Schizophrenia

Prognosis and Recovery Factors of Schizophrenia

Rashmi Nemade, Ph.D. & Mark Dombeck, Ph.D.

Prognosis

There is no known cure for Schizophrenia. Fortunately, there are effective treatments that can reduce symptoms, decrease the likelihood that new episodes of psychosis will occur, shorten the duration of psychotic episodes, and in general, offer the majority of people suffering from schizophrenia the possibility of living more productive and satisfying lives. With the proper medications and supportive counseling, the ability of schizophrenic persons to live and function relatively well in society is excellent. The outlook for these patients is optimistic.

Ten years after initial diagnosis, approximately fifty percent of people diagnosed with schizophrenia are either noted to be completely recovered or improved to the point of being able to function independently. Twenty five percent are improved, but require a strong support network, and an additional fifteen percent remain unimproved and are typically hospitalized. Unfortunately, ten percent of the affected population sees no way out of their pain except through death and ends up committing suicide. Long-term statistics for thirty years after diagnosis are similar to the ten year mark, except that there are even more people who improve to become independent. However, there is also an increase in the number of suicides to fifteen percent. Over time, women appear to have a better chance at sustaining recovery from symptoms than do men.

It is an unfortunate fact that people with schizophrenia attempt suicide more frequently than do people in the general population. This may occur for many reasons, including fears and anxieties associated with psychosis or depression and hopeless feelings that may occur when it is realized that a serious, chronic and life-changing disease has occurred. It is always difficult to predict which people are serious suicide risks, and this is the case for the schizophrenic population as well. While people in the general population talk about suicide from time to time, professional mental health help should be sought right away for people (schizophrenic or otherwise) who make a habit of discussing suicide, who express any sort of plan to commit suicide, who stockpile pills, tools (rope, razors) or weapons for the purpose of suicide or self-harm, or who act out a suicide or self-harm plan, however half-heartedly. The impulse to suicide is most always a temporary crisis that can be overcome with time and proper care. Given the right treatment, the chance for a reasonably balanced life is good.

Recovery

The key to successful recovery is early diagnosis and treatment. In general, the earlier someone with schizophrenia is diagnosed and stabilized on an appropriate treatment regime, the better their chance of recovery. In light of this tendency, anyone who suspects that they (or someone they know) may have signs and symptoms consistent with schizophrenia should consult with a psychiatrist at their earliest possible convenience.

Multiple factors appear to influence prognosis (disease outcome) in schizophrenia. Family history of schizophrenia is relevant. If no one in the immediate biological family of first degree relatives has schizophrenia or a related condition, that is a good sign. Multiple relatives who share schizophrenia outcomes is a bad sign. Other good signs include good social and professional adjustment prior to the onset of symptoms, and awareness and insight of symptoms as signs of a problem (rather than just reaction to symptoms without insight); patients demonstrating both of these signs may sometimes recover completely. Chances for recovery are improved if the disease comes on suddenly, as opposed to when it comes on slowly. The older one is at the onset of schizophrenia, the better. If schizophrenia is treated quickly and consistently (see above) with good response to treatment, the prognosis is usually very good. A short amount of time that people suffer with severe symptoms and a lack of symptoms reported during periods between severe psychotic episodes are also good indicators of recovery potential. A personal history or family history of mood disorders may help a person to move through a schizophrenic phase quickly because their primary condition may be some other affliction. Since schizophrenia is a brain disorder, a good outcome is predicted when the brain has a normal structure and function as indicated by a brain scan.

 




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