Prognosis of schizophrenia
[1] It results in a decreased life expectancy of 12–15 years primarily due to its association with obesity, little exercise, and smoking, while an increased rate of suicide plays a lesser role.
This has been cited at 10%, but a more recent analysis of studies and statistics places the estimate at 4.9%, most often occurring in the period following onset or first hospital admission.
The findings were held as important in moving patients, careers and clinicians away from the prevalent belief of the chronic nature of the condition.
[15] This outcome on average however is worse than for other psychotic and otherwise psychiatric disorders though a moderate number of people with schizophrenia were seen to remit and remain well, some of these without need for maintenance medication.
[23] The low likelihood of being married and high possibility of outliving their parents and/or siblings may lead to social isolation as one ages.
[26][27] Numerous international studies have demonstrated favorable long-term outcomes for around half of those diagnosed with schizophrenia, with substantial variation between individuals and regions.
[17] A five-year community study found that 62% showed overall improvement on a composite measure of symptomatic, clinical and functional outcomes.
[30] Rates are not always comparable across studies because an exact definition of what constitutes recovery has not been widely accepted, although standardized criteria have been suggested.
[31] The World Health Organization conducted two long-term follow-up studies involving more than 2,000 people with schizophrenia in different countries.
[34] Many clinicians and researchers hypothesize that this difference is due to relative levels of social connectedness and acceptance,[35] although further cross-cultural studies are seeking to clarify the findings.
Family members' critical comments, hostility, authoritarian and intrusive or controlling attitudes (termed high 'expressed emotion' or 'EE' by researchers) have been found to correlate with a higher risk of relapse in schizophrenia across cultures.
A "Remission in Schizophrenia Working Group" has proposed standardized remission criteria involving "improvements in core signs and symptoms to the extent that any remaining symptoms are of such low intensity that they no longer interfere significantly with behavior and are below the threshold typically utilized in justifying an initial diagnosis of schizophrenia".
[40] Some mental health professionals may have quite different basic perceptions and concepts of recovery than individuals with the diagnosis, including those in the Psychiatric survivors movement.
Schizophrenia and recovery often involve a continuing loss of self-esteem, alienation from friends and family, interruption of school and career, and social stigma, "experiences that cannot just be reversed or forgotten".
[42] While there is no cure for schizophrenia, there are treatment options that aim to reduce symptoms and teach those affected how to manage their day-to-day lives.
[43] With atypical antipsychotics, tremors are often reported as a common side effect because dopamine is involved in processing movement related neurons.
[49][50] Poor cognitive functioning, decision-making, and facial perception may contribute to making a wrong judgement of a situation that could result in an inappropriate response such as violence.
Homicide is linked with young age, male sex, a history of violence, and a stressful event in the preceding year.
[55] What role schizophrenia has on violence independent of substance misuse is controversial, but certain aspects of individual histories or mental states may be factors.
When this impulsive-aggression is evident in schizophrenia neuroimaging has suggested the malfunctioning of a neural circuit that modulates hostile thoughts and behaviours that are linked with negative emotions in social interactions.
