Abstract
Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective well-being in patients suffering from SMI.
Highlights
Recovery is a concept that cuts across medicine, with particular importance in the context of chronic disease
Because socio-demographic variables have been found to modulate the prognosis of schizophrenia (Westermeyer and Harrow, 1984; Wieselgren et al, 1996), discriminant validity was assessed across categories of age, education and disease duration, and found to be robust (Supplementary Table 5)
The contrary, was not true, i.e., subjective QoL was not related to Global Assessment Functioning Score (GAF) incrementally to Mental Health Recovery Measure (MHRM)-20. Considered globally, these findings suggest that CBR, as evaluated by the MHRM-20 scale, could be used to measure global recovery, while incorporating aspects of subjective QoL
Summary
Recovery is a concept that cuts across medicine, with particular importance in the context of chronic disease. Clinical definitions of recovery are generally related to reduction or remission of symptoms and return to pre-morbid or full levels of functioning These definitions are variable according to disease or disorder and, frequently, consensus definitions are difficult to obtain. In the contexts of clinical psychiatry, mental health policy and psychiatric research, the concept of recovery from severe mental illness (SMI) has become increasingly relevant (Slade, 2010). This is true for conditions such as schizophrenia, where recovery is very heterogeneous (Lieberman et al, 2008), since there are arguments that stigma and negative stereotyping are self-fulfilling attitudes directly resulting from a misconception of a very limited potential for recovery (Liberman and Kopelowicz, 2005). The concept of CBR has gained increasing relevance, given the movements toward promotion of patient-centered medicine and patient engagement in healthcare (Barello et al, 2012; Mullins et al, 2012; Domecq et al, 2014; Richards et al, 2015)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
