Assessing recovery from schizophrenia as an individual process. A review of self-report instruments

Abstract

Objective: Studies investigating indicators of recovery from schizophrenia yielded two concepts of recovery. The first is the reduction of psychiatric symptoms and functional disabilities ('clinical recovery'), while the second describes the individual adaptation process to the threat posed to the individual sense of self by the disorder and its negative consequences ('personal recovery'). Evidence suggests that both perceptions contribute substantially to the understanding of recovery and require specific assessment and therapy. While current reviews of measures of clinical recovery exist, measures of personal recovery have yet to be investigated. Considering the steadily growing literature on recovery, this article gives an update about existing measures assessing personal recovery.

Method: A literature search for instruments was performed using Medline, Embase, PsycINFO&PSYNDEXPlus, ISI Web of Knowledge, and Cochrane Library. Inclusion criteria were: (1) quantitative self-report measures; (2) specifically developed for adults with schizophrenia or schizoaffective disorder or at least applied to individuals suffering from severe mental illness; (3) empirically tested psychometric properties and/or published in a peer-reviewed, English-language journal. Instruments were evaluated with regard to psychometric properties (validity and reliability) and issues of application (user and administrator friendliness, translations).

Results: Thirteen instruments met the inclusion criteria. They were individually described and finally summarized in a table reflecting the pros and cons of each instrument. This may enable the reader to make an evidence-based choice for a questionnaire for a specific application.

Conclusion: The Recovery Assessment Scale is possibly the best currently available measure of personal recovery when all evaluation criteria are included. However, the ratings listed in the current paper depended on the availability of information and the quality of available reports of previous assessment of the measurement properties. Considering the significant amount of information lacking and inconsistent findings, further research on the reviewed measures is perhaps more important than the development of new measures of personal recovery.