More knowledge about positive outcomes for people with first-episode psychosis (FEP) is needed. An FEP 10-year follow-up study investigated the rate of personal recovery, emotional wellbeing, and clinical recovery in the total sample and between psychotic bipolar spectrum disorders (BD) and schizophrenia spectrum disorders (SZ); and how these positive outcomes overlap.

FEP participants (n = 128) were re-assessed with structured clinical interviews at 10-year follow-up. Personal recovery was self-rated with the Questionnaire about the Process of Recovery-15-item scale (total score ⩾45). Emotional wellbeing was self-rated with the Life Satisfaction Scale (score ⩾5) and the Temporal Experience of Pleasure Scale (total score ⩾72). Clinical recovery was clinician-rated symptom-remission and adequate functioning (duration minimum 1 year).

In FEP, rates of personal recovery (50.8%), life satisfaction (60.9%), and pleasure (57.5%) were higher than clinical recovery (33.6%). Despite lower rates of clinical recovery in SZ compared to BD, they had equal rates of personal recovery and emotional wellbeing. Personal recovery overlapped more with emotional wellbeing than with clinical recovery (χ2). Each participant was assigned to one of eight possible outcome groups depending on the combination of positive outcomes fulfilled. The eight groups collapsed into three equal-sized main outcome groups: 33.6% clinical recovery with personal recovery and/or emotional wellbeing; 34.4% personal recovery and/or emotional wellbeing only; and 32.0% none.

In FEP, 68% had minimum one positive outcome after 10 years, suggesting a good life with psychosis. This knowledge must be shared to instill hope and underlines that subjective and objective positive outcomes must be assessed and targeted in treatment.

The benefits of peer support interventions (PSIs) for individuals with mental illness are not well known. The aim of this systematic review and meta-analysis was to assess the effectiveness of PSIs for individuals with mental illness for clinical, personal, and functional recovery outcomes.

Searches were conducted in PubMed, Embase, and PsycINFO (December 18, 2020). Included were randomized controlled trials (RCTs) comparing peer-delivered PSIs to control conditions. The quality of records was assessed using the Cochrane Collaboration Risk of Bias tool. Data were pooled for each outcome, using random-effects models.

After screening 3455 records, 30 RCTs were included in the systematic review and 28 were meta-analyzed (4152 individuals). Compared to control conditions, peer support was associated with small but significant post-test effect sizes for clinical recovery, g = 0.19, 95% CI (0.11–0.27), I2 = 10%, 95% CI (0–44), and personal recovery, g = 0.15, 95% CI (0.04–0.27), I2 = 43%, 95% CI (1–67), but not for functional recovery, g = 0.08, 95% CI (−0.02 to 0.18), I2 = 36%, 95% CI (0–61). Our findings should be considered with caution due to the modest quality of the included studies.

PSIs may be effective for the clinical and personal recovery of mental illness. Effects are modest, though consistent, suggesting potential efficacy for PSI across a wide range of mental disorders and intervention types.

Growing old with schizophrenia is a profound challenge. However, impact and course of the disorder vary widely among individuals. The recovery concept has inspired outcome evaluation. In older schizophrenia patients, research on recovery is limited and mainly cross-sectional.

To compare 5-year outcome of clinical recovery (symptomatic remission and adequate community functioning) with outcome of subjective well-being (as a key element of personal recovery).

Our catchment-area based study sample consisted of 73 older Dutch schizophrenia patients (mean age 65.9 years; SD 5.4), including both community living and institutionalized patients regardless of the age of onset of their disorder.

At baseline (T1) 5.5% of participants qualified for clinical recovery, while at five-year follow-up (T2) this rate was 12.3% (p=0.18, exact McNemar’s test). Subjective well-being was reported by 20.5% of participants at T1, and by 27.4% at T2 (p=0.27, exact McNemar’s test). Concurrent clinical recovery and subjective well-being was exceptional, being present in only one participant at T1 and in two participants at T2. Clinical recovery and subjective well-being were not correlated at T1 (p=0.82; phi=0.027), nor at T2 (p=0.71; phi= -0.044).

Transitions over time confirm a dynamic course of schizophrenia in later life, with room for improvement. In our sample, we found no linkage between clinical recovery and subjective well-being. Results suggest that while clinical recovery is relatively rare in older individuals with schizophrenia it is not a prerequisite to experience subjective well-being. In spite of ongoing symptoms a substantial number of older schizophrenia patients report subjective well-being and thus may find ‘wellness within illness’.

No significant relationships.