The prognosis of schizophrenia varies at the individual level. In general has a large human and economic costs. This results in a declining life expectancy of 12-15 years mainly due to its association with obesity, a bit of exercise, and smoking, while an increased suicide rate plays a lower role. These differences in life expectancy have increased between the 1970s and 1990s, and between the 1990s and 2000s did not change substantially in health systems with open access to care (Finland).
Schizophrenia is a major cause of disability. About three-quarters of people with schizophrenia have sustained disability with relapse. But some people actually recover and the extra numbers work well in the community.
Most people with schizophrenia live independently with community support. In people with the first episode of psychosis, good long-term outcomes occurred in 42% of cases, intermediate outcomes in 35% of cases, and poor outcomes in 27% of cases. The results for schizophrenia appear to be better in developing countries than in developed countries. But this conclusion has been questioned.
There is a suicide rate that is higher than the average associated with schizophrenia. This has been cited at 10%, but newer analyzes of studies and statistics place estimates at 4.9%, most commonly in the period after the onset or admission of the first hospital. Several times more attempted suicide. There are various reasons and risk factors.
Video Prognosis of schizophrenia
Course
After long-term follow-up, half of people with schizophrenia had a favorable outcome while 16% experienced delayed recovery after an unrelenting recovery. More typically, courses in the first two years predict long-term courses. Early social intervention is also associated with better outcomes. The findings were considered important in moving patients, careers and doctors away from the general beliefs of chronic conditions.
However, these outcomes are on average worse than psychotic disorders and other psychiatric disorders although a small number of people with schizophrenia appear to let go and stay healthy, some without the need for maintenance maintenance.
A clinical study using strict recovery criteria (simultaneous reduction of both positive and negative symptoms and vocational and social functions for two years) found a recovery rate of 14% within the first five years. A 5-year community study found that 62% showed an overall improvement in the combined measures of clinical and functional outcomes.
Maps Prognosis of schizophrenia
Specify recovery
Prices are not always comparable throughout the study because the exact definition of remission and recovery has not been widely established. A "Remission in the Schizophrenia Working Group" has proposed a standard remission criterion that involves "improvement in core signs and symptoms to the extent that any remaining symptom has a low intensity so that they no longer interfere significantly with behavior and fall below that threshold usually used in justifying the initial diagnosis of schizophrenia ".
The standard recovery criteria have also been proposed by a number of different researchers, with the DSM definition stated that "complete return to premorbid function level" or "full refund to full function" is considered inadequate, unlikely to be measured, inconsistent with variability. in how society defines normal psychosocial functioning, and contributes to self-satisfying pessimism and stigma. Some mental health experts may have very different perceptions and concepts of recovery than individuals with diagnoses, including those in the movement of survivors of psychiatric disorders.
One of the major limitations of almost all of the research criteria is the failure to respond to the evaluation and the person's own feelings about their lives. Schizophrenia and recovery often involve loss of self-esteem, alienation from friends and family, school and career disturbances, and social stigma, "an experience that can not be reversed or forgotten". An increasingly influential model defines recovery as a process, similar to "recovery" from drug and alcohol problems, and emphasizes personal travel involving factors such as expectations, choices, empowerment, social inclusion, and achievement.
Predictors
Several factors have been associated with better overall prognosis: Being symptom-onset of women, rapid (vs. insidious), older than the first episode, especially positive (non-negative) symptoms, mood symptoms, and good pre-disease function.. The internal strengths and internal resources of the individual, such as psychological resolve or resilience, are also associated with a better prognosis.
The attitude and level of support from people in the life of an individual can have a significant impact; research framed in terms of these negative aspects - the level of critical comments, hostility, and disruptive or controlling attitudes, termed 'high expressed emotions' - consistently indicates the association with recurrence. Most of the research on predictive factors is correlational, and clear causal relationships are often difficult to determine.
Violence
The relationship between acts of violence and schizophrenia is a controversial topic. Current research shows that the percentage of people with schizophrenia who commit acts of violence is higher than the percentage of people without interruption, but lower than that found for disorders such as alcoholism, and the difference is reduced or not found in the same environmental comparison when related factors are taken into account, especially variables sociodemography and substance abuse. Studies have shown that 5% to 10% of those accused of murder in Western countries have a schizophrenic spectrum disorder.
The occurrence of psychosis in schizophrenia is sometimes associated with a higher risk of acts of violence. Findings about the specific role of delusions or hallucinations are inconsistent, but focus on delusional jealousies, threat perceptions and command hallucinations. It has been suggested that certain types of individuals with schizophrenia are likely to be offensive, characterized by a history of educational difficulty, low IQ, behavioral disorders, early onset of abuse of substances and offensive prior to diagnosis.
Individuals with a diagnosis of schizophrenia are often the victims of violent crime - at least 14 times more often than they are perpetrators. Another consistent finding is the association with substance abuse, particularly alcohol, among the violent minorities. Violence by or against individuals with schizophrenia usually occurs in the context of complex social interactions in family settings, and is also a problem in clinical services and in the wider community.
International
A number of international studies have shown favorable long-term outcomes for about half of those diagnosed with schizophrenia, with substantial variation between individuals and regions. One retrospective study found that about a third of people experienced full recovery, about one-third showed improvement but not full recovery, and one-third remained ill.
A clinical study using strict recovery criteria (simultaneous reduction of both positive and negative symptoms and vocational and social functions for two years) found a recovery rate of 14% within the first five years. A 5-year community study found that 62% showed overall improvement in combined measures of symptoms, clinical and functional outcomes. Prices are not always comparable in studies because the precise definition of what constitutes a recovery has not been widely accepted, although standard criteria have been suggested.
The World Health Organization is conducting two long-term follow-up studies involving more than 2,000 people suffering from schizophrenia in various countries. These studies find patients have far better long-term outcomes in developing countries (India, Colombia and Nigeria) than in developed countries (USA, UK, Ireland, Denmark, Czech Republic, Slovakia, Japan and Russia), regardless of the fact that antipsychotic drugs are not usually widely available in poor countries, raises the question of the effectiveness of drug-based care.
In many non-Western societies, schizophrenia can only be treated with more informal and community-led methods. Several international surveys by the World Health Organization for decades show that results for people diagnosed with schizophrenia in non-Western countries are on average better than those in the West. Many physicians and researchers hypothesize that this difference is due to relative levels of relative and social acceptability, although cross-cultural studies further seek to clarify the findings.
Several factors are associated with better prognosis: female gender, onset of acute symptoms, older onset, older age of first episode, dominant (not negative) symptoms, good mood and premorbid function. Much of the research done on this subject, however, is correlational, and a clear causal relationship is difficult to establish. The evidence is also consistent that negative attitudes toward individuals with schizophrenia can have a significant negative impact, especially in individual families. Critical, hostile, authoritarian, and intrusive comments or controlling family attitudes (called high 'expressing emotions' or 'EEs' by researchers) are found to correlate with a higher risk of recurrence in cross-cultural schizophrenia.
Aging
The prevalence of schizophrenia in adults aged 65 and older ranges from 0.1 to 0.5%. Aging is associated with exacerbation of schizophrenia symptoms. Positive symptoms tend to decrease with age, but negative symptoms and cognitive impairment continue to worsen.
Older adults with schizophrenia are susceptible to extrapyramidal side effects, anticholinergic toxicity, and sedation due to increased body fat, decreased total body water, and decreased muscle mass. Older adults with slow-onset schizophrenia usually take half of the common dose for older adults with early-onset schizophrenia. Continuous drug treatment is common for older adults with schizophrenia and the dose may increase with age.
There seems to be a gender difference regarding the impact of aging on schizophrenia. Men with schizophrenia tend to have more severe symptoms in the early stages of the disorder, but gradually increase with age. However, women with schizophrenia tend to have milder symptoms initially, and develop into more severe symptoms as they get older.
The low probability of getting married and most likely to live longer than parents and/or siblings can lead to social isolation as one age.
References
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