Schizophrenia Bulletin Advance Access published online on January 6, 2009
Schizophrenia Bulletin, doi:10.1093/schbul/sbn171
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Toward a Terminology for Functional Recovery in Schizophrenia: Is Functional Remission a Viable Concept?
2 Emory University School of Medicine, Atlanta, GA
3 Department of Veterans Affairs Veterans Integrated Service Network-5 Mental Illness Research, Education, and Clinical Center, Baltimore, MD
4 Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
1 To whom correspondence should be addressed; tel: 404-727-2707, fax: +1-404-727-3233, e-mail: philipdharvey1{at}cs.com.
Recovery in schizophrenia is receiving increasing attention. Part of the increased focus is based on the recent working criteria for clinical remission in schizophrenia and the realization that many people with schizophrenia meet these criteria for remission. In this article, we consider whether functional disability can also be evaluated in a "remission" model. In so doing, we evaluate the concept of clinical remission, evaluate the possibility of remission of other generally stable features of schizophrenia such as negative symptoms, and make some heuristic terminological recommendations. We also propose a "level and breadth" model for the definition of functional remission and examine some of the alternate influences that could produce suboptimal everyday functioning, including effort, motivation, and societal barriers toward functional achievement.
Keywords: functional disability / recovery / remission