Bellack Alan S
VISN 5 Mental Illness REsearch, Education, and Clinical Center, and University of Maryland School of Medicine, USA.
Schizophr Bull. 2006 Jul;32(3):432-42. doi: 10.1093/schbul/sbj044. Epub 2006 Feb 3.
Schizophrenia has traditionally been viewed as a chronic condition with a very pessimistic outlook, but that assumption may not be valid. There has been a growing consumer movement among people with schizophrenia that has challenged both the traditional perspective on the course of illness and the associated assumptions about the possibility of people with the illness living a productive and satisfying life. This new conception of the illness is supported by long-term studies that suggest that as much as 50% of people with the illness have good outcomes. There has also been a change in political and public health perspectives of the illness, stimulated in part by the President's New Freedom Commission on Mental Health. The purpose of this article is to provide an overview of some key themes about the recovery concept, as applied to schizophrenia. The article will address 3 questions: (1) What is recovery? (2) Is recovery possible? and (3) What are the implications of a recovery model for a scientific approach to treatment (ie, the use of evidence-based practices)? Scientific and consumer models of recovery are described, and commonalities and differences are discussed. Priorities for future research are suggested.
传统上,精神分裂症一直被视为一种预后非常悲观的慢性疾病,但这种假设可能并不成立。在精神分裂症患者中,一场日益壮大的消费者运动对关于疾病进程的传统观点以及有关该疾病患者过上充实且满足生活可能性的相关假设都提出了挑战。这种对疾病的新观念得到了长期研究的支持,这些研究表明,多达50%的患者预后良好。疾病的政治和公共卫生观念也发生了变化,这在一定程度上受到总统心理健康新自由委员会的推动。本文旨在概述一些适用于精神分裂症的康复概念的关键主题。文章将探讨三个问题:(1)什么是康复?(2)康复是否可能?以及(3)康复模式对科学治疗方法(即基于证据的实践的应用)有何影响?文中描述了科学和消费者的康复模式,并讨论了它们的异同。还提出了未来研究的重点。