Prognosis

Most people make a good recovery following a first episode of psychosis. Early detection and treatment for prodrome psychosis and first-episode psychosis are associated with more favourable outcomes.[59][163][164]​​ Data vary, but it is estimated that up to 20% of patients will make a full recovery.[5] Many people who have subsequent episodes of psychosis maintain a good quality of life despite symptoms. Nonetheless, the mean life expectancy of a patient with schizophrenia is 14.5 years shorter compared with the general population.[116] With currently available treatments, patients with schizophrenia often remain symptomatic, and approximately 20% to 30% of them are considered treatment-resistant.[113] Varying percentages of clinical recovery (including the remission of symptoms), from 13.5% to 57%, have been reported.[165]

Social skills training, cognitive behavioural therapy, cognitive remediation, and social cognition training address several key components of social rehabilitation, which in conjunction with psychopharmacology contribute to domains of functional recovery and ultimately are promising approaches to helping patients achieve better outcomes beyond symptom stabilisation.[166][167][168][169]​ Access to employment plays an important role in the recovery and function of people with schizophrenia.[9]​ Evidence from one large meta-analysis suggests that participating in a psychosocial treatment to enhance employment outcomes increases the chance of patients receiving an offer of employment, and has a positive impact on the number of hours worked.[170]​​​

Of factors influencing the disease course, family environment, substance misuse, and duration of untreated psychosis are the most important modifiable predictors of outcome.[171][172][173][174] Early detection and treatment can reduce the duration of psychosis and can predict more favourable outcomes, although some studies do not support this observation.[175][176][177][178][179][180][181][182]

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