In World Psychiatry, two Canadian psychiatrists argue that the body of scientific evidence about schizophrenia shows that it is not a progressive illness and therefore we should have much higher expectations of full recoveries than we do.
“Despite the introduction of effective pharmacological treatments and evidence-based psychosocial interventions, fewer than one in seven people affected are considered to meet criteria for recovery,” the authors write. “The possibility that the pathophysiology of schizophrenia involves mechanisms that progress over the longitudinal course of the illness is often assumed to explain the poor outcomes observed. Advocates for early intervention have embraced this paradigm… While progression of an active disease process would provide a compelling explanation for the poor outcomes so commonly observed, it is not consistent with what we have learned from modern studies of the longitudinal course of structural brain abnormalities, cognitive deficits and clinical outcomes associated with schizophrenia.”
Zipursky, Robert B., and Ofer Agid. “Recovery, Not Progressive Deterioration, Should Be the Expectation in Schizophrenia.” World Psychiatry 14, no. 1 (February 1, 2015): 94–96. doi:10.1002/wps.20194. (Full text)