Recovery among patients with severe mental illness: Factor analysis of recovery assessment scale in Indian setting

Abstract

Aim: This study aimed to evaluate recovery among patients with severe mental disorders by using Recovery Assessment Scale (RAS). Additionally this study evaluated the, factor structure of RAS in the Indian setting, and assessed the correlates of recovery in severe mental illness. Methodology: Two hundred and eighty-five patients with severe mental illness (bipolar disorder-185 [BD], schizophrenia-100) currently in remission were recruited for the study. Clinical rating scales - Young Mania Rating Scale, Hamilton Depression Rating Scale, and Positive and Negative Syndrome Scale for Schizophrenia were used for assessing remission and residual symptoms. RAS was administered for recovery assessment. Results: Majority of the patients were married males belonging to urban background with no significant difference in sociodemographic profile of schizophrenia and BD groups. On factor analysis of RAS, all 41 items had loaded on one of the factors (compared to 24 items on the old factor structure). Five-factor were obtained with two factors - personal confidence and hope, goal and success orientation being similar to the old factor structure and three new factors being identified as awareness and control over the illness, seeking and relying on social support and, defeated/overcome the illness. Overall recovery measures were higher in BD group, and higher levels of residual depressive symptoms were associated with significantly lower level of recovery in BD. In the schizophrenia group, level of positive symptoms correlated negatively with goal and success orientation (as per the current analysis) and higher level of negative symptoms correlated positively with the domain of “reliance on others” as per the old factor structure. Conclusion: RAS follows a five-factor structure in Indian context, which is different than that reported in the previous study. There are few sociodemographic and clinical correlates of recovery.