Recovery and Recovering in Older Adults with Schizophrenia: A 5-Tier Model.

Abstract

Rationale: There are little recent data on clinical recovery in older adults with schizophrenia. This exploratory study uses an empirically measurable construct to address this issue.

Methods: From an original sample of 248 community-dwelling persons aged 55 and over with early-onset schizophrenia spectrum disorder, a subsample of 102 persons was reassessed at a mean of 52 months. Clinical recovery required meeting criteria for its two components: clinical remission and community integration.

Results: Prospective analysis generated a 5-tier taxonomy of recovery in which 12% remained persistently in clinical recovery at both baseline and follow-up (Tier 1) and 18% never met criteria of clinical recovery (Tier 5). The remaining 70% exhibited a variety of components of clinical recovery at baseline and follow-up (Tiers 2, 3, and 4).

Conclusion: The findings generated a dynamic picture of recovery, with most persons being in varying states of "recovering." The 5-tier taxonomy of recovery adumbrated potential treatment strategies for each tier.

Keywords: Recovery; community integration; elderly; older adults; outcome; remission; schizophrenia.