Recovery in Psychosis: Perspectives of Clients with First Episode Psychosis

2020 ◽  
Vol 49 (4) ◽  
pp. 186-198
Author(s):  
Janhavi Ajit Vaingankar ◽  
Laxman Cetty ◽  
Mythily Subramaniam ◽  
Ying Ying Lee ◽  
Siow Ann Chong ◽  
...  
Keyword(s):  
Lived Experience ◽  
Meaning In Life ◽  
Tertiary Care ◽  
Recovery Process ◽  
First Episode Psychosis ◽  
First Episode ◽  
Psychiatric Institute ◽  
Qualitative Thematic Analysis ◽  
Episode Psychosis ◽  
The Individual

Introduction: Recovery from psychosis relates to connectedness, hope for the future, identity, meaning in life and empowerment. The process of recovery is often described as gradual and non-linear, with many stages and turning points, and without a definitive end point. This qualitative study aims to understand what recovery means to clients, to better understand their unique recovery process and what helps in recovery among clients with lived experience of first episode psychosis (FEP) in a developed Asian setting. Materials and Methods: The study design and interview guide development included inputs from persons with psychosis, following which 7 focus group discussions were conducted with 40 FEP clients of a tertiary care psychiatric institute. Results: Thematic qualitative analysis identified three themes: 1) meaning of recovery (where participants expressed their views on what recovery meant to them); 2) recovery as a journey (due to the constant ups and downs in the long process of recovery, it was often articulated as a “journey”); and 3) facilitators of recovery (related to resources, practices and experiences that supported their recovery). Conclusion: The emergent themes provide an understanding of the meaning of recovery to persons with FEP, their experiences as they proceed with their recovery journey and factors they found helpful. The importance of acceptance of the condition and the personal role the individual plays in his or her own recovery was evident in the narratives of the participants. The study suggests a need to incorporate recovery-relevant approaches right from the first episode of psychosis. Ann Acad Med Singapore 2020;49:186–98 Key words: Meaning of recovery, Qualitative, Thematic analysis

QUALITY OF INDIVIDUAL AND GROUP LEVEL INTERVENTIONS FOR FIRST EPISODE PSYCHOSIS AT THE TERTIARY PSYCHIATRIC HOSPITAL IN UGANDA.

2020 ◽  
Author(s):  
Emmanuel Kiiza Mwesiga ◽  
Noeline Nakasujja ◽  
Lawrence Nankaba ◽  
Juliet Nakku ◽  
Seggane Musisi
Keyword(s):  
Psychiatric Hospital ◽  
Psychotic Disorders ◽  
First Episode Psychosis ◽  
First Episode ◽  
Group Level ◽  
Group Interventions ◽  
Episode Psychosis ◽  
Essential Components ◽  
The Individual

Introduction: Individual and group level interventions have the largest effect on outcomes in patients with the first episode of psychosis. The quality of these individual and group level interventions provided to first-episode psychosis patients in Uganda is unclear.Methods: The study was performed at Butabika National Psychiatric Teaching and referral hospital in Uganda. A retrospective chart review of recently discharged adult in-patients with the first episode of psychosis was first performed to determine the proportion of participants who received the different essential components for individual and group level interventions. From the different proportions, the quality of the services across the individual and group interventions was determined using the first-Episode Psychosis Services Fidelity Scale (FEPS-FS). The FEPS-FS assigns a grade of 1-5 on a Likert scale depending on the proportion of patients received the different components of the intervention. Results: The final sample included 156 first-episode psychosis patients. The median age was 27 years [IOR (24-36)] with 55% of participants of the female gender. 13 essential components across the individual and group interventions were assessed and their quality quantified. All 13 essential components had poor quality with the range of scores on the FEPS-FS of 1-3. Only one essential component assessed (use of single antipsychotics) had moderate quality.Discussion: Among current services at the National psychiatric hospital of Uganda, the essential for individual and group level interventions for psychotic disorders are of low quality. Further studies are required on how the quality of these interventions can be improved.

What Is Psychosis?

2021 ◽  
pp. 3-16
Author(s):  
Beth Broussard ◽  
Michael T. Compton
Keyword(s):  
Mental Illness ◽  
Young People ◽  
First Episode Psychosis ◽  
Initial Evaluation ◽  
Treatment Programs ◽  
First Episode ◽  
Her Family ◽  
Episode Psychosis ◽  
The Individual ◽  
Work Goals

This first chapter explains what psychosis is. Psychosis is a treatable mental illness. For many people with first-episode psychosis, symptoms begin to clear up partially or completely within weeks of starting treatment. Although the symptoms of psychosis may be frightening to the individual and his or her family, there are treatments for these symptoms. First-episode psychosis is the period of time when a person first begins to experience psychosis. It is during this time that young people and their families need detailed information about the initial evaluation and treatment. People who get into treatment earlier often do better. In many places, specialty treatment programs now exist that specifically focus on first-episode psychosis. Those programs often provide treatments designed to help young people get back on track in terms of school and work goals.

scholarly journals Using genetic, cognitive and multi-modal neuroimaging data to identify ultra-high-risk and first-episode psychosis at the individual level

2013 ◽  
Vol 43 (12) ◽  
pp. 2547-2562 ◽  
Author(s):  
W. Pettersson-Yeo ◽  
S. Benetti ◽  
A. F. Marquand ◽  
F. Dell‘Acqua ◽  
S. C. R. Williams ◽  
...  
Keyword(s):  
High Risk ◽  
First Episode Psychosis ◽  
First Episode ◽  
Support Vector ◽  
Single Subject ◽  
Individual Level ◽  
Episode Psychosis ◽  
Ultra High Risk ◽  
The Individual ◽  
Cognitive Data

BackgroundGroup-level results suggest that relative to healthy controls (HCs), ultra-high-risk (UHR) and first-episode psychosis (FEP) subjects show alterations in neuroanatomy, neurofunction and cognition that may be mediated genetically. It is unclear, however, whether these groups can be differentiated at single-subject level, for instance using the machine learning analysis support vector machine (SVM). Here, we used a multimodal approach to examine the ability of structural magnetic resonance imaging (sMRI), functional MRI (fMRI), diffusion tensor neuroimaging (DTI), genetic and cognitive data to differentiate between UHR, FEP and HC subjects at the single-subject level using SVM.MethodThree age- and gender-matched SVM paired comparison groups were created comprising 19, 19 and 15 subject pairs for FEPversusHC, UHRversusHC and FEPversusUHR, respectively. Genetic, sMRI, DTI, fMRI and cognitive data were obtained for each participant and the ability of each to discriminate subjects at the individual level in conjunction with SVM was tested.ResultsSuccessful classification accuracies (p < 0.05) comprised FEPversusHC (genotype, 67.86%; DTI, 65.79%; fMRI, 65.79% and 68.42%; cognitive data, 73.69%), UHRversusHC (sMRI, 68.42%; DTI, 65.79%), and FEPversusUHR (sMRI, 76.67%; fMRI, 73.33%; cognitive data, 66.67%).ConclusionsThe results suggest that FEP subjects are identifiable at the individual level using a range of biological and cognitive measures. Comparatively, only sMRI and DTI allowed discrimination of UHR from HC subjects. For the first time FEP and UHR subjects have been shown to be directly differentiable at the single-subject level using cognitive, sMRI and fMRI data. Preliminarily, the results support clinical development of SVM to help inform identification of FEP and UHR subjects, though future work is needed to provide enhanced levels of accuracy.

scholarly journals Quality of individual and group level interventions for first-episode psychosis at the tertiary psychiatric hospital in Uganda

2021 ◽  
Vol 27 ◽  
Author(s):  
Emmanuel K. Mwesiga ◽  
Noeline Nakasujja ◽  
Lawrence Nankaba ◽  
Juliet Nakku ◽  
Seggane Musisi
Keyword(s):  
Psychiatric Hospital ◽  
First Episode Psychosis ◽  
Poor Quality ◽  
First Episode ◽  
Group Level ◽  
Group Interventions ◽  
Episode Psychosis ◽  
Essential Components ◽  
The Individual

Background: Individual and group level interventions have the largest effect on outcomes in patients with the first episode of psychosis. The quality of these individual and group level interventions provided to first-episode psychosis patients in Uganda is unclear.Aim: To determine the quality of the individual and group level interventions provided to first episode psychosis patients in UgandaSetting: The study was performed at the only tertiary psychiatric hospital in Uganda.Methods: A retrospective chart review of recently discharged adult in-patients with the first episode of psychosis was performed. The proportion of participants who received different essential components for individual and group level interventions were calculated. From the different proportions, the quality of the services across the individual and group interventions was determined using the first-episode psychosis services fidelity scale (FEPS-FS). The FEPS-FS assigns a grade of 1–5 on a Likert scale depending on the proportion of patients who received the different components of the intervention. Twelve essential components across the individual and group interventions were assessed and their quality quantified.Results: The final sample included 156 first-episode psychosis patients. The median age was 27 years (inter-quartile range [IQR] [24–36]) and 55% of the participants were female. All 12 essential components had poor quality with the range of scores on the FEPS-FS between one and three. Only one essential component assessed (use of single antipsychotics) had moderate quality.Conclusion: Amongst current services at the Butabika National Referral Mental Hospital in Uganda, the essential components for individual and group level interventions for psychotic disorders are of poor quality. Further studies are required on how the quality of these interventions can be improved.

scholarly journals Psychosocial Needs of the Families with a Person with First Episode Psychosis

2019 ◽  
Vol 10 (1) ◽  
pp. 56
Author(s):  
Praful Prabhuappa Kapse ◽  
Manisha Kiran
Keyword(s):  
Tertiary Care ◽  
Family Members ◽  
First Episode Psychosis ◽  
First Episode ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Episode Psychosis ◽  
The Family ◽  
Expressed Emotions

Background: The people who experience psychotic symptoms first time can be frightening for them and their close family members. It is crucial to provide family support and care to persons with first episode psychosis. Aim: To assess the needs of family members presenting to a tertiary care centre. Methods: Cross-sectional outpatient based study design was adapted to collect data from the family members of persons with first episode psychosis presented to a tertiary care centre. Total 60 family members were randomly selected for the study and assessed for the burden, attitude, ways of coping and quality of life. Results: Study results indicate the high burden; it has noted that high negative expressed emotions among family members. Negative coping styles were also found and the family members and having a poor quality of life. Conclusion: First episode of psychosis can traumatizing to the patients and their family members. Family members can experience the burden of caregiving including financial burden, can have faulty ways of coping and negative expressed emotions towards their own wards having psychosis which can lead to poor treatment outcome. Findings indicated that need to provide psychosocial intervention for family members of persons with first episode psychosis. Keyword: Family, psychosocial intervention, needs, first episode psychosis, expressed emotions, burden

scholarly journals Outcome and recovery in first-episode psychosis

2017 ◽  
Vol 211 (6) ◽  
pp. 331-333 ◽  
Author(s):  
Paddy Power
Keyword(s):  
Treatment Options ◽  
First Episode Psychosis ◽  
Predisposing Factors ◽  
First Episode ◽  
Treatment Protocols ◽  
Individual Level ◽  
Episode Psychosis ◽  
The Individual

SummaryThere is now a good body of evidence about factors that determine outcome and recovery in a first episode of psychosis. However, so far, this is of limited benefit when making predictions at an individual level. Treatment protocols are one size fits all and the recommended duration of medication remains unclear. What is needed is a more sophisticated approach to predicting outcomes and tailoring treatment options to the individual. Removing predisposing factors is an important aspect of this.

scholarly journals A Synthetic Literature Review on the Management of Emerging Treatment Resistance in First Episode Psychosis: Can We Move towards Precision Intervention and Individualised Care?

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 638
Author(s):  
Siân Lowri Griffiths ◽  
Max Birchwood
Keyword(s):  
Machine Learning ◽  
Early Treatment ◽  
Treatment Resistance ◽  
First Episode Psychosis ◽  
First Episode ◽  
Clinical Practices ◽  
Episode Psychosis ◽  
Wide Range ◽  
The Individual ◽  
Early Intervention In Psychosis

Treatment resistance is prevalent in early intervention in psychosis services, and causes a significant burden for the individual. A wide range of variables are shown to contribute to treatment resistance in first episode psychosis (FEP). Heterogeneity in illness course and the complex, multidimensional nature of the concept of recovery calls for an evidence base to better inform practice at an individual level. Current gold standard treatments, adopting a ‘one-size fits all’ approach, may not be addressing the needs of many individuals. This following review will provide an update and critical appraisal of current clinical practices and methodological approaches for understanding, identifying, and managing early treatment resistance in early psychosis. Potential new treatments along with new avenues for research will be discussed. Finally, we will discuss and critique the application and translation of machine learning approaches to aid progression in this area. The move towards ‘big data’ and machine learning holds some prospect for stratifying intervention-based subgroups of individuals. Moving forward, better recognition of early treatment resistance is needed, along with greater sophistication and precision in predicting outcomes, so that effective evidence-based treatments can be appropriately tailored to the individual. Understanding the antecedents and the early trajectory of one’s illness may also be key to understanding the factors that drive illness course.

COMPARISON OF TWO JOINT PSYCHIATRY/ENDOCRINOLOGY CLINICS STARTED IN A CHRONIC TERTIARY CARE PSYCHIATRIC HOSPITAL AND A FIRST EPISODE PSYCHOSIS PROGRAM

2008 ◽  
Vol 102 (1-3) ◽  
pp. 243-244
Author(s):  
Sharman Robertson ◽  
Mark Silverman ◽  
Amel Arnaoult ◽  
Carolyn Antonello ◽  
Margo Gibson ◽  
...  
Keyword(s):  
Psychiatric Hospital ◽  
Tertiary Care ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis

scholarly journals S34. EFFECTIVENESS OF INDIVIDUAL METACOGNITIVE TRAINING (MCT+) IN FIRST-EPISODE PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S44-S45
Author(s):  
Susana Ochoa ◽  
Raquel Lopez-Carrilero ◽  
Maria Luisa Barrigon ◽  
Esther Pousa ◽  
Eva Grasa ◽  
...  
Keyword(s):  
Repeated Measures ◽  
First Episode Psychosis ◽  
Post Treatment ◽  
First Episode ◽  
Positive Symptoms ◽  
Metacognitive Training ◽  
Cognitive Insight ◽  
Episode Psychosis ◽  
The Difference ◽  
The Individual

Abstract Background The individual Metacognitive Training (MCT+) is useful to reduce positive symptoms in people with schizophrenia, however less is known in people with first-episode psychosis (FEP). The aim of the study is to assess the effectiveness of MCT+ in FEP regarding symptoms and cognitive insight. Methods A random clinical trial was performed with people with FEP from 10 clinical centers of Spain. One group received ten sessions of MCT+ and the other group received TAU. A total of 75 patients were included in the study, however only 40 finished the final assessment. Patients were assessed before treatment, post-treatment and 6 month follow-up. The assessment includes a battery of instruments for the main aims the Positive and Negative Syndrome Scale (PANSS) and the Beck Cognitive Insight (BCIS) will be analyzed. Repeated measures statistical test were used in order to assess differences between groups. Results Both groups improved in Positive symptoms, in the MCT+ group the difference was 5.18 (SD=6.8) with a significance of p=0.002, while in the TAU group the difference was 3.38 (SD=4.9) with a significance of p=0.005. Regarding cognitive insight, in the MCT+ group patients improved in Self-reflectiveness, obtaining a score in baseline of 15.21 (SD=5.52) and 18 (SD=5.28) in post-treatment (p=0.017). The TAU group did not improve in any subscale of the BCIS. Discussion The MCT+ seems to improve more in positive symptoms than TAU, although both interventions diminished the presence of these symptoms. The MCT+ improved the self-reflectiveness, being one of the important areas for the understanding of the daily social functioning in relation to other. Further analysis should be explored.

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