On the importance of remission in psychiatry Review article

Abstract

The concept of remission in psychiatry is not unequivocally defined. It is used simultaneously with other, synonymous terms such as improvement or recovery. Many definitions of remission in relation to mental disorders are proposed. Their core permanent feature is the complete or nearly complete absence of psychopathological symptoms, lasting long enough to allow the recovery of psychosocial functioning. In the system of the International Classification of Diseases ICD-10, it was declared that the ambiguity of the definition results from the differentiation between particular disorders. Meanwhile, the operational definition of remission is of fundamental importance for the course of therapy. Achieving remission is the most important goal of treatment, it is also the most important criterion for assessing the effectiveness of treatment methods, and it marks a natural end to the duration of a given disorder or its recurrence. In relation to these ambiguities, patients develop convictions about the permanence or incurability of mental disorders, about the determination of their lives by traumatic events. These anachronistic views come from the nineteenth-century psychiatry, i.e. from the times when effective treatments were not offered, and the life perspective was extremely short, and thus it was impossible to observe the natural recovery of most functional disorders. The ambiguity of the concept of remission thus contributes to the emergence of a harmful stereotype, contrary to the goals and possibilities of modern treatment. It is also inconsistent with the natural course of functional disorders that undergo internal evolution, especially with the occurrence of 5- or 10-year remission periods – just like all psychological components of mental life, including even the most persistent ones, such as personality profile, evolve.