105 Personal recovery suits us all INTRODUCTION Recovery and subjective wellbeing of patients with schizophrenia spectrum disorders have increasingly become the focus of mental health services. The concept of recovery is complex and different types are defined (1-3). At least two main categories of recovery are distinguished: clinical and personal recovery (4). Clinical recovery is described as long-term reduction or resolution of symptomatology (5, 6). Personal recovery is defined as “a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness (7).” This definition emphasizes the ability to live a good life irrespective of ongoing symptoms and conceptualizes recovery as a unique process with essential themes including hope, meaning, and rebuilding oneself (8, 9). Effective ways to facilitate personal recovery have become a central topic in mental health care (10). The word recovery suggests that it is about returning to a pre-existing state. Following the definition of Anthony mentioned above, the word ‘to overcome’ might suit better what this process is about: not about a complete return, but about rebuilding and going on after an impactful life-event. Because this event does not necessarily have to be a mental disease, the process of recovery (or overcoming) might also be applicable to the general population and not only to patients. Anthony states: “Recovery transcends illness and the disability field itself. Recovery is a truly unifying human experience. Because all people (helpers included) experience the catastrophes of life (death of a loved one, divorce, the threat of severe physical illness, and disability), the challenge of recovery must be faced (7).” The general applicability is also illustrated by the fact that personal recovery is closely related to concepts such as well-being (11) and quality of life (12). In a systematic review five core recovery processes were identified: connectedness, hope and optimism about the future, identity, meaning in life and empowerment (CHIME) (13). Law and Morrison interviewed individuals who had experienced psychotic symptoms and asked them to rate statements essential or important for their recovery. Particularly, environmental factors such as having a place to live or work, social support and having a good understanding of mental health problems were endorsed (8). Similarly, a review of qualitative studies found that patients with mental disorders reported contribution from others, participating in social activity and individual processes such as accepting and finding an identity or using coping strategies to contribute to their recovery (14). Accordingly, a review of qualitative studies in patients with psychosis found similar themes, i.e. faith and spiritualty, social support, personal agency and hope, environmental resources and positive support from services (15). Which factors correlate with or influence personal recovery has been investigated in qualitative, as well as in quantitative research. In a meta-analysis concerning 6
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