Tag Archives: Schizoaffective

Four Mental Illness Recovery Patterns Identified in Study

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A two-year study of patients with schizophrenia, schizoaffective disorder, bipolar disorder, or affective psychosis reveals four recovery trajectories and the factors that affect those outcomes. Generally speaking, those four trajectories are:

  • Stable with a high level of recovery
  • Stable with a lower level of recovery
  • Fluctuating high-level recovery
  • Fluctuating low-level recovery

Of the factors that affect recovery, having access to good-quality mental health care—defined as including satisfying relationships with clinicians, responsiveness to needs, satisfaction with psychiatric medications, receipt of services at needed levels, support in managing deficits in resources and strains, and care for general medical conditions—may facilitate or improve recovery trajectories.

These results are promising, because all too often, serious mental illness is seen as incurable, permanent, and progressively deteriorating. The reality is that as many as 60% to 70% of patients can achieve a measurable level of recovery. Carla Green Ph.D., M.P.H., and colleagues of the Center for Health Research at Kaiser Permanente Northwest, in Portland, Ore., reported the findings in their report, “Recovery From Serious Mental Illness: Trajectories, Characteristics, and the Role of Mental Health Care” in the December Psychiatric Services.

“Few demographic or diagnostic factors differentiated clusters at baseline. Consistent predictors of trajectories included psychiatric symptoms, physical health, resources and strains, and use of psychiatric medications.” 

The most consistent predictors of recovery were psychiatric symptoms and changes in those symptoms. Those in turn are dependent on good-quality care, which includes satisfaction with their clinicians and with the medications they are taking. “Providing such care has the potential to change recovery trajectories over time.”

What is Cognitive Behavioral Therapy?

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Cognitive Behavioral Therapy (CBT) is a blend of two therapies: cognitive therapy (CT) and behavioral therapy. CT was developed by psychotherapist Aaron Beck, M.D. in the 1960’s. CT focuses on a person’s thoughts and beliefs, and how they influence a person’s mood and actions, and aims to change a person’s thinking to be more adaptive and healthy. Behavioral therapy focused on a person’s actions and aims to change unhealthy behavior patterns.

CBT helps a person focus on his or her current problems and how to solve them. Both patient and therapist need to be actively involved in this process. The therapist helps the patient learn how to identify distorted or unhelpful thinking patterns recognize and change inaccurate beliefs, related to others in more positive ways, and change behaviors accordingly.

CBT can be applied and adapted to many conditions, including depression, bipolar disorder, Anxiety disorders, eating disorders, schizophrenia and schizoaffective disorder. For instance, people with bipolar disorder usually need to take medication, such as a mood stabilizer. But CBT is often used as an added treatment. The medication can help stabilize a person’s mood so that he or she is receptive to psychotherapy and can get the most out of it. CBT can help a person cope with bipolar symptoms and learn to recognize when a mood shift is about to occur. CBT also helps a person with bipolar disorder stick with a treatment plan to reduce the chances of relapse (e.g., when symptoms return).

With schizophrenia, the disorder generally requires medication first. But research has shown that CBT, as an add-on to medication, can help a patient cope with schizophrenia, helping patients learn more adaptive and realistic interpretations of events. Patients are also taught various coping techniques for dealing with “voices” or other hallucinations. They learn how to identify what triggers episodes of the illness, which can prevent or reduce the chances of relapse. CBT for schizophrenia also stresses skill-oriented therapies. Patients learn skills to cope with life’s challenges. The therapist teaches social, daily functioning, and problem-solving skills. This can help patients with schizophrenia minimize the types of stress that can lead to outbursts and hospitalizations.

CBT for schizoaffective treatment shares elements of each of the foregoing. Over the past two decades, CBT for schizophrenia and schizoaffective disorder has received considerable attention in the United Kingdom and elsewhere abroad. While this treatment continues to develop in the United States, the results from studies in the United Kingdom and other countries have encouraged therapists in the U.S. to incorporate this treatment into their own practices. In this treatment, often referred to as cognitive behavioral therapy for psychosis (CBT-P).

For more information, see the National Institute for Mental Health Site and NAMI.

From: National Institute of Mental Health and NAMI National.