Recovery from schizophrenia: a four-year study of an inner city cohort.

Converging evidence support the establishment of integrative approaches combining pharmacotherapy and psychosocial interventions for the treatment of patients with schizophrenia. Nonetheless, most studies have been limited with regard to treatment duration and their external validty has been questioned. The present study aimed at evaluating the effectiveness of the routine use of a continued integrative treatment approach in promoting clinical and social recovery from schizophrenia over 4 years. At a community mental health centre in Athens, 60 consecutive cases with a DSM-IV diagnosis of schizophrenic spectrum disorders were included into the study. Indepedent raters assessed the patients' level of functioning, cognitive impairment, disability, distress and caregivers' stress at baseline and annually for 4 years. The results of the study showed a stable linear pattern of improvement in all outcome measures with moderate to small effect sizes; while competitive employment and independent living emerged as the areas which benefited the least from the treatment program. Overall, the study supports the application of evidence-based integrative strategies to routine services, as long as they are provided in a timely and continued manner.