thesis statement on schizophrenia

Schizophrenia - Essay Samples And Topic Ideas For Free

Argumentative essays can be prepared on different subjects and reveal different issues of the science branch. Medicine is among the most popular sciences that medical college or university students choose. They can be asked to describe different types of illnesses: a symptom, conditions of progression, and methods to handle them. If you are given to craft an essay about Schizophrenia, we recommend you get familiar with our list of argumentative essay topics to opt for the unique one. Then, you can find some essay examples on Schizophrenia to understand how to accurately provide your research and content.

Schizophrenia is a disease that leads to a psychological disorder. Such diseases affect a person’s health, and they can experience hallucinations. To be able to uncover the entire topic, you should explore many sources and use writing samples. You can also find a documentary movie that reflects the life of people diagnosed with Schizophrenia. We understand how difficult it can be to keep all information in your head. That’s why it is advisable to draw an outline and fix there all your ideas about your topic. It is important to organize your content through an introduction, main body, and conclusion. When determining thesis statements, mention them in the introductory part and conclude them. You can find a research paper example about Schizophrenia on our platform.

Two Different Approaches Used to Explain the Psychological Phenomenon of Schizophrenia

Schizophrenia is a very rare psychological disorder or brain condition that a significantly small number of people. This disorders most common symptoms include hallucinations or hearing voices, and having a hard time with concentrating or thinking. When most people think of someone having Schizophrenia, they think of a person who is crazy or not in their ""right mind,"" which is not really the case. Sometimes, Schizophrenia is also often mistaken for Dissociative Identity Disorder, which can be similar in a […]

Schizophrenia – the Beautiful Mind of John Forbes Nash Jr.

Patient's Information John Forbes Nash, Jr. was born in 1928 in Bluefield, West Virginia to John Forbes Nash Senior, an electrical engineer, and Margaret Virginia Nash, a school teacher. According to his biographer Sylvia Nasar, Nash's upbringing was stable and he benefited from his parents' middle-upper class status. Although socially awkward, Nash excelled in mathematics and was described as a mathematical genius by his professors. After attending the Carnegie Institute of Technology, Nash began graduate school at Princeton University in […]

A Psychological Diagnosis of John Wayne Gacy

In 1942, a baby was born in a Chicago hospital, named John Wayne Gacy. He came from what seemed like a normal family. He grew up with his two sisters, his mother, and his father. However, no one knew that Gacy's father was both verbally and physically abusing him. This would ultimately affect Gacy for the rest of his life. In 1968, Gacy was indicted by a grand jury for allegedly committing the act of sodomy with a young teenage […]

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Cognitive Behavioral Therapy for Schizophrenia

Schizophrenia is a major psychiatric disorder, or cluster of disorders, characterized by psychotic symptoms that alter a person's perception, thoughts, affect and behavior (NICE, 2009). Tai and Turkington (2009) define Cognitive Behavior Therapy (CBT) as an evidence-based talking therapy that attempts cognitive and behavioral change, based on an individualized formulation of a client's personal history, problems and world views. CBT was built on behavioral principles that emphasized clear relationships between cognition, physiology and emotion (Beck, 1952). This essay will look […]

Schizophrenia: Mind and Mental Health

Psychological clarity is something that everyone strives for. A mind that is free from abundant clutter and jumbled thoughts that bring on stress and negativity. Everyone wants a mind that is able to recognize what is presented to it. A reliable psyche that is free from hallucinations and unwanted paranoia. Even though clarity can be achieved, certain illnesses can hinder individuals from reaching it. There are a multitude of disorders that affect the mind in more ways than one. The […]

The Wrongful Conviction of Charles Milles Manson

The first: Charles Manson as the ringleader, the main man, the cult king. He ordered his followers to do everything. The other, a group of middle aged "hippies" caught up in heavy drug use committed all the murders. They later accused a mentally ill man who was a delusional schizophrenic that they took in as a mascot, of orchestrating all the murders. Carrie Leonetti provides a wonderful argument and presents many facts and statistics as to how Charles Manson could […]

The Causes Effects and Treatments of Schizophrenia

Schizophrenia is a very complex, chronic mental health disorder. It is often characterized by displaying multiple symptoms which may include, but are not limited to, delusions, hallucinations, disorganized behavior and/or speech, and impaired cognitive ability. Schizophrenia affects about 1% of the population at some point in their lifetime (Patel, Cherian, Gohil, & Atkinson, 2014). The current Diagnostic and Statistical Manual of Mental Disorders (DSM-V) describes schizophrenia as an illness that displays psychotic symptoms and significant interpersonal or occupational dysfunction that […]

Schizophrenia – a Genetic and Environmental Review

Introduction Schizophrenia is defined as "a severe brain disorder characterized by disturbances of thoughts, perceptions, volition, and cognition, which affects about 1% of the world population today" (Ozawa et al., 2006, p. 546). The disorder can be incapacitating to those who live with it, preventing normal societal function. Despite its frequency in the population, scientists and medical professionals still struggle to find a conclusive explanation for why some people develop schizophrenia. This may be, in part, due to its ties […]

Schizophrenia: Definition, Symptoms, Causes

Schizophrenia alters how a person thinks, feels, and acts, making it hard for them to differentiate between reality and imagination. Individuals with schizophrenia can often become unresponsive or withdrawn, making it difficult to establish personal and professional relationships (Haycoco, 2009). Contrary to popular misconception, schizophrenia is not a split or multiple personality disorder. Most people with schizophrenia are non-violent and do not pose a danger to others (Mental Health America, 2013). People with schizophrenia may conjure up details about people […]

Schizophrenia in the United States

In the United States, schizophrenia is one of the most prevalent mental health disorders that Americans suffer from daily. Those who deal with such a debilitating disorder go through a variety of different symptoms that can be classified in three categories, positive, negative and cognitive. Initial symptoms of schizophrenia-like irritability and the inability to sleep may cause alarm before a diagnosis is made. Positive symptoms of schizophrenia, those symptoms that are not usually present, can include hallucinations and delusions ("How […]

Schizophrenia and Substance Abuse

Up to 60 percent of chronic schizophrenic patients have been reported to be substance abusers (Hambrecht 1). The comorbidity of drugs and alcohol asks the question if one disorder causes another disorder. From a collected sample of 232 schizophrenic patients, alcohol abuse prior to admission was found in 24 percent (Hambrecht 2). Whereas, drug abuse was found in 14 percent. These rates are two times higher than the rates in the general population (Hambrecht 2). Both alcohol and drug abused […]

Emotions and Schizophrenia

Do you know anyone with a mental disorder? Have you ever felt nervous around them? Do you feel it is hard to understand their feelings? Let me tell you about schizophrenia. I decided to further research schizophrenia when one of my brothers was diagnosed with it a couple of years ago. It was weird at first because I didn't feel comfortable around him due to the way he was acting. Even though it wasn't in a harmful way, I never […]

What is Schizophrenia?

Schizophrenia is a chronic mental disease that drastically affects how a person thinks, feels, and behaves. People with schizophrenia often seem disconnected from reality, with a long list of symptoms that significantly change the lives of those it affects. Throughout history, society has held resentment for the mentally ill and discriminated against them in terrible ways. Following the classification of schizophrenia, the disease became gravely misunderstood by the public. Society harshly stigmatized people with schizophrenia because of the extensive list […]

Schizophrenia: Chronic and Severe Mental Disorders

As we know, schizophrenia and its spectrum disorders are chronic and severe mental disorders that affect an individual in many aspects of life. These disorders impact the ability to think and feel and also affect behavior. This means that people with schizophrenia may seem as if they have lost touch with reality. Sometimes, diagnoses can be difficult as there are no specific tests and the only way to identify it is to recognize symptoms that negatively impact an individual's social […]

Portrayals of Schizophrenia by Media

In media portrayal of schizophrenia, such as A Beautiful Mind, schizophrenic characters are depicted as dangerous, violent, distrusting, paranoid, awkward, and unstable people that need to be hospitalized due to exaggerated delusions and hallucinations. Not only does this stigmatize the diagnosis, but it also inflates the reality of knowing someone with the diagnosis. In actuality, schizophrenia shares many of the same characteristics as other disorders such as OCD, depression, anxiety, and ADD, yet none of these disorders have a more […]

Bipolar Disorder and Schizophrenia

Bipolar disorder and schizophrenia affect many people. According to Mahoney (2017), over 2.5 million Americans over the age of 18 are believed to be living with bipolar I or bipolar II disorder. This does not include those who have not been diagnosed properly due to misinformation about symptoms. Schizophrenia affects approximately one percent of people worldwide, impacting men and women equally. Schizophrenia can strike anyone and usually occurs between the late teenage years and thirty years of age. Males typically […]

Living with Schizophrenia

In today's modern world, research has found and diagnosed multiple mental illnesses. Through this spread of information, psychologists generated Schizophrenia. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Schizophrenia involves a range of cognitive, behavioral, and emotional symptoms, and can be difficult to diagnose. There is no test for it, resulting in the diagnoses involving the recognition of negative symptoms that impact social functioning. These symptoms include diminished emotional expression, delusions, and hallucinations, etc. all for […]

Mental Disorder: Schizophrenia

Schizophrenia is a mental disorder that affects many adults all around the world. It is usually diagnosed between the late teenage years and early 20s. Even though Schizophrenia is a mental disorder, it affects the entire body as well. It also has many symptoms that are usually misinterpreted and portrayed incorrectly in movies and everyday life. Schizophrenia is described as a mental disorder that makes the person suffering it seem like they are detached from reality. They usually experience delusions, […]

Schizophrenia and Problems in Everyday Lives

People with schizophrenia have a lot of struggles in their everyday lives. Their minds work differently than the average, mentally sound individual. Schizophrenia is defined as a long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation (Oxford English Dictionary). Some examples of schizophrenia symptoms consist of delusion, hallucinations, […]

Modern Plague Vs Schizophrenia

Although the cause is unknown, this mental illness can be developed through factors such as genetics, brain chemistry, brain abnormality and environmental factors."" Schizophrenia affects more than 21 million people worldwide. Scientists are still unable to locate the cause of this disorder. Symptoms of this disorder include hallucinations, abnormal behavior, inability to complete activities, lack of pleasure, and emotional flatness. Although a cure has not yet been discovered, treatments may help. Even though the cause is unknown and the disease […]

Negative Symptoms of Schizophrenia

Mental health illnesses affect many people worldwide, among them is schizophrenia which is a chronic mental health disorder that affects a person's brain. Patients with schizophrenia can experience various symptoms as well as functional impairments. Symptoms include delusions, trouble concentrating, and hallucinations (Parekha, 2017). Schizophrenia also interferes with activities of daily living, social interactions, and occupational performance. Most patients will require financial assistance to help support themselves, because only a very low percentage of people are able to work full […]

Schizophrenia: Mental Illness that Controls how a Person Thinks, Behaves and Feels

When you have schizophrenia you lose touch with reality. You make things up and start to hallucinate and began to get violent. You can start feeling irritated and get mad easily at the person near or by you. It can be hard to handle a person with schizophrenia they can sometimes be intolerable, when dealing with someone with schizophrenia you need to keep an eye on them at all times. Schizophrenia normally starts between the ages of 16 and 30, […]

Growth Patterns and Risk of Schizophrenia

In the introduction of this article called Growth Patterns and Risk of Schizophrenia, it mentions how the growth and nutrition of a fetus can play a part that leads to schizophrenia. It includes, that during the fetal development stage if there is malnutrition can lead a higher risk of the baby developing schizophrenia The studies involve with adult height, weight, or growth patterns. In continuation it mentions that birth weight has an effect when it comes to disorders later in […]

Schizophrenia Symptoms and Treatment in a Beautiful Mind

The film A Beautiful Mind chronicles the adult life of John Nash Jr., a Nobel Prize recipient widely regarded as a brilliant mathematician who greatly influenced modern economic theory. The film focuses on Nash's decades long struggle with paranoid schizophrenia after he receives a diagnosis in 1958. Although it is well known that Nash was diagnosed with schizophrenia in real life, I will use this paper to discuss specific symptoms portrayed in the film, and consider how his treatment and […]

Age of Onset of Schizophrenia

Schizophrenia, which occurs in late adulthood, is characterized as a mental health disorder marked by psychotic features, disrupted relationships, and thought processes that disturb a person's mood, thoughts, and behavior. It affects approximately 1.1% of the world's population, or about three and a half million Americans (About Schizophrenia, 2018). Schizophrenia, a disease that impairs neurocognitive functioning (Snyder, 2013), requires long-term treatment given the varying severity of symptoms across different age groups. Affected individuals may suffer from delusions, false beliefs such […]

Schizophrenia and Stigma

While there are a variety of feasible and effective programs to reduce stigmatization among health professionals in mental health related areas, there are several other strategies that can be put in place by health professionals to counter stigmatization within the population. Thornicroft (2006) identifies some of them. First, health professionals would benefit from getting more involved in the media to properly inform the public about mental health issues. The media, often overly sensational, convey negative images of violence, weakness, and […]

A Beautiful Mind Summary: John Nash’s Struggle with Schizophrenia

A Beautiful Mind Summary: Hallucinations In the movie A Beautiful Mind, they bring forth multiple symptoms of schizophrenia. One of the most apparent symptoms shown is Johns's hallucinations. Hallucinations are "the experiencing of sights, sounds, or other perceptions in the absence of external stimuli." In Johns's case, in the movie, he heard as well as saw things that weren't real. The voices that he heard would talk directly to him, giving him commands and tasks to accomplish as well as […]

Decoding the Enigma: a Journey through the DSM-5 Labyrinth of Schizophrenia

Schizophrenia, a labyrinthine puzzle of the mind, has captured the intrigue of both scholars and practitioners for generations. Within the intricate tapestry of psychiatric literature, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), stands as a guiding compass for understanding this enigmatic condition. Yet, delving into its depths requires more than mere academic prowess; it demands a voyage through the complexities of human experience and perception. At the heart of the DSM-5 criteria for schizophrenia lies the […]

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How To Write an Essay About Schizophrenia

Understanding schizophrenia.

Before starting an essay about schizophrenia, it's important to have a comprehensive understanding of this mental disorder. Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. It's characterized by distortions in thinking, perception, emotions, language, sense of self, and behavior. Begin your essay by explaining the symptoms of schizophrenia, which can include hallucinations, delusions, disorganized thinking and speech, and impaired cognitive ability. Discuss the known causes of schizophrenia, such as genetic factors, brain chemistry, and environmental influences. Also, explore the impact of schizophrenia on individuals' daily lives, including social interactions, employment, and self-care challenges.

Developing a Thesis Statement

A strong essay on schizophrenia should be centered around a clear, concise thesis statement. This statement should present a specific viewpoint or argument about schizophrenia. For example, you might discuss the challenges in diagnosing and treating schizophrenia, analyze the social stigma associated with the disorder, or explore the latest research in understanding its underlying causes. Your thesis will guide the direction of your essay and provide a structured approach to your analysis.

Gathering Supporting Evidence

To support your thesis, gather evidence from credible sources, such as medical journals, research studies, and healthcare professionals. This might include data on the prevalence of schizophrenia, treatment success rates, or personal narratives from individuals living with schizophrenia. Use this evidence to support your thesis and build a persuasive argument. Remember to consider different perspectives and address potential counterarguments to your thesis.

Analyzing Treatments and Challenges

Dedicate a section of your essay to analyzing the treatments available for schizophrenia and the challenges associated with them. Discuss various treatment methods, such as antipsychotic medications, psychotherapy, and community support. Explore the benefits and limitations of these treatments and the challenges patients face, such as medication side effects and the ongoing need for support and care. Additionally, consider the impact of societal attitudes and healthcare policies on the treatment and management of schizophrenia.

Concluding the Essay

Conclude your essay by summarizing the main points of your discussion and restating your thesis in light of the evidence provided. Your conclusion should tie together your analysis and emphasize the importance of understanding and effectively addressing schizophrenia in society. You might also want to suggest areas for future research or policy improvements that could benefit individuals with schizophrenia.

Reviewing and Refining Your Essay

After completing your essay, review and refine it for clarity and coherence. Ensure that your arguments are well-structured and supported by evidence. Check for grammatical accuracy and ensure that your essay flows logically from one point to the next. Consider seeking feedback from peers or mental health professionals to further improve your essay. A well-crafted essay on schizophrenia will not only demonstrate your understanding of the disorder but also your ability to engage with complex medical and social issues.

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• v.11(6); 2021 Jun

Schizophrenia outcomes in the 21st century: A systematic review

Peter huxley.

1 Centre for Mental Health and Society, School of Health Sciences, Bangor University, Bangor UK

Anne Krayer

Louise prendergast, sanjaya aryal.

2 Department of Sociology, University of Essex, Colchester UK

Richard Warner

3 Clinical Professor of Psychiatry and Adjunct Professor of Anthropology, University of Colorado, Denver CO, USA

Associated Data

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

We report a review of outcomes in schizophrenia in the twenty‐first century, replicating and extending work undertaken by the late Richard Warner in his seminal book, “ Recovery from Schizophrenia: Psychiatry and Political Economy” (1985;2004).

Warner's methods were followed as closely as possible. Only observational/naturalistic studies were included. Six scientific databases were searched from 2000 to 2020. 6,640 records were retrieved. 47 met inclusion criteria.

Overall, complete recovery is higher in this study than in Warner's (37.75% cf 20.4%), especially for first episode psychosis (FEP) (57.1% cf 20.7%). Clinical recovery, annualized remission rate (ARR), and employment outcomes were significantly superior for first episode psychosis compared with multiple episode psychosis (MEP). ARR shows a trend toward reduction over time, from 2.2 before the financial crash of 2008 to 1.6 after (t = 1.85 df 40 p  = .07). The decline is statistically significant for the MEP group (t = 2.32 df 18 p  = .03). There were no differences in outcome by region, sample characteristics, outcome measures used, or quality of studies. Heterogeneity of clinical outcome measures across the literature makes evidence synthesis difficult. Weak and inconsistent reporting of functional and employment outcomes mean that findings lack meaning with respect to lived experience.

Future research strategies should aim to reduce heterogeneity in clinical outcome measures and to increase the emphasis on capture and reporting of more sophisticated measures of social and functional outcome. Outcome domains should be disaggregated rather than conflated into unitary recovery constructs.

A systematic review of the 21st century outcomes in schizophrenia.

1. INTRODUCTION

This paper reports a review of outcomes in schizophrenia in the twenty‐first century and is an extension of the work undertaken by the late Dr Richard Warner in his seminal book, “Recovery from Schizophrenia: Psychiatry and Political Economy” (1985 (Warner,  1985 ); 2004 (Warner,  2004 )). The present work was started with Dr Warner's involvement, and the preliminary results were presented at the XVII World Congress of Psychiatry in Berlin in 2017. Here, we present the final results based on research findings published between 2000 and 2020. Initially, we intended to conduct a systematic review and meta‐analysis, but study heterogeneity and paucity of data, including data capture problems and reporting weaknesses, means that meta‐analysis was not possible. The relevance of these issues is considered further below.

2. BACKGROUND

In 1985, Warner used empirical evidence to strongly challenge the prevailing view of schizophrenia, which largely arose through the influence of Kraepelin (Kendler,  2020 ), who suggested that psychosis was strongly characterized by poor clinical and social outcomes. Since then, evidence from epidemiological, sociological, psychological, and biological studies has made many aspects of the Kraepelinian model of schizophrenia unsustainable (Murray,  2017 ). Few hold to the concept of schizophrenia as a unitary disorder, or even, as Bleuler suggested when he coined the term, a distinct group of psychoses. (Bleuler and Zinkin, 1950 )

Richard Warner was one of the first to systematically bring together and analyze data from outcome studies of schizophrenia in the twentieth century. Although we (and others) regularly refer to his work in the 2004 edition of Recovery from Schizophrenia, it is important to remember that the first edition was published in 1985, almost two decades earlier. He was interested in shedding light on whether “schizophrenia is an inherently catastrophic illness from which only modern psychiatric treatment can afford relief; or that it is a condition with a considerable spontaneous recovery rate upon which treatment has little long‐term effect.” (p.60). Most importantly, he showed that conditions such as social and political attitudes and the state of the economy, “mould the course and outcome of the illness and influence, along with other factors, its incidence.” (p. xii) and by implication, outcome. Subsequent work has confirmed his challenge to the Kraepelinian notion of a dementia‐like psychotic process, mainly determined by biological factors. His work has contemporary relevance.

Warner distinguished between “complete recovery” and “social recovery.” He defined the former as loss of psychiatric symptoms and return to preillness level of functioning, where as he defined social recovery in functional terms, economic and residential independence with low social disruption, an important component of which is employment.

Since Warner's 1985 edition of Recovery from Schizophrenia, there has been intense debate over the concept of recovery. In particular, there has been controversy over the ownership of definitions of recovery; the preferred model of patient self‐definition of recovery creates methodological problems for quantitative researchers, whereas the emergence of a “Recovery Model” in statutory services has led to accusations that service definitions of “recovery” are sometimes euphemisms for withholding care and treatment. Consequently, the literature is marked by a variety of definitions of “recovery,” “complete recovery,” and “partial recovery,” some of which are agreed by some groups of researchers, some of which are idiosyncratic (Cornish,  2020 ; Liberman & Kopelowicz,  2002 ; Livingston, 2020 ). We must acknowledge the existence of these differences and their impact on our conclusions.

Warner (Warner,  2009 ) provided a neat attempt to weave the scientific and experiential approaches to “recovery” together. He rightly pointed out that “the proportion of patients considered to have recovered will depend on how rigorously recovery is defined” (p61). A number of issues of definition are of significance here. First, it seems to us that to combine both clinical remission and social function into a single recovery definition is not helpful and risks the loss of important outcome information. As Warner himself said, measures of social functioning are hard to standardize and can cover a wide range of behaviors and activities. In the experiential approach to recovery, individuals value different behaviors and activities (work, family contact etc) differently and the importance attributed to them may vary overtime. Warner hypothesized that social environment had a profound effect on the outcome of psychosis, so that circumstances that support people to social inclusion led to a virtuous cycle of improved well‐being. This being the case, his thesis was that the political economy is a key modifiable factor in improving rates of recovery. In line with this, we believe that employment status ought to receive more attention as an outcome indicator. This is not without its difficulties, which we mention later. Nevertheless, we have included employment outcomes in this review.

Second, with regard to the rigor of the definition, it is the case that the length of “recovery” needs to be defined. Warner himself did not include an explicit time criterion in his definition, although a 12 month criterion was implicit in his selection of studies. Although the Remission17 criteria for proposed evidence‐based and consensus‐based criteria for defining clinical remission does include a 6‐month time criterion, this is not adhered to in all studies.

We believe that the most satisfactory definition of “complete recovery” is clinical remission and sustained functional outcomes, which should include employment, for at least 6 months, but it is in the nature of a review of this sort that the relevant information is not always available in the public domain.

In his most recent review, Warner included 114 studies from the 1,880 to 2004. He found that recovery rates overall were little changed since the 1900s. In the last period of his review between 1976 and 1995, he separately reported on clinical recovery and social recovery for people with first episodes of psychosis (FEP) and for those who experienced multiple episodes of psychosis (MEP). In MEP, the mean complete recovery rate was 20% and social recovery 33%, which was not very different from the overall recovery rate from 1901 to 1910 (20% and 41%, respectively). In FEP, recovery occurred in 27%, and social recovery in 35%; higher compared to the earliest figure he gave (for the years 1921–1940) which were 12% and 28%, respectively. He was unable to present detailed findings for what he termed “the developing world” (that is, low‐ and middle‐income countries or LMICs), but he did break down the US and UK results. From 1976 to 1995, complete recovery occurred in 17% in the USA and 19% in the UK, while social recovery in the USA was 43% and in the UK 30%.

Since Warner's work there have been several reviews, some of which report pooled outcomes (Cohen et al.,  2008 ; Leucht & Lasser,  2006 ; Van Eck et al.,  2018 ), and two reviews of reviews (Miettunen, 2015 ; NeuRA (Neurosciences Research Australia). Remission and recovery), 2020 ). The reviews reporting pooled outcome data use very different methodologies. In fact, the heterogeneity that scholars bemoan in individual outcome studies is equally present in the reviews (cited chronologically in the Supplementary Material A ). For instance, Menezes (Menezes et al.,  2006 ) did not require included studies to report both clinical remission and social outcome and did not specify a time period for outcomes. Clemmensen et al. (Clemmensen et al.,  2012 ) looked at FEP and included patients with mood and other disorders (mixed samples) as well as some retrospective studies, hospital discharge and outpatient samples. The studies were categorized as reporting outcome by use of both the General Functioning Scale (GFS) and study‐specific functioning (SSF) outcomes. The GFS studies were categorized by the study authors as a “poor” outcome (score ≤50), “moderate” outcome (score 51–70), or “good” outcome (score >70), but there was no consistency in the use of these precise cutoff points across all studies. The authors subjectively and independently rated the SSF outcome data in the papers as “poor,” “moderate,” or “good.”

In 2003, the Remission in Schizophrenia Working Group (RSWG) (Andreasen et al.,  2005 ) proposed evidence‐based and consensus‐based criteria for defining clinical remission. Remission was defined as “a level of core symptoms (positive, negative, and disorganized) that does not interfere with an individual's behavior and is also below that required for an initial diagnosis of schizophrenia to be made according to the Diagnostic and Statistical Manual of Mental Disorder, fourth edition (DSM‐IV)” (Nasrallah & Lasser, 2006 ). AlAqeel and Margoleses’ review (AlAqeel & Margolese,  2012 ) used the RSWG criteria and included only those papers that provided data with a minimum six‐month follow‐up of patients—the length of follow‐up originally suggested by the RSWG.

Jääskeläinen et al. (Jääskeläinen et al.,  2013 ) included both clinical and social outcomes using the RSWG definition of recovery with persistence for two years. They commented on the “high” heterogeneity of recovery estimates (I 2 statistic=99.8%) and found a median annual recovery rate of 1.4%, with no statistically significant difference in outcome by gender. There was a significantly higher rate of recovery LMICs, as suggested by Warner and others (although this has been disputed by some (Cohen et al.,  2008 ) and rejoindered by others (Bromet,  2008 ; Jablensky & Sartorius,  2008 )). Their recovery figure for the 1976–1995 period (9.9%) was much lower than Warner's. They reported, however, that the strictness of the definition of recovery used had no effect on outcome results. The difference between their results and Warner's is almost certainly due to their use of a persistence criterion in the definition. We will examine the relevance of a persistence criterion in the analysis section of this paper.

Lally et al. (Lally et al.,  2017 ) included FEP studies only and used Jääskeläinen's criteria for recovery but also examined improvement persisting over one year. Studies that failed to meet the Jääskelänen criteria were designated “broad criteria.” The pooled rate of clinical remission for all included diagnoses was 58% (56% for schizophrenia). Only 23% achieved full recovery. They reported no difference in remission rates by study quality, duration of follow‐up, study setting, or use of narrow/broad remission criteria/the RSWG criteria. Recovery rates were higher in Africa (73%; 2 studies only), Asia (66%; 2 studies only), and North America (65%; 17 studies) compared with Europe and Australia. In the most recent period, 2005–2016, recovery rates remained higher but not significantly so. Miettunen (Miettunen, 2015 ) reviewed systematic reviews of schizophrenia outcomes and reported an overall recovery rate of 13.5% and also found higher rates of recovery in poorer countries. NeuRA (NeuRA (Neurosciences Research Australia). Remission and recovery, 2020 ) reported a review of six reviews conducted through three search engines (all these engines are included in our searches). They suggest that the quality of the evidence in the six reviews is at best moderate, that the overall recovery rate for schizophrenia in the 21st century has been between 13% and 16%, and that the five year outcome for first episode is 58% clinical recovery, but they do not provide pooled averages for social or employment outcomes.

We do not believe that the existence of this marked heterogeneity should be a reason to cease all comparative outcome research. In our opinion, researchers should continue to strive to reduce heterogeneity and to use indicators where greater consensus can be achieved. Employment status is one such candidate. A contextualized measure of financial strain might be another. The advantage of the present review is not that it reduces heterogeneity but that it allows a meaningful longitudinal view because, by using the same methods as Warner, it compares like with like.

Since the first edition of Warner's book, there has been a substantial increase in outcome research: in first episode psychosis (FEP), in early onset, in intervention samples, and, most recently, in high‐risk groups. This has led to intense interest in the role of duration of untreated psychosis. This variable is excluded from the present review (as there is nothing in Warner's 1985 & 2004 editions to compare it with). Since Warner's original work there has been a growing awareness of the need to incorporate other features of recovery other than simply clinical remission (Andreasen et al.,  2005 ; Emsley et al.,  2011 ; Gorwood & Peuskens,  2012 ; Harvey,  2009 ; Karow et al.,  2012 ; Lally et al.,  2017 ; Lambert et al.,  2009 ; Vita & Barlati,  2018 ). Employment is considered as an outcome in some reviews, but pooled data are not given (Cohen et al.,  2008 ). None of the reviews (summarized in the Supplementary Material A ) include employment status as an outcome indicator in spite of its growing relevance and evident support for its consideration. (Bouwmans et al.,  2015 ; Kinoshita et al.,  2010 ; Lloyd‐Evans et al.,  2013 ; Srinivasan & Thara,  1997 ; Srinivasan & Thara,  1999 ; Tsang et al.,  2010 ).

As indicated earlier, wherever the data were presented, we have included employment outcome in this review.

The purpose of the present review is to assess the extent to which Warner's conclusions, and the conclusions of subsequent reviews, hold in the twenty‐first century. Are remission rates stable, are they influenced by different definitions of remission and by different persistence criteria, are they affected by duration of follow‐up or other study features? How do clinical, social, and employment outcomes differ in MEP and FEP studies and are outcomes better in LMICs? To explore the evidence supporting Warner's hypothesis concerning the importance of changes in the political economy, we have taken the opportunity to look for any noticeable difference in outcomes for data gathered before and after the 2008 crash.

We followed Warner's methods as closely as possible. As in his original review, only observational/naturalistic studies were included, and study samples comprised at least 80% individuals with diagnoses of schizophrenia, schizophreniform, and schizoaffective disorder (i.e., broadly defined “schizophrenia”) with at least 6 months follow‐up (Warner included those of one year or over, but we adhered to the more recent RSWG criteria). In studies where a “schizophrenia” subsample of 30 or more cases was fully described independently within the paper, we used only those data. In addition, if early intervention or first episode studies included persons with a schizophrenia diagnosis and reported these results separately, then the schizophrenia group results are also included in our analysis. FEP is defined as patients who are making their first treatment contact for psychotic symptoms OR are in their first episode of psychosis AND do not meet diagnostic criteria for an affective disorder (i.e., only schizophrenia‐spectrum diagnoses included).

Exclusion criteria were as follows:

• Age <18 years old at study inception (but not for FEP studies where no lower age limit was applied).
• source not written in English language;
• clinical trials;
• primary diagnosis other than schizophrenia (e.g., bipolar disorder);
• selected outpatient and hospital discharge samples;
• retrospective studies;
• cross‐sectional studies;
• small studies ( n  < 25);
• cognitive and neurological function only assessed;
• data gathered entirely or mainly in the 20th century.

We also excluded studies where outcome ratio data could not be computed (see also Hegarty (Hegarty et al.,  1994 )). Where a study was reported in more than one paper using the same data, the paper with usable and latest results was included (as in Jääskeläinen et al. (Jääskeläinen et al.,  2013 )). In some cases where different outcomes (clinical and functional) from the same study were reported in separate papers (e.g., Addington et al. (Addington et al.,  2003 ; Addington et al.,  2003 )), both outcomes were included in the results, but the total number of subjects was adjusted to avoid double counting. Where a research group reported single study results separately for MEP and FEP cases, we entered both sets of results into the analysis, but did not double count respondents. We examined four types of outcome: clinical; social; complete recovery (which we defined as meeting both RSWP and Warner criteria), and employment (measures of social recovery are listed in Supplementary Material B ). Given Warner's thesis regarding the influence of the political economy, we felt it was important to consider social and employment outcomes (employed/not) as well as clinical outcome, and complete recovery (as defined above). In some studies, the only usable outcome data were on employment (Segarra et al.,  2012 ). The abrupt contextual changes in the global economy in 2008 (the generally accepted date of the global financial crash) created an opportunity to assess any changes from pre‐ to postcrisis.

RW and PH began the search and review process, using Warner's inclusion and exclusion criteria and made decisions jointly whether to include or exclude studies. At this stage (2015–6), more than 700 papers were under review. Warner's untimely death occurred before the process could be completed. Searches were undertaken again in 2017–18 and updated in 2020.

• • Search terms : terms schizo* OR psychos*s OR psychotic AND recovery OR outcome* OR remission OR longitudinal OR course OR follow‐up in a title search.
• •Period: 1 Jan 2000‐30 June 2020
• •Science Direct
• •Proquest (Social Sciences Collection)
• •PsycArticles
• •Cinahl (Ebscohost)
• •Medline (Ebscohost)
• •Web of Science (Biosis, Core, Scielo)

Decisions on study inclusion were undertaken in pairs between PH, AK, SA, and LP. In all cases where it was possible, the decisions were confirmed by reference to Warner's own notes shared with PH in 2016. In the event of disagreement, a third opinion was sought from one of the other authors of this paper.

To explore any impact of the financial crash, we divided the studies into those where data collection was entirely completed before 2008, and those whose data were collected entirely after 2008. Remaining studies where data collection included 2008 were assigned to the period in which the majority of data were gathered.

We also divided the studies depending upon their definition of outcome and recovery. We contrasted studies using the RSWG definition of clinical remission (Andreasen et al.,  2005 ) and those that did not. The location of the study was examined categorizing data collection areas into Europe, North America, and the rest of the world (a catch‐all necessitated by low numbers of studies). We further compared outcomes in first episode psychosis (FEP) or early intervention study samples with all outcomes in non‐FEP/Early Intervention studies, labeled various or multiple episodes of psychosis (MEP) (called “mixed duration” by Warner). Length of follow‐up was divided into 6 months (our minimum) or longer than 6 months. Where follow‐up was repeated at more than one time point, the final assessment was used. This enabled us to include the longest available outcomes while avoiding double counting.

3.1. Statistical procedures

Recovery estimates are presented as pooled averages or as medians. For change over time, we used the same year categories as Warner. For economic comparisons, we used the per capita income statistics as recommended by Cohen et al. (Cohen et al.,  2008 ) based on the latest figures provided by the World Bank ( World Bank ). Analysis by regions compared studies conducted in the USA, Europe, and the rest of the world. For comparisons by definition of recovery, we used the Andreasen et al. criteria (2005) (Andreasen et al.,  2005 ) (RSWG) versus studies using other definitions. Warner did not include an explicit persistence criterion in his definition of recovery but others have done, and so we examine all the outcomes by the persistence criterion used in the included studies, using analysis of variance. In relation to study quality, we followed the MOOSE criteria for meta‐analysis in observational studies (Stroup et al.,  2000 ) and consulted subsequent relevant guidance (Aromataris and Munn, 2020 ; Briggs,  2017 ; Deeks et al.,  2008 ; Huedo‐Medina et al.,  2006 ).

Variable distributions were checked. Skewed variables were transformed appropriately, for example, the social/functional outcome variable. Annualized recovery rate was calculated by dividing the remission rate by the length of follow‐up (see Jääskeläinen et al. 2013) (Jääskeläinen et al.,  2013 ). Means of the independent continuous outcome variables were analyzed in relation to the dependent variables using t tests or one‐way ANOVA, and relationships between continuous variables by correlational analysis. Heterogeneity was tested using the I 2 statistic.

A total of 47 studies (Addington et al.,  2012 ; Addington & Addington,  2008 ; Addington, Leriger, et al.,  2003 ; Addington, Young, et al.,  2003 ; Alem et al.,  2009 ; Arceo & Ulloa, 2019 ; Bachmann et al.,  2007 ; Bodén et al.,  2014 ; Carter et al.,  2011 ; Češková et al., 2007 , 2011 ; Chan et al., 2015 , 2019 ; Chang et al.,  2014 ; Chua et al.,  2019 ; Economou et al.,  2011 ; Giraud‐Baro et al.,  2016 ; Hassan & Taha,  2011 ; Heering et al.,  2015 ; Hegelstad et al.,  2012 ; Jaracz et al.,  2015 ; Johansson et al.,  2018 ; Johnson et al.,  2012 ; Kebede et al.,  2005 ; Kurihara et al.,  2011 ; Lauronen et al.,  2007 ; Malla et al.,  2002 , 2006 ; Mattsson et al.,  2008 ; Norman et al., 2014 , 2018 ; Revier et al.,  2015 ; Ritsner et al.,  2014 ; Ruggeri et al.,  2004 ; Saravanan et al.,  2010 ; Schennach et al.,  2020 ; Segarra et al.,  2012 ; Shibre et al.,  2015 ; Singh et al.,  2007 ; Spellmann et al.,  2012 ; Strålin et al., October 2018 ; Suresh et al.,  2012 ; Torgalsbøen et al.,  2014 ; Üçok et al.,  2011 ; Verdoux et al.,  2010 ; Verma et al.,  2012 ; Whitty et al.,  2008 ; Wolter et al.,  2010 ) (full details are given in Supplementary Material B ) met the inclusion criteria and provided data for year of study, definition of outcome, stage of illness, length of follow‐up (in all but one instance follow‐up was 12 months or more), and region (Figure ​ (Figure1 1 ).

Search strategy

Some of these gave only functional or employment outcomes. In three instances, the study reported separate data for two outcomes. Accordingly, 50 data sets were entered into the analysis. The number of studies that followed the Warner criteria for clinical remission was 43. The clinical results below are based on these 43 studies unless otherwise specified. In some other studies, data were presented in a format that could not be interpreted for our present purposes. Such studies usually involved the use of predictive regression models, and raw outcome data were not reported. In all instances, we attempted to, but were unable to, access the raw data. Examples of the types of studies excluded are given in the Supplementary Material C .

The total number of (unduplicated) participants is 13,430 (FEP: 6,049; MEP: 7,381). Clinical outcome was reported in 43 papers (11,048 participants), functional or social outcomes in 20 papers (5,602 participants), and employment outcomes in 23 papers (9,990 participants). Since we are interested in changes in the recent past, our outcomes are reported in table  1 alongside Warner's (2004) results from the latter part of the 20th century, that is, 1945–2000 (derived from Warner 2004; Table 3.1 pages 64–76).

Complete and social recovery: comparison of 20th and 21st century studies

Abbreviations: FEP, First episode psychosis; MEP, Multi Episode Psychosis.

4.1. Study quality

There was no relationship between the quality rating and any of the outcome measures, including clinical outcomes (t = 1.379 df 41 p  =.175; mean difference =8.817; SE diff=6.394 95% CI −4.095 to 21.730). The Jääskeläinen review (Jääskeläinen et al.,  2013 ) found considerable heterogeneity in the recovery rate (I 2 statistic =99.8%), and we too found high heterogeneity in the clinical outcome variable in our included studies (I 2 statistic =97.1%).

4.2. Definition used

Most of the studies used the RSWG criteria, but a very few added the duration requirement, some at 6 months, (Heering et al.,  2015 ; Kurihara et al.,  2011 ) some one year, (Wolter et al.,  2010 ) and others required two years. (Schennach et al.,  2020 ) A comparison between groups of studies that had no duration criterion (36%), or a criterion of six months (42%), or a criterion of twelve months or more (22%) showed no significant differences in any outcome. The outcomes for those studies that used RSWG criteria compared to those using “other” criteria also showed no differences. In all outcomes, the “other” definitions had better outcomes by a few percentage points, with the exception of ARR which was higher in the RSWG studies (ARR 2.2 cf 1.9) but was not significant.

4.3. Clinical and social outcomes and stage of illness

Table  1 shows the mean (pooled average) outcomes in the original Warner work (from post‐World War Two to the end of the century) together with the 21st century results from the present review. Complete recovery improves significantly in the MEP group, but social recovery is not significantly improved in either MEP or FEP. The most striking feature is the significantly higher complete recovery rate (57%) in FEP studies in the present review.

Warner presented the recovery data by decade, and Jääskeläinen et al. (Jääskeläinen et al.,  2013 ) did the same. By their own account, the latter authors used a stricter definition of recovery. We reanalyzed Warner's data to obtain the median recovery rates of FEP and ME by decade, and these are presented in Table  2 .

Comparison of median (%) recovery rate by decades

Data derived from Warner 2004 (Warner,  2004 ); Table 3.1 pages 64–76

Our figures for the first two decades of the 21st century continue trend of improvement previously reported by Warner. Our median is 54.0%. This is consistent with the mean figures given in Table  1 . Similarly, our median for MEP is also considerably improved at 33.45 and is a return to the median levels Warner observed between 1941 and 1955. Possible reasons for these changes are considered in the discussion.

4.4. Annualized recovery rate (ARR)

Using the ARR as defined by Jääskeläinen and colleagues(Jääskeläinen et al.,  2013 ), (who found a median ARR of 1.4%) we found a median ARR of 2.2%. Warner's median ARR for the last period in his review (1980 to 2000) was 2.9. In our data, the ARR shows a trend toward significant reduction over time, reducing to 1.6 after the financial crash of 2008 from 2.2 before (t = 1.85 df 40 p  =.07). The reduction is statistically significant for the MEP group (t = 2.32 df 18 p  =.03).

Table  3 compares all the outcomes for the MEP and FEP groups in our review. Because ARR and social outcome were both skewed, we used log‐transformed variables. Clinical remission, the annualized recovery rate, and employment are all significantly superior for the FEP group, but social outcome is not.

Multiple episode compared to first episode outcomes

4.5. Location

While there is a trend for employment outcome rate to be better in the rest of the world (45% sd 19.9; 8 papers) than in Europe (38.6% sd 18.9; 19 papers) and North America (35.4% sd 24.6; 5 papers), there is no statistically significant relationship between any of the outcomes and region. There was no difference in the regional annualized recovery rate. This result holds for both FEP and MEP studies. Using RSWG studies only, there are still no significant differences by region.

Comparing the 5 LMIC countries with the HICs showed that only employment was significantly different (better in LMIC t = 2.18 df 30 p  =.037).

4.6. Sample characteristics (Sample size, % male, % follow‐up, and length follow‐up)

There are no significant associations between these variable (sample size, gender distribution, percentage followed up, and length of follow‐up) and any outcome measure. The results are the same in both the MEP and FEP groups.

4.7. Measures used

PANSS was the most commonly used clinical outcome measure (62.5% of studies). GAF was the most commonly used functional outcome measure (39.3% of studies). There are no differences in clinical, social, employment, or ARR outcomes in either MEP or FEP cases when PANSS and GAF are used compared to the other measures used.

4.8. Year of data collection

In studies conducted after 2008, good clinical and employment outcomes both decline. Functional outcome improves, but the functional data are highly skewed. Although positive clinical outcome is reduced from a pooled average of 49% before 2008 to 45.6% after, this change is not significant. Employment outcome is markedly worse after the crash (employed 34.9%) than before (employed 42.3%) (as one would expect), but this is not statistically significant. These findings apply to both the FEP and MEP groups.

5. DISCUSSION

Our review has some limitations. The most significant of these is heterogeneity of methods and outcome criteria between studies. This is a limitation which is intrinsic to reviews of naturalistic outcome studies, and it has affected all of the previous reviews. It precludes overconfident conclusions or a claim of definitive findings, especially in those subanalyses where the number of studies is small. While most of our results are indicative only, they do shed light on the multifaceted nature of recovery and on important temporal trends.

This review of 21st century studies tends to confirm one of Warner's key assertions that a significant proportion of people who receive a schizophrenia diagnosis make a good recovery. There are some significant new findings. Generally speaking, these do not reach statistical significance owing to wide confidence intervals, but they resonate with many other findings on the impact of poverty, employment, and other social factors (Wolter et al.,  2010 ).

While we have found that rates of complete recovery have increased substantially for people experiencing a first episode of psychosis in the 21st century, not all of our findings are positive. Findings by both Warner and Jääskeläinen showed decreasing annualized rates of recovery over time, and we have found a continuing decline in ARR since Warner's review. Differences in method and criteria almost certainly account for differences in their figures, particularly the use of a persistence criterion by Jääskeläinen. Nonetheless, the trend is the same in all three reviews.

People with multiple episodes fare much worse than people who respond well to intervention for FEP (Table  1 ). While it has long been recognized that relapse increases the risk of subsequent relapse, something appears to have changed. It is reasonable to speculate that this might be due to changed priorities in mental health policy since the end of the era of deinstitutionalization (roughly 1955–1995). High‐income countries (HICs) have made huge efforts to improve outcomes from FEPs. There has been substantial investment in specialist FEP/early intervention services, which contrasts starkly with disinvestment, loss of research interest and, some would say, neglect of rehabilitation and other services for people with MEP. (Poole et al.,  2013 ).

There is an apparent paradox that an improved rate of complete recovery has been accompanied by a deteriorating ARR. The same clinical and research focus on FEP in the UK and USA might account for this. It is possible that better early intervention on first presentation of psychosis results in an increasingly high proportion of those who will achieve recovery experiencing this immediately, with a consequent reduction in recovery rates for those who relapse, who predominate in the annualized sample. A similar explanation is unrelated to treatment. Overtime, changes in social attitudes may mean that a history of a single episode of psychosis may have become less marginalizing, say with respect to employment, but that recurrent episodes, with attendant disruption to employment and housing, have a much more marginalizing effect, a poor social outcome then contributing to poor clinical outcome.

A further temporal change is a trend toward better outcomes prior to the 2008 crash, and for this to decline somewhat afterward. Both findings are compatible with Warner's emphasis on the political economy as a key factor influencing people's ability to recover. Warner notes (pp38‐40) that when the business cycle goes into recovery, patients in the low income groups disproportionately pay the psychological price of adapting to new jobs, in new locations, with new colleagues, all of which result in new illnesses or the exacerbation of existing ones.

There is a trend to better outcomes in the non‐UK non‐US studies, but this is hard to interpret. The category includes data from LMICs and some HICs, and the number is very small. The finding is of interest, but cannot be taken to show that recovery rates are better in LMICs. More importance can be attached to the fact that, overall, participants in the non‐UK non‐US group probably had poorer access to treatment. If treatment accounted for improved outcomes, you would expect the trend in this group to be in the opposite direction to one we have found.

The same caveats must attach to the finding of a trend toward better employment outcomes in non‐UK non‐US studies, but there may be an important factor relating to better but less formal employment opportunities in LMIC settings. Although we cannot say that outcomes in LMICs are better, our review lends no credence to the idea that LMIC outcomes are worse. Warner took the view that outcomes were better in the developing world, and our limited findings are congruent with other recent findings (Jääskeläinen et al.,  2013 ; Killaspy & Priebe,  2020 ; Miettunen, 2015 ).

Our findings of changes in outcomes over time, with possible attenuation of improvements in HICs after 2008 and outcomes probably no worse in LMICs (possible better), tend to suggest that Warner was right and that social factors are key determinants of recovery. It may be argued that a definition of recovery that includes employment will inevitably become less common in hard times, but this misses the point. Recovery and context cannot be separated. As suggested above, sustained employment is a measure of recovery, but employment is also known to improve clinical outcomes.

There must be some caution about the impact of the 2008 crash. Doubtless, its effects took time to work through. The collapse of the Lehman Brothers Bank (the first sign of problems) was in 2006. Arguably, studies conducted shortly after 2008 were less affected by the crash than those reporting later. It is, of course, possible to make other assumptions and take other cutoff points and the data are available for those who wish to do that. Also, it can be argued that the period since 2008 is too short to reveal significant differences in all of the outcomes.

Comparison of our findings and Warner's original findings shows significant improvements in rates of recovery FEP, with more disappointing results for MEP, especially post‐2008. There appears to have been no real improvement in social outcomes for either FEP or MEP. Rates of recovery are lower when a length of recovery criterion is applied, but trends are unaffected. Taken with Warner's, Miettunen's ( Miettunen, 2015 ) and Jääskeläinen's (Jääskeläinen et al.,  2013 ) findings, there may be a consistent decline in annualized recovery rates decade by decade. The research synthesis literature has found no consistent increases in recovery when defined solely by changes in clinical symptoms. As the published data do not permit robust analysis of social or employment outcomes, there is a pressing need, noted by other authors, for improvements in the capture and reporting of clinical and social outcomes. A reduction in methodological heterogeneity of studies would be a major step forward, with adoption of standard definitions of functional recovery and social outcomes. Having said that, we were unable to show that the greater homogeneity produced by using the RSWG standard definition of recovery led to any differences in reported outcomes compared to other definitions.

Our understanding of functional outcomes would be improved if employment outcomes were disaggregated into meaningful categories of type, length, security of employment, and remuneration rates. This is important for the evaluation of social interventions and system‐wide service improvements. Warner would strongly approve of such a development. One could argue on the basis of this and other reviews that a more profitable way forward might be to think in terms of outcome profiles based on several functional and clinical measures rather than conflating them as many definitions of “recovery” do.

To conclude, there is growing recognition that “outcome” is most meaningfully understood in terms of social parameters. A new approach is needed that does not ignore the biological and psychological aspects of psychosis but does place both causation and intervention firmly in their social context. Psychosis is a disorder where onset, course, and outcomes are profoundly affected by social factors. Recovery can only meaningfully be understood as a social phenomenon.

CONFLICT OF INTEREST

None declared

• During the 21st century, the trend of improvement in rates of recovery appears to have continued, irrespective of how recovery is defined.
• Outcomes for first episode psychosis appear to be far better than for multi‐episode psychosis, which may be due to improvements in intervention, social attitudes, both, or neither. The predominance of multi‐episode individuals in annualized recovery rate data may account for the paradoxical deterioration in this parameter.
• Changes in the political economy appear to have an immediate impact in slow improvements in recovery rates, emphasizing the central importance of social factors.

LIMITATIONS

• The studies included are highly heterogenous with respect to definitions of recovery and reporting of outcome parameters. Measures of social recovery tend to be crude or omitted altogether.
• The degree of heterogeneity in the literature precludes meta‐analysis
• All studies included are naturalistic, which improves relevance to clinical practice, but makes interpretation of impact of specific factors more difficult.

PEER REVIEW

The peer review history for this article is available at https://publons.com/publon/10.1002/brb3.2172 .

Supporting information

Supplementary Material A

Supplementary Material B

Supplementary Material C

Huxley P, Krayer A, Poole R, Prendergast L, Aryal S, Warner R. Schizophrenia outcomes in the 21st century: A systematic review . Brain Behav . 2021; 11 :e02172. 10.1002/brb3.2172 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

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Schizophrenia

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Diagnosis and Treatment of the Schizophrenia Essay

Schizophrenia is among many psychiatric disorders that have been identified my medical professionals. It is a disorder which is characterized by hallucinations, loss of reality, improper reasoning as well as poor social and occupation functioning. A person’s emotions are also affected as it is a psychiatric disorder.

Although research has been conducted, the exact cause of the problem is not actually known. However, the available research illustrates that there is enough evidence to suggest that genetics may have a great role to play in the whole issue.

It manifests mostly in the adolescence stage and it affects men and women equally. The prevalence rate of the disease is around 1% in the whole world and despite the fact that its rate is higher among the poor; there is no much difference from one culture to another (Bustillo, 2008). There is a lot of information on schizophrenia and this essay shall narrow down to signs and symptoms as well as to the main methods of treatment. In addition, the essay shall also focus on the roles of a biopsychologist and neuroscientist in the research.

In the View of the fact that schizophrenia is a chronic illness, it progresses in different phases. In many instances, patients seek treatment after experiencing symptoms for a period of one or two years. The first phase is referred as premorbid phase and is characterized by symptoms such as coping difficulties, anhedonia as well as different perception problems. However, it is important to note that in many cases, such symptoms are too mild to be noticed.

The next phase is known as the prodromal phase and is characterized by subclinical symptoms like disorganization, irritability, disorganization and perceptual distortions, to mention just a few. The middle phase is characterized by the same symptoms but they are usually more severe. In the last phase, the disease may stabilize or start all over again (Bustillo, 2008).

Upon diagnosis, there are several ways that can be used to treat the disorder which are inclusive of antipsychotic drugs, rehabilitation and psychotherapy. The main aim of treatment is to reduce not only the symptoms, but also to enable the patient to continue functioning normally.

The antipsychotic drugs are divided in to two categories; conventional antipsychotics and second generation antipsychotics. The second generation antipsychotics are more advantageous in relation to their efficacy and also due to the fact that they contain less adverse effects.

Nonetheless, it is important to note that they are also associated with a greater risk of a metabolic disorder like hypertension and insulin resistance. The choice of drugs depends on patient’s response to drugs, effects and administration requirement. Even the conventional antipsychotics have effects which are inclusive but not limited to, stiffness of the muscles, weight gain and sedation (Bustillo, 2008).

According to American Psychiatric Association (2006), behavioral therapy is very effective in treatment of the disorder especially due to the fact that it is a chronic illness. In this type of a treatment, the disorder is viewed as a problem behavior which may be influenced by environmental factors like the relationships in the family of origin.

Behavioral family therapy is therefore an effective method of treatment and is usually aimed at reducing or eliminating severity of the disorder. This is due to the fact that research has indicated that negative behaviors that are directed to the victims by their family members contribute greatly to the severity of the symptoms. It is therefore clear that if such behaviors can be dealt with, the problem can be solved.

Neuroscientist and biopsychologists are very significant in the research of various psychiatric disorders like the Schizophrenia. Neural scientists conduct research on psychiatric diseases in human beings at either molecular or cellular level.

In addition, they study the neural psychopathology of various diseases and also conduct genetic studies to investigate their interaction with environmental and other factors related to psychiatric disorders. On the other hand, biopsychologist conducts study of the behaviour of the brain in relation to perception, cognition and feelings to name just a few.

Therefore, it is clear that both a neural scientist and a biopsychologist need to work together not only during treatment procedures but also in research. This is due to the fact that it is through research that better methods of treatment are discovered. More research is required on schizophrenia especially due to the fact that the medications available contain a lot of negative effects.

American Psychiatric Association. (2006). American Psychiatric Association practice guidelines for the treatment of psychiatric disorders: Compendium 2006. Washington: American Psychiatric Pub.

Bustillo, J. R. (2008). Schizophrenia . Web.

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IvyPanda. (2018, July 16). Diagnosis and Treatment of the Schizophrenia. https://ivypanda.com/essays/schizophrenia/

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IvyPanda . 2018. "Diagnosis and Treatment of the Schizophrenia." July 16, 2018. https://ivypanda.com/essays/schizophrenia/.

1. IvyPanda . "Diagnosis and Treatment of the Schizophrenia." July 16, 2018. https://ivypanda.com/essays/schizophrenia/.

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IvyPanda . "Diagnosis and Treatment of the Schizophrenia." July 16, 2018. https://ivypanda.com/essays/schizophrenia/.

Investigating Resting-State Functional Connectivity in Children and Adolescents at High Familial Risk for Schizophrenia

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• Affiliation: College of Arts and Sciences, Department of Psychology and Neuroscience
• Schizophrenia is characterized by disruptions in resting-state functional connectivity, which has been proposed to underlie cognitive dysfunction that is prevalent in both individuals with schizophrenia and their first-degree relatives. Specifically, individuals with schizophrenia exhibit altered network organization at whole brain network and hippocampal network levels. The current study investigated whether such abnormalities are present in 76 children and adolescents (aged 9-16 years) with and without familial risk for schizophrenia. I characterized whole brain functional connectivity by employing graph theory metrics of network segregation (i.e., local efficiency, modularity), integration (i.e., global efficiency), and small-worldness. Then, I assessed the modularity of two hippocampal networks (i.e., hippocampal-MTLC and hippocampal-cortical network) that are integral to episodic (day-to-day) memory, as well as the participation coefficient of the hippocampus. I observed that when a pre-defined network structure was assumed, participants at high familial risk for schizophrenia (i.e., high-risk) showed altered levels of modularity than controls at both whole brain and hippocampal-cortical network levels. Higher modularity in hippocampal networks was associated with better episodic memory for control participants. However, these patterns were no longer present when community structures were optimized for each participant. Together, these results imply that while familial risk for schizophrenia may affect the modularity of functional networks, the detection of such effects relies heavily on the methodological approach used to identify functional communities.
• network organization
• schizophrenia
• episodic memory
• familial risk
• https://doi.org/10.17615/2vty-3t70
• Dissertation
• In Copyright - Educational Use Permitted
• Giovanello, Kelly S
• Belger, Ayşenil
• Telzer, Eva H
• Cohen, Jessica R
• Hopfinger, Joseph B
• Doctor of Philosophy
• University of North Carolina at Chapel Hill Graduate School

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Thesis statement for schizophrenia research paper

In addition, they are construed to be negative patient outcomes and negative indicators laper Judy Chen. We use cookies to personalyze your web-site experience. Despite the euphoria over it, a dampening grammarly content writing can be felt in the background. Various triggers of the brain may lead to the occurrence of schizophrenia among the people. Are you thesis statement for schizophrenia research paper resdarch schizophrenia essay? Ok, so i need some help on this schizolhrenia GOAL: Analyze a magazine essay for a thesis statement and organization. Until recently Psychology was thesis statement for schizophrenia research paper accorded the importance it holds in our lives and in some parts of the world the importance of psychology is still largely under-rated. To maintain patient and staff confidentiality required by NMC, a pseudonym shall be used to refer to the patient as Norbert. Starting from 3 hours delivery. Essay On Schizophrenia. It was a happy moment for Cindy, as she had been dreaming of being a mother. Crisis Management Planning Course Work. The antidepressants usually assist in improving the level of goal-directed functions and an increased emotional functionality. It prepares the family unit mentally and physically on what to expect and what the appropriate reaction would be. Her first reported psychotic incident came after the birth of Noah. Studies done have revealed that people who are exposed to viruses during their development have high chances of getting schizophrenia. B Green Hon, at University of Liver pool UK describes some symptoms that is shown in children around the age of 4 to 6 who associated with later schizophrenia is that late walk, speech problems, and preferring to play alone.

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A Q&A with Our Doctoral Graduates

GPH is proud to introduce its largest cohort of doctorates ever, having granted ten PhD degrees last week. After dedicating countless hours of research and field work to become experts on their topic, these scholars are poised for new endeavors that are only the beginning of the impact they will have, and we wish them the best. Scroll below to read a Q & A featuring happy PhD grads who share words of advice, public health aspirations, fun facts and fond memories of their GPH experience.

Gawon Cho, PhD in Social & Behavioral Sciences Advisor: Virginia Chang Dissertation Title: “Work Schedules, Sleep Variability, and Cognition" Dr. Cho continues her research as a postdoctoral associate focusing on sleep and cognition at the Yale School of Medicine.

Q: Think back to your first day as a doctoral student; what advice would you give yourself? A: I wouldn’t give her any advice and let her explore!

Q: If you could solve any public health challenge in the world, what would it be? A: Pathological brain aging.

Q: What skill or characteristic was indispensable as you earned your degree? A: Good writing skills and an analytical mind.

Q: Describe one of your favorite NYU memories. A: Defending while being 36 weeks pregnant.

Q: What's your secret food/beverage/hangout spot in New York City? A: There are a few: Ootoya; Yakitori Totto; Cafe Reggio; 108 Food Dried Hot Pot; Le Baobab; and The Halal Guys!

Margaux Grivel, PhD in Social & Behavioral Sciences Advisor: Lawrence Yang Dissertation Title: "Cognition in UntReated SchizophrEnia (COURSE): A cluster analysis of naturally occurring cognitive subtypes in never-treated individuals with late-stage schizophrenia" Dr. Grivel continues her research in global mental health at GPH and received a University award for an outstanding dissertation.

Q: Think back to your first day as a doctoral student; what advice would you give yourself? A: My advice is twofold: First, leave perfectionism at the door — it won't serve you or your research. Second, keep those self-limiting beliefs in check! Often, the most significant battles we face are within ourselves, so remember to be kind and patient with yourself.

I'd also like to share a valuable piece of wisdom from Dr. Danielle Ompad that resonated deeply with me: "The best dissertation is a done dissertation." This mantra carried me through the final months of my dissertation journey!

Q: If you could solve any public health challenge in the world, what would it be? A: While my dissertation did not focus on stigma, I have been mentored by Dr. Lawrence Yang, renowned stigma expert, for more than eight years. Through my ongoing collaboration with him, I‘ve gained insights into the pervasive nature of stigma and its role as a significant barrier to care. As such, if I could tackle any public health challenge, it would be mental illness stigma, in all its varied forms — internalized, public and structural. Imagine a world where individuals can access appropriate care without hesitation, shame or fear of social repercussions, where health systems are designed and tailored to support and empower individuals facing mental health challenges, and where compassion and understanding are not just the ideal, but the standard?

Q: What skill or characteristic was indispensable as you earned your degree? A: Persistence!

Q: Describe one of your favorite NYU memories. A: I feel most nostalgic about my early days at GPH — days that were spent cooped up in the 12th floor grad student space in the old GPH building, studying with my cohort and fellow GPH peers, and being chronically over-caffeinated. Also, dancing to 'The Fitness Marshall' YouTube videos in Dr. Ompad's Epi classes -- a core NYU memory for sure!

Q: What's your secret food/beverage/hangout spot in New York City? A: These might not be so secret, but my favorite spots are Empanada Mama in Midtown, and Lum Lum on 49th and Ninth — the chicken fried rice is exceptional!

Avni Gupta, PhD in Public Health Policy and Managment Advisor: José Pagán Dissertation Title: "Dental, Vision, and Hearing Supplemental Benefits in Medicare Advantage: Selection Value and Equity." Dr. Gupta continues her work in health care coverage and access as a researcher at The Commonwealth Fund.

Q: Think back to your first day as a doctoral student; what advice would you give yourself? A: Connect with other doctoral students and decide which career path you want to pursue.

Q: If you could solve any public health challenge in the world, what would it be? A: To prevent civilian casualties and being denied access to food, healthcare and homes during wars.

Q: What skill or characteristic was indispensable as you earned your degree? A: Networking, making connections, communication.

Q: Describe one of your favorite NYU memories. A: An outing in Washington Square Park to take a headshot.

Q: What's your secret food/beverage/hangout spot in New York City? A: Dominique Ansel Bakery. It’s not a secret, but I love it!

Vivian Wang, PhD in Public Health Policy and Management Advisor: José Pagán Dissertation Title: "Health-Related Social Needs and Patterns of Health Services Use: A Population Health Perspective with the All of Us Research Program." Dr. Wang continues her social justice work as a consultant “at the crossroads of food and health systems.”

Q: Think back to your first day as a doctoral student; what advice would you give yourself? A: I hardly recall the first day! However, the general principle I lived by was to be open-minded while staying true to my personal values.

Q: If you could solve any public health challenge in the world, what would it be? A: Communication with empathy—at both individual and organizational levels.

Q: What skill or characteristic was indispensable as you earned your degree? A: Appreciating different opinions and approaches to the same public health and health care challenges.

Q: Describe one of your favorite NYU memories. A: Developing friendships of a lifetime.

Q: What's your secret food/beverage/hangout spot in New York City? A: It wouldn't be a secret if I said it out loud ;)

Kelley Akiya, PhD in Public Health Policy and Management Advisor: José Pagán Dissertation Title: "Applications of Trajectory and Transition Modeling Methods to Improve Understanding of Food Insecurity, Health, and Health Care Use Among Low-Income Late Middle Age and Older Adults in the United States." After graduation, Dr. Akiya will begin a postdoctoral fellowship with the Institute for Health Policy Studies at the University of California San Francisco.

Q: Think back to your first day as a doctoral student; what advice would you give yourself? A: Have more fun!

Q: If you could solve any public health challenge in the world, what would it be? A: To achieve health equity. People assume that health disparities are inevitable, but they're a reflection of social and political values. If we changed our values, we could eliminate the problem.

Q: What skill or characteristic was indispensable as you earned your degree? A: Kindness. It's very easy for me to become hyper-focused on my own flaws and failures that I get unmotivated or stuck. Being kind with myself and remembering to connect with others to show them support is one of the best ways to move forward. I owe my success to the moments of kindness from mentors and colleagues and hope to show more kindness to others in the future.

Q: Describe your favorite NYU memory. A: Taking time off in the middle of the day on a weekday to celebrate a fellow student. That's one of those things I could do as a student that was hard to do when I worked a 9-5 job while also being a parent.

Q: What's your favorite food/beverage/hangout spot in New York City? A: Not very secret, but eating, drinking, and hanging-out in Prospect Park near my apartment. Especially during the pandemic, having access to that space was a real refuge.

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