos 50 años han permitido cambiar de una perspectiva pesimista a un moderado optimismo respecto a que la remisión sintomática se puede considerar como una meta con posibilidades reales de lograrse [32][33][34] al igual que la recuperación funcional. [35][36][37][38][39] Con todas estas consideraciones, han surgido diversas preguntas en el sentido de conocer: ¿cómo definir la remisión sintomática?, ¿cómo definir la recuperación funcional?, ¿cómo medir estos aspectos?, ¿cuántos pacientes logran obtener remisión sintomática y/o recuperación funcional?…”

Section: Introductionunclassified

Remisión sintomática y recuperación funcional en pacientes que padecen esquizofrenia

Valencia¹,

Caraveo²,

Colín³

et al. 2014

Salud Ment

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SUMMARYA recently proposed definition for remission and recovery in schizophrenia is receiving increased attention by clinicians and researchers. The interest on these issues is based on the recent proposed definition for symptomatic remission, and the development of operational criteria for its assessment, by the Remission in Schizophrenia Working Group (RSWG), in the United States, in 2005. Remission is assessed using eight items of the Positive and Negative Syndrome Scale (PANSS), all of which have to be scored with a symptom severity of ≤3 points (mild or better), sustained for a minimum duration of six months. In Europe, since 2006, proposed definition criteria about response and remission were introduced. Response can be assessed, with the PANSS, using a cut-off of at least 50% reduction of the baseline score for the acutely ill, and a cut-off of at least of 25% reduction for refractory patients. Remission could be assessed using a formula for calculating percentage PANSS reduction from baseline. Definition criteria have also been introduced to assess functional recovery that includes the combination of clinical and social outcomes for two consecutive years, including dimensions such as psychosocial functioning, cognition, and quality of life.The purpose of this review is to examine existing research on symptomatic remission and functional recovery in schizophrenia. We included clinical and epidemiological studies, reviews and meta-analyses published between January 1970 and July 2013. Sixty two studies on remission and recovery were included, with a total of 94 940 patients, comprising six months to 37 years follow-up. Thirty two studies on functional recovery were included, with a total of 6 483 patients with a range of six months to 42 years follow-up. Research indicates that symptomatic remission can be achieved in 20-97%, and functional recovery in 10-68% of people with schizophrenia. The use of remission and recovery criteria has been recommended for clinical practice and scientific research.Key words: Symptomatic remission, functional recovery, symtomatology, psychosocial functioning. RESUMENRecientemente los conceptos de remisión sintomática y recuperación funcional en los pacientes que padecen esquizofrenia han recibido una considerable atención por parte de los clínicos y los investigadores. El interés en estos aspectos tiene que ver con la propuesta realizada en el 2005 por el "Grupo de trabajo para evaluar la remisión en esquizofrenia", con el objetivo de proponer una definición de remisión sintomática, así como el desarrollo de criterios operacionales para su evaluación. La remisión sintomática se evalúa utilizando ocho reactivos de la escala PANSS, los cuales deben puntuar tres o menos, con una duración mínima de seis meses de remisión. En Europa, desde el 2006, también se han propuesto criterios para evaluar la respuesta al tratamiento, así como la remisión sintomática. La remisión se puede evaluar usando una fórmula para calcular el porcentaje de reducción de síntomas desde el inicio del tr...

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The process of recovery from schizophrenia

Cited by 209 publications

References 20 publications

In defence of a humanistic approach to mental health care: recovery processes investigated with the help of clients' narratives on turning points and processes of gradual change

In defence of a humanistic approach to mental health care: recovery processes investigated with the help of clients' narratives on turning points and processes of gradual change

Fostering Recovery from Life-transforming Mental Health Disorders: A Synthesis and Model

Remisión sintomática y recuperación funcional en pacientes que padecen esquizofrenia

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