Factors associated with recovery during schizophrenia and related disorders: A review of meta-analysis

Abstract

Background: The spectrum of schizophrenia disorders (SSD) is a severe mental disorder. It is one of the main medical causes of disability that generates high health and social costs.

Objective: To analyze the factors associated with clinical recovery (CR) (symptomatic remission-SR and functional recovery-FR) and personal recovery (PR) in people diagnosed with SSD.

Methods: 14 meta-analyses focused on recovery were reviewed following the PRISMA model statements. 95 % of CI was established.

Results: Shorter Duration of Untreated Psychosis (Zr = 0.24, [0.17, 0.30]) and total Duration of Untreated Illness (Zr = 0.34, [0.20, 0.48]) were related to greater SR and general functioning, respectively. Resilience was the variable with the greatest effect on FR (Zr = 0.67, [0.63, 0.71]). Premorbid adjustment (Zr = 0.34, [0.18, 0.49]) and physical intervention (Zr = 0.71, [0.55, 0.86]) had the greatest effect on occupational and social functioning, respectively. Less severe affective symptoms were related to greater PR (Zr = 0.46, [0.42, 0.50]). There are differences between affective SR and the other types of SR (Zr_{(SR-A - SR-)} = 0.13, Qb = 6.51, p = 0.011), (Zr_{(SR-A - SR+)} = 0.20, Qb = 8.52, p = 0.004), (Zr_{(SR-A - SR)} = 0.18, Qb = 19.29, p = 0.0001). In all, resilience was associated with greater recovery (Zr = 0.67, [0.53, 0.80]), with the global effect being greater on PR than on CR (Zr_(PR-CR) = 0.07, Qb = 3.45, p = 0.05).

Conclusions: Resilience was the variable most strongly associated with recovery. Symptomatic or functional improvement obtained less statistical weight.

Keywords: Clinical recovery; First-episode psychosis; Meta-analysis; Personal recovery; Schizophrenia spectrum disorders.