In schizophrenia treatment, traditional practice often prioritizes clinical recovery outcomes, such as hospitalization avoidance and social integration, potentially overlooking patients' needs and sparking debates around the concept of “normalcy”.¹ Consequently, the significance of personal recovery in schizophrenia has been investigated. At the EPA 2023: 31st European Congress of Psychiatry, Dr. Mike Slade from the University of Nottingham, the United Kingdom (UK), discussed the correlation between clinical and personal recovery in schizophrenia patients.¹

In 2 systemic review and meta-analyses, a weak association between clinical and personal recovery was shown.¹ Specifically, affective symptoms had a medium negative association with personal recovery (r=-0.44, 95% CI: -0.5 to -0.37), while positive, negative, and general symptoms had a small negative correlation (Range: -0.22 to -0.37), indicating a loose association between personal recovery and clinical recovery.¹ Cross-sectional studies from Asian and European countries concluded that clinical and personal recovery are distinct and not substitutes for each other, although a study from Spain found that they gradually become positively correlated during a prolonged period of time.¹  Furthermore, longitudinal studies in France, the UK, and Hong Kong indicated that personal recovery outcomes may shift over time and significantly impact patients' well-being.¹

These findings informed the development of the CHIME framework, a widely-utilized personal recovery assessment tool for schizophrenia patients.¹ CHIME encompasses five categories, based on patients' identified recovery processes: connectedness, hope and optimism, identity, meaning and purpose, and empowerment.¹ Dr. Slade emphasized that certain clinical recovery outcomes might not correspond to patients' personal recovery.¹ “While symptom management is important, helping patients to develop an identity beyond their patient status is, in fact, more valuable,” Dr. Slade said.

Dr. Slade concluded that schizophrenia recovery assessment should extend beyond clinical recovery, incorporating individualized patient-created measures based on their perspectives.¹  The future challenge for clinicians lies in tailoring outcome measurements for each schizophrenic patient.¹