What does recovery from psychosis mean? Perceptions of young first-episode patients.
ABSTRACT This study explored the experience of first-episode psychosis from the patients' perspective and the meanings they attach to the illness and their recovery.
A qualitative methodology was used based on a focus group. Audio tapes were transcribed verbatim and three researchers participated in a content analysis that identified four major themes: the meaning of psychosis and psychotic experience; the meaning of recovery; stigma; and having an optimistic view of recovery.
Participants' view of recovery was broader than that often held by psychiatrists, extending beyond symptom control and medication compliance, and they identified positive features that the experience of illness had brought. Their concerns included the side effects of medication and the fear of their illness being disclosed (to employers, university authorities, acquaintances, etc.) in the face of societal stigma.
Ideas about what constitutes recovery need to take account of patients' views and experience in order to emphasize therapeutic optimism rather than pessimism, and to inform treatment contexts and the views of medical staff.
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ABSTRACT: Western countries have put the mental health recovery approach into practice since the 80 s, and other cultures have started to adopt it into their services. However, the cross-cultural application of the recovery approach has to be addressed, and individualistic-collectivistic values often take center stage in the debate. While people with individualistic value orientations place importance on personal goals, people with collectivistic value orientations see themselves and their goals as an inseparable part of a family or community. However such a simplistic view on the two values may polarize the differences rather than appreciate the intricacies and heterogeneity within and across people and cultures. This brief paper outlines how these two value paradigms may help and hinder recovery on a practical level. The present paper offers a framework for providing culturally responsive mental health service that adequately engages service users and families, thereby generating more dialogues on the topic.05/2014; 1(1):7-13. DOI:10.1007/s40737-014-0010-5
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ABSTRACT: Purpose Studies have suggested that appraisal of relapse risk and knowledge of medications in relapse prevention may shape one’s reactions towards an illness and treatment, and influence the illness outcome. The aim of this study is to explore patients’ and caregivers’ knowledge of medications, perceived chances of relapse and its predictors, as well as their relations with medication adherence. Methods Eighty patient-caregiver dyads participated in the study. Their knowledge about psychosis, specific knowledge about medications and course of illness of their own and their relatives, medication adherence and symptomatology of patients were assessed. Differences in knowledge between patients and caregivers were compared. The link between adherence with perceived relapse risk and consequences of stopping medication were explored. Multinomial regression analyses were performed to examine predictors of perceived relapse risk. Results More patients underestimated their chance of relapse and were unaware that stopping medication may lead to relapse. The lack of understanding about the effect of stopping medication of both caregivers and patients was related to poor medication adherence of patients. Patients perceived of having higher chance of relapse had more severe positive symptoms. Positive symptoms of patients and greater knowledge about psychosis of caregivers were related to higher caregivers’ perceived relapse risk of their relative. Conclusions This study explored the views of patients and their caregivers on the perceived risk of relapse and role of medication in preventing relapse, and the potential significance. Specific interventions addressing these areas should be considered in developing relapse prevention programs.Social Psychiatry and Psychiatric Epidemiology 07/2014; 50(2). DOI:10.1007/s00127-014-0930-0 · 2.58 Impact Factor
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ABSTRACT: Schizophrenia is associated with pronounced vocational impairment. Previous research has mostly focused on chronic patients and few studies were conducted to investigate predictors of work outcome in first-episode populations. The impact of cognitive dysfunction on employment outcome in early psychosis was under-studied. In this study, we prospectively followed up 93 patients aged 18-55 years presented with first-episode schizophrenia-spectrum disorder for 3 years with an aim to identify early clinical and cognitive predictors of vocational outcome. Pre-morbid adjustment, baseline symptomatology and cognitive functions, and employment outcome were assessed. Result indicated that approximately half of the patients (53.8%) were engaged in full-time work at intake and at 3 years. Pre-morbid adjustment, baseline occupational status and Wisconsin Card Sorting Test (WCST) performance were found to predict vocational outcome. Analysis on a subgroup of patients who were unemployed at intake showed that subjects who remained unemployed over 3 years had poorer WCST performance and more severe positive symptoms at baseline than those having job attainment during follow-up. Our results thus confirmed predictive value of pre-morbid functioning and baseline occupational status on vocational outcome. In addition, our findings suggested that executive function might be a critical cognitive determinant of employment outcome in the early course of schizophrenia.Psychiatry Research 09/2014; 220(3). DOI:10.1016/j.psychres.2014.09.012 · 2.68 Impact Factor