Overlap and Mutual Distinctions Between Clinical Recovery and Personal Recovery in People With Schizophrenia in a One-Year Study
Julien Dubreucq, Franck Gabayet, Ophélia Godin, Myrtille André, Bruno Aouizerate, Delphine Capdevielle, Isabelle Chéreau, Julie Clauss-Kobayashi, Nathalie Coulon, Thierry d’Amato, Jean‐Michel Dorey, Caroline Dubertret, Mégane Faraldo, H. Laouamri, Sylvain Leigner, Christophe Lançon, Marion Leboyer, Pierre‐Michel Llorca, Jasmina Mallet, D. Misdrahi, Christine Passerieux, Romain Rey, Baptiste Pignon, Benoît Schorr, Mathieu Urbach, Franck Schürhoff, Andreı̈ Szöke, Fabrice Berna, Émmanuel Haffen, M Leboyer, P M Llorca, F Schürhoff, V. Barteau, S Bensalem, Ophélia Godin, H. Laouamri, K. Souryis, M Leboyer, Baptiste Pignon, F Schürhoff, J. Petrucci, G Wahiche, Erika Bourguignon, Andreı̈ Szöke, Bruno Aouizerate, A. Deloge, D. Misdrahi, E Vilà, O. Blanc, Isabelle Chéreau, H. Denizot, R M Honciuc, Denis Lacelle, P M Llorca, Sara Xavier Pires, Caroline Dubertret, Jasmina Mallet, C. Portalier, Nathalie Coulon, Mégane Faraldo, Franck Gabayet, S Leignier, Carlos R. Detrés Román, G. Chesnoy-Servanin, Thierry d’Amato, Jean‐Michel Dorey, Romain Rey, A. Vehier, Christophe Lançon, C Faget, E. Metairie, P Peri, F. Vaillant, Laurent Boyer, Guillaume Fond, Fabrice Berna, Pierre Vidailhet, A. Zinetti-Bertschy, Delphine Capdevielle, M. André, Tanja Maria Michel, A Garbisson, Cristobal Belmonte, Thomas Dubois, Stéphanie Esselin, M. Jarroir, Christine Passerieux, Mathieu Urbach, Guillaume Fond, Fabrice Berna
Abstract
Recovery is a multidimensional construct that can be defined either from a clinical perspective or from a consumer-focused one, as a self-broadening process aimed at living a meaningful life beyond mental illness. We aimed to longitudinally examine the overlap and mutual distinctions between clinical and personal recovery. Of 1239 people with schizophrenia consecutively recruited from the FondaMental Advanced Centers of Expertise for SZ network, the 507 present at one-year did not differ from those lost to follow-up. Clinical recovery was defined as the combination of clinical remission and functional remission. Personal recovery was defined as being in the rebuilding or in the growth stage of the Stages of Recovery Instrument (STORI). Full recovery was defined as the combination of clinical recovery and personal recovery. First, we examined the factors at baseline associated with each aspect of recovery. Then, we conducted multivariable models on the correlates of stable clinical recovery, stable personal recovery, and stable full recovery after one year. At baseline, clinical recovery and personal recovery were characterized by distinct patterns of outcome (i.e. better objective outcomes but no difference in subjective outcomes for clinical recovery, the opposite pattern for personal recovery, and better overall outcomes for full recovery). We found that clinical recovery and personal recovery predicted each other over time (baseline personal recovery for stable clinical recovery at one year; P = .026, OR = 4.94 [1.30-23.0]; baseline clinical recovery for stable personal recovery at one year; P = .016, OR = 3.64 [1.31-11.2]). In short, given the interaction but also the degree of difference between clinical recovery and personal recovery, psychosocial treatment should target, beyond clinical recovery, subjective aspects such as personal recovery and depression to reach full recovery.