- - Tuesday, October 21, 2014

ANALYSIS/OPINION:

Mental health problems are very burdensome for individuals, society and the health care system. The prevailing idea in psychiatry to date has been that the disability associated with certain conditions would disappear after symptoms are gone, and therefore, the goal of treatment is usually symptom resolution.

Unfortunately, severe mental disorders, such as schizophrenia and bipolar disorder, often have lifelong courses, although there may be periods with lack of symptoms. Other, “less severe” disorders, such as unipolar depression or anxiety, may occur most often as single episodes. It is in these cases, where symptoms would remit, that psychiatry has assumed there has been complete recovery.

A new approach suggests that the disability of mental disorders is beyond the presence of symptoms. This approach instead favors measuring the disability’s impact on the individual’s quality of life. In a study conducted by a team of researchers from Columbia University and published in the Journal of Clinical Psychiatry, quality of life in individuals who recovered from different mental health problems was measured by examining one of the largest national databases in mental health in the United States.

In their findings, researchers found that even after resolution of symptoms, where most psychiatrists would consider that treatment would have as its goal to prevent a new episode, recovery of quality of life was only mild, and therefore individuals would still need help. These results suggest that the main goal of future treatments should be not just the resolution of the symptoms, but the recovery of the quality of life.

Mental health providers, individuals requiring provider services and the health care system should all reconsider the way in which we establish the treatment goals for different mental health disorders. We should focus more on improvement of quality of life and reduction of disability, beyond treatment of symptoms, considering that worse quality of life may persist for years even after symptoms are gone.

LUDWIG FLORENZ-SALAMANCA

New York

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