Rejecting Illness as Chronic Contributes to Better Outcomes


Swiss researchers investigated the paradox that both low and high levels of “insight” are a risk factor for poor outcomes such as depression, hopelessness, and lowered quality of life. They found, in a sample of 142 schizophrenia or schizoaffective disordered outpatients, that the perception of their illness as chronic and disabling was associated with depressive symptoms and demoralization, while a positive attitude toward recovery contributed to symptom reduction, functional improvement, and subjective well-being. Their recommendations will appear in an upcoming Journal of Clinical Psychology.

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. It is pure common sense. A person who gets brainwashed into believing that there is no recovery possible and no hope for a decent future,will become depressed. Also I wonder: do psychiatrist have really insight into their patients’illness since they usually don’t bother to look for the rootcause of the problem. They blindly jump to conclusions and thus mislead their patients by diagnosing them with a lifelong illness which might not be the case at all.

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