Outcome, recovery and return to work in severe mental illnesses

The assessment of outcomes of severe mental illnesses has become recently an important line of research in psychiatry, leading to distinguish different levels of outcomes and a diversity of underlying factors. The focus has shifted from a traditional medical notion of 'disease outcome' to a wider notion of 'functional outcome', and even to an inquiry about the fate of the person and its determinants. Recovery, rather than cure or remission, is regarded as the good outcome, with its own underlying factors. Return to work, as a vocational outcome, represents in research one of the good functional outcomes. It is generally understood as a sign of social recovery. But may work be regarded as a good outcome in its broader sense, i.e. as a means of full recovery? Several theoretical and empirical arguments are in favor of considering work as a privileged way toward recovery, but this does not mean it is the only way.