Evidence map›Paper›PMID 33991072›Full record

SynthesisBrain and behavior2021

Schizophrenia outcomes in the 21st century: A systematic review.

Peter Huxley, Anne Krayer, Rob Poole, Louise Prendergast, Sanjaya Aryal, Richard Warner

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Brain and behavior, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Serotonin type 3 receptor (5-HTNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
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  9. Review
  10. Metaphorical analysis of medical school students' perceptions of schizophrenia.Dusunen adam : Bakirkoy Ruh ve Sinir Hastaliklari Hastanesi yayin organi · 2025
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  13. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Peter HuxleyCentre for Mental Health and Society, School of Health Sciences, Bangor University, Bangor, UK.ORCID 0000-0001-5152-8030
Anne KrayerCentre for Mental Health and Society, School of Health Sciences, Bangor University, Bangor, UK.
Rob PooleCentre for Mental Health and Society, School of Health Sciences, Bangor University, Bangor, UK.
Louise PrendergastCentre for Mental Health and Society, School of Health Sciences, Bangor University, Bangor, UK.ORCID 0000-0003-2516-1479
Sanjaya AryalDepartment of Sociology, University of Essex, Colchester, UK.
Richard WarnerClinical Professor of Psychiatry and Adjunct Professor of Anthropology, University of Colorado, Denver, CO, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe report a review of outcomes in schizophrenia in the twenty-first century, replicating and extending work undertaken by the late Richard Warner in his seminal book, "Recovery from Schizophrenia: Psychiatry and Political Economy" (1985;2004).

methodWarner's methods were followed as closely as possible. Only observational/naturalistic studies were included. Six scientific databases were searched from 2000 to 2020. 6,640 records were retrieved. 47 met inclusion criteria.

resultsOverall, complete recovery is higher in this study than in Warner's (37.75% cf 20.4%), especially for first episode psychosis (FEP) (57.1% cf 20.7%). Clinical recovery, annualized remission rate (ARR), and employment outcomes were significantly superior for first episode psychosis compared with multiple episode psychosis (MEP). ARR shows a trend toward reduction over time, from 2.2 before the financial crash of 2008 to 1.6 after (t = 1.85 df 40 p = .07). The decline is statistically significant for the MEP group (t = 2.32 df18 p = .03). There were no differences in outcome by region, sample characteristics, outcome measures used, or quality of studies. Heterogeneity of clinical outcome measures across the literature makes evidence synthesis difficult. Weak and inconsistent reporting of functional and employment outcomes mean that findings lack meaning with respect to lived experience.

conclusionFuture research strategies should aim to reduce heterogeneity in clinical outcome measures and to increase the emphasis on capture and reporting of more sophisticated measures of social and functional outcome. Outcome domains should be disaggregated rather than conflated into unitary recovery constructs.

Indexed as

Psychotic DisordersSchizophreniaEmploymentHumansannualized remission rateemploymentrecoverysocial outcome

Identifiers

PMID33991072
PMCPMC8213926

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.