Social Outcome in Clinically Recovered First-Episode Schizophrenia in a Naturalistic, Ten-Year, Follow-Up Study in IndiaAuthor(s): Amresh Shrivastava , Megan Johnston , Meghana Thakar , Larry Stitt , Nilesh Shah
Background: Remission of symptoms and clinical outcome seldom capture real-life outcome in schizophrenia. Measurement of social outcome provides a culturally meaningful indicator of how a patient is performing his or her role after recovery. The present study examined the status of social outcome on multidimensional parameters in a cohort of clinically recovered patients in a ten-year, long-term study of first-episode schizophrenia. Methods: First-episode hospitalized patients were recruited for a long-term outcome study. At the ten-year end point, those patients who showed good clinical outcome were assessed on culture-specific parameters of social outcome to find out the true nature of recovery in schizophrenia. Results: Sixty-one recovered patients showed differential outcome on various social parameters after ten years. Overall, 52.5% of patients showed good social recovery on all four social parameters. We found that 19 subjects (31.1%) were functioning socially satisfactorily, 10 subjects (16.4%) were productive in day-today life, 29 (48.3%) were economically independent, and 11 (18.3%) were satisfied with their education and new skills. Conclusions: This study shows that not all patients who show clinical recovery have also improved in social functions on socially relevant parameters. Half of the patients continued to have limitations in the areas of social function (the ability to earn a sufficient income and conform to the expected social role). Social parameters need to be considered in everyday practice when defining outcome status.