Recovery and Recovering in Older Adults with Schizophrenia: A 5-Tier Model

Am J Geriatr Psychiatry. 2020 Aug;28(8):872-875. doi: 10.1016/j.jagp.2020.03.008. Epub 2020 Apr 2.

Abstract

Rationale: There are little recent data on clinical recovery in older adults with schizophrenia. This exploratory study uses an empirically measurable construct to address this issue.

Methods: From an original sample of 248 community-dwelling persons aged 55 and over with early-onset schizophrenia spectrum disorder, a subsample of 102 persons was reassessed at a mean of 52 months. Clinical recovery required meeting criteria for its two components: clinical remission and community integration.

Results: Prospective analysis generated a 5-tier taxonomy of recovery in which 12% remained persistently in clinical recovery at both baseline and follow-up (Tier 1) and 18% never met criteria of clinical recovery (Tier 5). The remaining 70% exhibited a variety of components of clinical recovery at baseline and follow-up (Tiers 2, 3, and 4).

Conclusion: The findings generated a dynamic picture of recovery, with most persons being in varying states of "recovering." The 5-tier taxonomy of recovery adumbrated potential treatment strategies for each tier.

Keywords: Recovery; community integration; elderly; older adults; outcome; remission; schizophrenia.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Age of Onset
  • Aged
  • Aging / psychology*
  • Community Integration / psychology*
  • Female
  • Humans
  • Independent Living* / psychology
  • Independent Living* / statistics & numerical data
  • Male
  • Outcome and Process Assessment, Health Care / methods
  • Recovery of Function
  • Remission Induction / methods*
  • Schizophrenia* / epidemiology
  • Schizophrenia* / rehabilitation
  • Schizophrenia* / therapy
  • Schizophrenic Psychology*