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Resilience and clinical recovery in first-episode schizophrenia: a 10-year longitudinal study of clinically recovered, non-recovered, and healthy control participants

Year: 2026

Type: article

Abstract: Introduction: Research on resilience in clinical recovery following first-episode schizophrenia (FES) remains limited, and few longitudinal studies achieve sufficient retention to capture long-term trajectories. To address this, the Oslo Schizophrenia Recovery Study (OSR) was designed to examine resilience over time in FES. Investigating resilience is essential for understanding how individuals exposed to schizophrenia may achieve favorable outcomes. We addressed two primary questions: First, how does resilience change over time in individuals with FES compared with healthy controls. Second, whether longitudinal resilience trajectories within the FES group differ between participants who meet predefined clinical recovery criteria compared to those who do not. Methods: Repeated assessments were conducted across 12 clinical evaluations. The sample comprised 28 individuals with FES and 28 healthy controls. Resilience was measured with the Connor-Davidson Resilience Scale, and social and role functioning were indexed using the Global Functioning Scales. The data were analyzed using linear multilevel models. Candidate longitudinal mixed-effects models were compared using the small-sample corrected Akaike Information Criterion (AICc), with parameters estimated by maximum likelihood. Results: At 10-year follow-up, retention was 79%. Half of the FES group achieved clinical recovery. Model estimates indicated increasing resilience over time in the FES group, whereas resilience in healthy controls remained relatively stable, although statistical support for differential trajectories between groups was limited. Clinically recovered individuals showed a steeper increase in resilience. In contrast, non-recovered individuals exhibited only modest, gradual improvements, with resilience levels remaining lower at study completion. Conclusion: Different resilience trajectories were observed between clinically recovered and non-recovered individuals with FES, with greater improvements in resilience associated with recovery. Although causality remains uncertain and differences to healthy controls were less robust, these findings highlight the value of repeated longitudinal assessments of resilience in FES, both to more precisely characterize resilience trajectories and to reduce drop-out rates.

Source: Frontiers in Psychiatry

DOI: 10.3389/fpsyt.2026.1813256

Authors: Anne-Kari Torgalsbøen, Christine Mohn, Frank Larøi, Nikolai Czajkowski

Institutions: University of Oslo, University of Liège, Norwegian Institute of Public Health

Language: English

Topic: Schizophrenia research and treatment

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801