Functional Outcome

Functional outcome distinguishes itself from clinical outcome, focused instead of an individual’s recovery in areas such as vocational and social functioning rather than symptom resolution. Its measurement speaks to the impact of severe and chronic illnesses, such as schizophrenia, and a growing awareness that functional and clinical recovery do not necessarily parallel each other.

With schizophrenia, it was held for many years that the positive symptoms (e.g., delusions, hallucinations) were central to the gradual decline in functioning commonly seen over the course of the illness. However, more recent evidence suggests that other features of this illness, for example, deficit (negative) symptoms and neurocognitive changes, may play a more critical role in compromising functional recovery. This has diminished focus on positive symptoms and the implicit assumption that their resolution ensures a return to premorbid level of functioning and, in so doing, has forced a...