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The concept of schizophrenia as a chronic, deteriorating disease is examined from historical and nosological perspectives. Diagnostic systems as exemplified in the series of APA manuals DSM-I through DSM-IV which simply define schizophrenia as a chronic disease with a poor outcome, are seen as examples of circular reasoning. Mounting evidence of recovery rates in excess of 50% is noted from longitudinal studies, and this new paradigm of core schizophrenia as a prolonged illness with an ameliorating course is explored. The role of mental health personnel in extended family roles and as employment advocates for people with psychiatric disabilities is examined.