Intellectual functioning and personal recovery in individuals with schizophrenia spectrum disorder

BACKGROUND: Individuals with mild intellectual disability or borderline intellectual functioning (MID/BIF) and schizophrenia spectrum disorder (SSD) may encounter unique challenges that can hinder their personal recovery. This study investigates differences in personal recovery and its subdomains over time between individuals with and without an MID/BIF indication. METHODS: Data from two measurements (baseline and one-year follow-up) from the UP's cohort study were used. The sample included 344 individuals with SSD (Male = 65.7%, Female = 34.3%, mean age = 41.2, SD = 12.4), of whom 42.4% had an MID/BIF indication. Personal recovery was assessed with the Individual Recovery Outcomes Counter (I.ROC), both at total scale and across the subdomains Home, Opportunity, People, and Empowerment. The Screener for Intelligence and Learning disabilities (SCIL) identified an indication of MID/BIF. Linear mixed models examined the impact of MID/BIF on personal recovery over time. RESULTS: Participants with MID/BIF scored significantly lower on personal recovery (β = -0.31, p = .003), with the most pronounced difference observed on the empowerment subscale (β = -0.39, p < .001). A significant interaction between time and MID/BIF (β = 0.23, p = .049) suggested that recovery may evolve differently across groups. All effects remained significant after adjusting for age, sex, and psychotic symptom severity. CONCLUSIONS: Individuals with SSD and an MID/BIF indication report lower levels of personal recovery, especially in areas related to social inclusion and empowerment. These findings highlight the need for routine screening on MID/BIF and tailored, inclusive recovery-oriented care that fosters autonomy and empowerment for individuals with MID/BIF.