Do we Need to Review Outcome Measures in Schizophrenia to Capture ‘Real-life’ Situation? [PW02-05]

Abstract

Introduction:

Outcome measures in schizophrenia are defining aspects for deciding the status of recovery based upon which people’ scientific body forms opinions. It is also important in dealing with stigma related to schizophrenia. Recently the concept of ‘recovery’ and’ outcome’ has come under scientific scrutiny. Literature does not show a consistent pattern in outcome. Both short term and long-term outcome show variability, which is often, explained by cultural factors. It has been generally considered that devolved countries have poor outcome than developing, non-industrialized countries. This view has also been challenged recently. The paper draws from the conceptual aspects if our outcome measure are capturing ‘real-life’ situation. We conducted two studies in Mumbai, India:

1. 1. Study of stigma & discrimination, which brought out the facts of families’ expectation and disappointments with level of recovery.

2. 2. A 10 years long term study, to determine recovery status of recovered patients.

80% patients and families felt that recovery is inadequate and short of social integration despite continued treatment in stigma study. In outcome study, 60% patients showed good recovery as per CGIS. These patients were reassessed on 13 outcome criteria's of Meltzer. It is observed tat half of the patients who recovered continue to live with symptoms, a quarter with varying suicidality and side effects, most of the patients were not socially integrated, majority have not returned to productivity, employment and education It is concluded that outcome criteria's need a thoughtful revision and a new perspective to capture ground reality.