Natural History, What Gets Better, What Doesn’t
- Approximately 85 percent of older adults with schizophrenia live in communities with support, 13 percent reside in nursing homes, one percent in state or county hospitals and 0.5 percent in veterans hospitals.
- Positive symptoms (delusions, hallucinations, disorganization) improve with age. Negative symptoms (apathy, anhedonia, avolition) also improve with age. Cognitive symptoms (incoherence, loose associations, informational processing impairment) worsen with age.
- Quality of life in adults with major mental illness such as schizophrenia is lower than in unimpaired controls, but differences are small. Quality of life in major mental illness subjects is higher than in those with chronic pain.
- Psychosocial functional capacity is highly variable among people with schizophrenia. Functioning is dependent upon environmental circumstances (the better the environmental living conditions the higher the level of functioning), support system strength, opportunities for daily stimulation and the extent to which the schizophrenic is stigmatized.
- There is evidence of better functional outcomes with schizophrenics living in under-developed countries where family support systems are strong and well integrated, and roles of family members are simpler.
- Ten national and international studies spanning a period of 20-30 years indicate that recovery is possible for at least 50 percent of people with schizophrenia.