Schizophrenia Recovery Rare, Experts Say
Mass murderer Edward Charles Allaway says he has recovered completely from schizophrenia and is ready to live a normal life. If so, mental health experts said, he is a rare exception.
The vast majority of schizophrenia patients endure the condition throughout their lives.
It’s a mental illness marked by a withdrawal from reality, illogical patterns of thinking and delusions. It has no known cause and no known cure, and in extreme cases has provoked sufferers to sudden, deadly violence.
Of the more than 2 million Americans who have been diagnosed with schizophrenia, 10% to 20% eventually show some sign of recovery. The other 80% to 90%, according to experts, will see their condition worsen or stabilize.
As an Orange County Superior Court judge considers arguments this week that Allaway has overcome the paranoid schizophrenia that led him to murder seven people at the Cal State Fullerton library 25 years ago, experts in mental illness say the type of natural recovery Allaway describes is rare.
Even less common, they say, are cases where patients have overcome the disease without the use of drugs, as Allaway claims to have done. Even with the most promising recoveries, the odds of experiencing a relapse increase steadily with age unless patients receive regular treatment of antipsychotic drugs and psychotherapy.
Past incidents of violent behavior are viewed by some experts as another warning flag.
“The best predictor for violence is a past history of violent behavior,” said Dr. Jeffrey A. Lieberman, a professor and chairman of psychiatry at the University of North Carolina at Chapel Hill.
Schizophrenia is a broad term for disorders with symptoms ranging from deep depression to hallucinations. Sufferers also might believe they are being persecuted or conspired against. No one knows what causes it, but some scientists believe it’s genetically inherited because it seems to run in families.
They theorize that microscopic and chemical defects within the brain’s emotion-regulating centers are to blame. These defects may stimulate the brain excessively and generate false and misleading signals. Although there is no cure, medical research has developed drugs to control some symptoms.
In Allaway’s case, the janitor testified that prior to the shooting, he believed homosexual men were using the school’s library for sexual liaisons and were plotting to kill him. Soon after the shooting, officials diagnosed him as being schizophrenic.
In 1977, a judge found Allaway not guilty by reason of insanity.
John Hinkley, who shot President Ronald Reagan, and Theodore Kaczynski, the Unabomber, are two well-known examples who have done much to forge the image of schizophrenics as being prone to violence. While some experts said there is some element of truth to this, others said that schizophrenics more commonly pose a risk to themselves.
About half of all schizophrenics will attempt suicide at some point, according to Dr. Dilip Jeste, an expert on schizophrenia and the chief of the Division of Geriatric Psychiatry at UC San Diego. The suicide rate for people with schizophrenia is 10%, according to the Journal of Psychiatry. That compares to a suicide rate in the general population of 0.01%.
Experts such as Jeste said little is known about schizophrenics who recovered without the aid of drugs, because it is standard procedure now to treat schizophrenia with antipsychotic medications.
“Today, if somebody is diagnosed as having schizophrenia, it would be almost unethical not to treat him with antipsychotic drugs,” Jeste said.
Dr. Stephen Marder, director of the VA Mental Illness Research Center, Education and Clinical Center, Southern California, said patients helped by medications often relapse when they stop taking them.
“For most people, it’s a chronic condition that can be managed,” Marder said. “Of those people who go into remission and then stop taking drugs, 80% or more will relapse.”
The medical expert who examined Allaway over a period of years and testified on his behalf at recent sanity hearings agrees that instances of schizophrenic remission are rare. But he insists Allaway stopped showing signs of the disease by around 1983, about seven years after the shooting. He hasn’t show any symptoms since, suggesting he’s recovered, the doctor said.
But experts called by the district attorney’s office, which opposes Allaway’s release, said there is no guarantee he won’t have a relapse.
Speaking publicly for the first time about the seven people he killed, Allaway testified last week that delusions led him to believe he was one of the victims of the rampage, not the killer.
The former Marine and Detroit auto worker has spent nearly a quarter of a century in state mental hospitals. He has twice previously lost bids to gain his freedom, but this time, doctors and staff at the hospital where he lives say they consider him safe for release.
