Schizophrenia Prognosis

Oct 10, 2018

There is currently no known cure for schizophrenia and a full recovery from schizophrenia is unusual, with only approximately 15% returning to previous functioning capabilities. However, most individuals with the condition are able to live a meaningful and satisfying life, in the presence or absence of symptoms.

For most patients, the symptoms tend to change over time and the impact they have on the life and daily activities of each individual may vary significantly. In general, women patients are more likely than men to maintain improvement of symptoms.

John Nash, a US mathematician, began showing signs of paranoid schizophrenia during his college years. Despite having stopped taking his prescribed medication, Nash continued his studies and was awarded the Nobel Prize in 1994. His life was depicted in the 2001 film A Beautiful Mind.

Mortality Rates

Patients with schizophrenia are subjected to a slightly higher rate of mortality, which is 1.6 times higher than that of the general population. This is primarily linked to increased risk of cardiovascular disease, respiratory disease and cancer.

Suicide also plays a major role and suicide by patients with schizophrenia are nine times more likely than people that are not affected by the condition. The lifetime risk of suicide for patients is 5%.

Impact of Medical Management

Treatments are available that can help to reduce the symptoms of schizophrenia and decrease the number and duration of psychotic episodes. These are able to help most patients to live productive and satisfying lives.

Management of schizophrenia includes a combination of pharmaceutical treatment and counseling. Adequate control of the disorder with these methods has led to the majority of patients improving symptoms to be able to function independently, ten years following diagnosis. Some patients continue to require a strong support network, however, and approximately 15% remain in a hospitalized environment.

Positive symptoms tend to respond better to antipsychotic medication than negative symptoms, which are more persistent. For this reason, patients with fewer negative symptoms tend to have a better prognosis and medication is more effective at helping them to live normal lives.

Factors for Poor Prognosis

There are some particular factors that are associated with a poorer prognosis. These include:

Early onset of illness
Male
Strong negative symptoms
Family history of schizophrenia
Structural brain abnormalities
Prominent cognitive symptoms
Cigarette smoking
Poor nutrition
Sedentary lifestyle
Inadequate medical care
Poor support system
History of substance abuse

The prevalence of substance misuse among individuals with schizophrenia is much higher than the general population, with 36% of patients reporting a problem. Patients the use recreational drugs or smoke cigarettes have a poorer prognosis due to the effect of these substances on brain pathways and mental function.

Factors for Good Prognosis

There are some particular factors that are associated with a better prognosis. These include:

No family history of schizophrenia
Stable personality and relationships prior to diagnosis
Acute onset
Older age at onset
Prompt treatment
Motivation and initiative
Female
Fewer negative symptoms
Good support system

Additional Factors

Many patients with schizophrenia, particularly those with an insufficient support system, have difficulty coping in society and securing employment. For this reason, they often need to deal with the burden of poverty in addition to the medical symptoms. This can subsequently lead to limited medical care access and poor control of the disease.

It is essential that schizophrenic patients be offered adequate support and counseling to help them to integrate into society. With the appropriate management, most patients can improve significantly and many can become entirely independent when they have learned how to manage their symptoms.