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Is it true that schizophrenia may be "cured" or "overcome," as John Nash claims he has overcome schizophrenia?

Peggy Reyoso
San Antonio, Texas

Answered by Frederick J. Frese III, Ph.D.:
This is a very good question. The answer varies with time and is a function of who is asked the question.

A century ago, Dr. Emil Kraepelin, the acknowledged "father of psychiatric nosology" and first to identify schizophrenia, was very dubious about the possibility of recovery from schizophrenia. His pessimism continues to be reflected by many today, e.g., George Will's Newsweek review of A Beautiful Mind (January 14, 2002, p. 68), which describes "something extremely rare -- remission from a disease that is almost always irreversibly degenerative."

Because Dr. Kraepelin was such a dominant figure in psychiatric diagnostics, his views continue to be influential. In this regard I often meet psychiatrists and other mental health professionals who hold that if you were diagnosed with schizophrenia and "recovered", then you must have been mis-diagnosed. Obviously this is a tautological perspective and for such professionals, recovery from schizophrenia, in their eyes, is obviously impossible.

At the other extreme, psychiatrist Daniel Fisher, M.D., Ph.D., who has himself been diagnosed and hospitalized with schizophrenia claims that "it's possible to completely recover (Boston Globe, March 3, 2002, p. B1)." This is a view shared by several similarly experienced associates of Dr. Fisher as well as some other consumer/advocates who have been diagnosed with schizophrenia.

My perspective on this issue is also based on my own experience of having been diagnosed and repeatedly hospitalized for schizophrenia as well as having worked with and/or visited with groups of consumers around this, and other countries, virtually hundreds of times during the past twenty years. My feeling on this issue is as follows.

1) Schizophrenia, like other forms of psychosis, is not an "all or none" condition. There are most certainly degrees of the disability. Today, most persons with this condition can improve. Many of us can show marked improvements. Generally, those with greater degrees of disability are not able to improve to the degree that they appear "normal" in all respects. Those of us with lesser degree of disability can appear remarkable improved, sometimes virtually indistinguishable from "normal."

2) Treatments are improving, particularly during the past twenty years. I now meet many more persons who tell me they have been diagnosed with schizophrenia or schizoaffective disorder, who evidence virtually no symptoms during the brief periods of social interaction I have with them. This is true much more today than it was a few years ago.

3) For those of us who currently appear to be less disabled with this disorder, and our numbers appear to be increasing, we probably carry greater vulnerability to being subject to symptoms than those who have never had the condition. We probably also show greater likelihood of showing "schizophrenia spectrum" (paranoid, schizoid, schizotypal, etc.) personality symptoms than others do.

So, to summarize these thoughts as an answer to your question: Schizophrenia can be overcome, to varying degrees. Better treatments, better understanding of the disorder, and, for many of us, the aging process itself, all seem to contribute to this process. If some persons with this condition desire to characterize themselves as "fully recovered" or even "cured," I congratulate them, but I do not feel we are far enough along yet for this to be a realistic goal for those with the more serious forms of this illness.

Frederick J. Frese III, Ph.D.

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