Improving patient outcomes in schizophrenia: achieving remission, preventing relapse, and measuring success

Too many patients with schizophrenia do not achieve the ultimate goal of treatment-recovery. The first step to recovery is achieving response to treatment for the acute psychotic episode. Clinicians should routinely use rating scales to measure treatment response. The next phase is remission of symptoms, which is one of the criteria for recovery. Relapses, however, can disrupt remission and hinder recovery by causing rehospitalization, treatment resistance, and loss of gains in function. Medication adherence plays a major role in preventing relapses so that patients can maintain remission and work toward recovery. Clinicians should educate patients about adherence and consider treatment options that will improve adherence. Recovery is attained when patients experience symptom remission, vocational role fulfillment, independent living, and social relationships for at least 2 years. The proportion of patients who reach recovery can be increased when clinicians focus on treatment adherence, consistent symptom measurement, and appropriate treatment plans tailored to each patient.