Torgalsbøen Anne-Kari, Mohn Christine, Larøi Frank, Czajkowski Nikolai
Department of Psychology University of Oslo, Oslo, Norway.
National Centre for Suicide Prevention and Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Front Psychiatry. 2025 Jun 16;16:1588349. doi: 10.3389/fpsyt.2025.1588349. eCollection 2025.
Research on clinical recovery rates in first-episode schizophrenia has yielded inconsistent results due to varying definitions of recovery and methodological differences. The longitudinal trajectory of recovery-whether rates improve, decline, or remain stable-remains unclear. Schizophrenia significantly impacts young lives, making it crucial to examine self-efficacy, the belief in one's ability to manage adversity, and its relationship with clinical recovery.
The Oslo Schizophrenia Recovery study`s repeated assessment design, including twelve clinical evaluations over ten years, is ideal for studying longitudinal recovery. Self-efficacy was measured using the General Perceived Self-Efficacy scale, with data analyzed through linear multilevel models. Twenty-eight well-defined first-episode schizophrenia patients were assessed yearly, using a strict recovery definition (two years of full symptom remission and adequate social/role functioning), with 79% of patients retained from baseline.
Recovery rates improved and remained stable, suggesting better outcomes than previously reported. Of the participants, 50% achieved clinical recovery. Recovered individuals showed a sharp increase in self-efficacy within the first year, while non-recovered patients exhibited gradual improvement. The interaction between recovery status and time revealed distinct self-efficacy trajectories, particularly in the first post-onset year.
A significant proportion of first-episode schizophrenia patients can achieve clinical recovery. While these positive outcomes are noteworthy, it is important to recognize that recovery paths can vary widely among individuals. Since people with schizophrenia are concerned about their chances of recovery, the results must be shared with patients and their families. While the causal relationship between self-efficacy and recovery remains unclear, they likely influence each other.
由于康复定义的不同和方法学上的差异，关于首发精神分裂症临床康复率的研究结果并不一致。康复的纵向轨迹——即康复率是提高、下降还是保持稳定——仍不明确。精神分裂症对年轻人的生活有重大影响，因此研究自我效能感（即相信自己有能力应对逆境）及其与临床康复的关系至关重要。
奥斯陆精神分裂症康复研究的重复评估设计，包括在十年内进行十二次临床评估，非常适合研究纵向康复情况。使用一般自我效能感量表测量自我效能感，并通过线性多级模型分析数据。对28名明确诊断的首发精神分裂症患者进行年度评估，采用严格的康复定义（两年完全症状缓解且社会/角色功能良好），79%的患者从基线开始被保留。
康复率有所提高并保持稳定，表明结果比先前报道的更好。在参与者中，50%实现了临床康复。康复个体在第一年自我效能感急剧上升，而未康复患者则逐渐改善。康复状态与时间之间的相互作用显示出不同的自我效能感轨迹，尤其是在发病后的第一年。
相当比例的首发精神分裂症患者可以实现临床康复。虽然这些积极结果值得注意，但重要的是要认识到康复路径在个体之间可能有很大差异。由于精神分裂症患者关心自己的康复机会，必须将结果告知患者及其家属。虽然自我效能感与康复之间的因果关系尚不清楚，但它们可能相互影响。
