Redefining outcome measures in schizophrenia: integrating social and clinical parameters.
OBJECTIVE
Schizophrenia is a complex neurobehavioral disorder for which there are many promising new treatments. There is, however, a discrepancy in outcome measure reports when they are obtained from patients, relatives, caregivers, or professionals, making it difficult to determine the level of recovery. This lack of agreement may result from limitations of the measurement tools themselves, which are not comprehensive and may be measuring different aspects of outcome. Alternatively, it could be that the conceptual understanding of outcome and recovery require development.


RESULTS
For various reasons, patients assessed as 'recovered' remain excluded from mainstream society. We are of the opinion that present outcome measures do not capture real-life situations. We propose that the concept of recovery be carefully defined and the gold standard of outcome should incorporate social and clinical parameters. We attempt to redefine recovery. Patients who have shown clinical improvement do not necessarily do well in everyday situations even though there is obvious clinical improvement. Therefore, it has been repeatedly argued that a consensus of recovery should be determined and that routine clinical practice should then adapt to the agreed criteria.


CONCLUSIONS
We argue that the outcome measures should be multidimensional and consist of at least two parameters: clinical remission and social outcome.
Shrivastava
Amresh
A
Department of Psychiatry, University of Western Ontario, Regional Mental Healthcare, St. Thomas, Canada. amresh.edu@gmail.com
Johnston
Megan
M
Shah
Nilesh
N
Bureau
Yves
Y
D003072:Cognition Disorders / Q000453:epidemiology; D004651:Employment / Q000706:statistics & numerical data; D006801:Humans; D020127:Recovery of Function; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012919:Social Behavior; D012931:Social Environment; D012938:Social Perception; D016896:Treatment Outcome