Dunkley Jane E, Bates Glen W, Findlay Bruce M
Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia.
Early Interv Psychiatry. 2015 Jun;9(3):211-20. doi: 10.1111/eip.12103. Epub 2013 Nov 20.
This study examined the distress of first-episode psychosis (FEP) beyond the acute episode. It focused on how people understand the experience of FEP and its negative impact and how this relates to the traumagenic phenomena.
This research was a longitudinal qualitative study including interpretative phenomenological analysis of interview data. Ten people who had experienced FEP were interviewed 3-6 months following their psychotic episode (time one) and again 3 months after their initial interview (time two). Clinicians and significant others were interviewed at time two.
Interpretative phenomenological analysis of the interview data supported a conceptualization of recovery from FEP within a broad trauma framework. The traumatic nature of FEP was found to be extended beyond the acute episode and was not linked to symptoms of post-traumatic stress disorder (PTSD) but included impact on identity, relationships and worldview.
The diagnosis of PTSD does not appear to capture all aspects of the distress of FEP. Traumagenic distress appears explained by incorporating a range of negative emotions, viewing the impact of FEP as ongoing rather than contained to the acute episode, and recognizes disruption of the individual's views of the self, others and the world.
本研究考察了首发精神病（FEP）急性期之后的痛苦状况。研究重点在于人们如何理解FEP经历及其负面影响，以及这与创伤性现象之间的关系。
本研究为纵向定性研究，包括对访谈数据进行解释现象学分析。10名经历过FEP的患者在精神病发作后3至6个月（第一次）接受访谈，并在初次访谈3个月后（第二次）再次接受访谈。在第二次访谈时对临床医生和重要他人进行了访谈。
对访谈数据的解释现象学分析支持了在广泛创伤框架内对FEP康复的概念化。研究发现，FEP的创伤性质不仅限于急性期，且与创伤后应激障碍（PTSD）症状无关，但包括对身份认同、人际关系和世界观的影响。
PTSD诊断似乎并未涵盖FEP痛苦的所有方面。创伤性痛苦似乎可以通过纳入一系列负面情绪来解释，将FEP的影响视为持续存在而非局限于急性期，并认识到个体对自我、他人和世界的看法受到了干扰。
