Symptom Remission Does Not Equal Recovery


Researchers in the Netherlands and the U.K. explored the relationship between symptom reduction in schizophrenia (according to Andreason’s 2005 criteria for remission) and social function in daily life. They found that of 177 patients, 70 met criteria for symptomatic remission, but that remission was not related to functional recovery. The results appeared online in the British Journal of Psychiatry June 28, 2012.

Abstract → 

Oorschot, M., Lataster, T., et al; “Symptomatic remission in psychosis and real-life functioning,” British Journal of Psychiatry, online June 28, 2012

Note from Kermit Cole, “In the News” editor:
Jim van Os, along with Inez Myin-Germeys, two of the authors of the study, have a long and credible history in the research on the continuum of stress, psychosis, and schizophrenia. According to Wikipediak “In 2009, van Os proposed abolishing the diagnosis of schizophrenia due to lack of validity, and introduced a new syndromal definition, “salience syndrome”, citing previous work by other researchers that explains psychosis as aberrant salience regulation.”

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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. This is an excellent point often overlooked by “professionals” and some family members. Often, there’s such a desparation for the individual to be “better” even a “little bit better” that the sedating effects of many psychiatric meds, which seem to tamp down “symptoms”, are heralded. Finally, my loved one (or patient) is on the right track. Unfortunately, so-called symptom remission is as far as the drugs typically take folks. In fact many studies reported here on MIA have shown that long term use of psychiatric drugs actually worsen recovery (Harrow).

    How can we bring about that “relief” without the use of drugs?

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  2. Well, my take on it is that these so-called “symptoms” of “mental illness” are altogether reactions to life. Pretty meaningful, and pretty healthy. But unfortunately very much misunderstood, both by the person in crisis herself, and everybody else. What you don’t understand, you risk to get overwhelmed by. Come to an understanding of it, and it won’t overwhelm you anymore.

    The biggest problem with the research in the field is that it, ignorant of its own misunderstanding, focusses almost exclusively on “symptom reduction”. While it should focus on misunderstanding reduction — maybe its own first and foremost — instead.

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  3. Of course, once the symptoms have gone there is still a long way to recovery. You have to recover your physical fitness for a start, taken away by the meds; your concentration is not what it used to be either because of those meds. You have to deal with the problems that caused your breakdown as well as come to terms with what happened to you when you asked for help. It takes months, even years after you have stopped the meds. You don’t trust anyone anymore and your confidence has been shot to pieces.

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