While terms can vary, basically there are 3 stages to schizophrenia. Prodromal, Active and Residual.
Prodromal is a period of decreased function that frequently proceeds the obvious psychotic symptoms of the Active stage. The following numbers are about the Residual stage. I have read about people who said they felt as though a cloud lifted from their brain when they entered the residual stage. Most people will continue to have some symptoms, most have them to a lesser degree.
I’ve copied this from somewhere a couple of years ago, “most” other research about how long schizophrenia lasts has found these numbers to be pretty consistent about recovery over years.
When people with scz were discharged from the back wards of a Vermont mental hospital they were tracked at 10 and 30 years after release. These are similar to numbers we have seen before.
10% are dead, mostly suicide
25% improved with extensive supports
25% much improved
25% fully recovered
30 years after release:
15% dead, mostly suicide
10% hospitalized unimproved
15% improved but require extensive support network
35% much improved relatively independent
25% completely recovered
It has been suggested that some forms of schizophrenia have a 25 year span. My son’s doctor was asked, when do we start counting the 25 years? He smiled and shrugged - things can vary a good deal as the numbers tell you.
You particularly mentioned “insidious onset”. My son suffers from the insidious onset version of scz. The psychotic symptoms came on gradually for him. He had a long prodromal stage, his ability to function decreased very, very slowly. He graduated from college and began working. We know psychosis was present at age 27. His psychotic periods began lasting longer and occurring more frequently. Instead of having 2 bad days a month, now, 11 years later he has a couple of good days a month. He became fully disabled and unable to support himself any longer at age 31. He is pretty resilient and was able to work that long by creating his own accommodations, such as working night shifts when few people were around.
I should also point out that my son is totally unmedicated for his scz and basically always has been. He tried meds twice and didn’t last a week either time.
According to Dr Torrey’s book, insidious is a bad marker for future recovery. He is also quick to say that he has seen enough people with bad markers recover that it should make anyone humble about making predictions about outcomes for our family members.
Take care, I am so glad your son is pretty stable and willingly taking strong APs.