Transcending illness Personal recovery in psychosis

The aim of this thesis was to investigate the relationship between clinical and personal recovery in patients with psychosis. Clinical recovery means remission of symptoms and functional improvement. Personal recovery is about the development of new meaning and purpose in life as one grows beyond the effects of mental illness.
We conducted a systematic review and meta-analysis and a longitudinal study at flexible assertive community treatment teams. We found a negative association between symptom severity and personal recovery, however with a small effect-size. Affective symptoms showed a more substantial association with personal recovery than psychotic symptoms. From qualitative interviews we learned that clinical treatment interventions can have both positive and negative impact on personal recovery.
We also investigated whether factors associated with personal recovery in patients, unaffected siblings and healthy controls were similar. Resilience was linked to personal recovery in all three groups.
We conclude that recovery transcends illness, because:
1. Personal recovery seems to occur largely independent of remission of (psychotic) symptoms.
2. Personal recovery is associated with factors that are universally human.
For clinical practice this means that symptom reduction is not the only road to personal recovery. It is important to pay attention to affective symptoms. The finding that patients and nonpatients share supportive factors of personal recovery, may suggest that carers and professionals can use their own experiences with coping to help patients recover.
Future studies should be co-created with people with lived experience to bring recovery-oriented research and care forward.