Kamens Sarah, Davidson Larry, Hyun Emily, Jones Nev, Morawski Jill, Kurtz Matthew, Pollard Jessica, van Schalkwyk Gerrit Ian, Srihari Vinod
Department of Psychology, Wesleyan University.
Specialized Treatment Early in Psychosis (STEP) program, Yale University School of Medicine.
Psychosis. 2018;10(4):307-318. doi: 10.1080/17522439.2018.1524924. Epub 2018 Oct 25.
Mounting evidence has indicated that early intervention leads to improved clinical and functional outcomes for young persons experiencing recent onset psychosis. As part of a large early detection campaign, the present study aimed to investigate subjective experiences during the duration of untreated psychosis (DUP), or time between psychosis onset and treatment contact. Participants were 10 young adults participating in early intervention services for psychosis. After DUP was estimated during standardized baseline assessment, participants engaged in qualitative interviews focused on their life experiences prior to treatment and leading up to the present. Mixed methods data analyses compared standardized DUP estimates with participants' subjective narratives. Findings revealed that participants experienced and conceptualized a longer trajectory of subjective difficulties (TSD) beginning before and extending beyond standardized DUP estimates. Participants emphasized striving for independence and social belonging. The majority of participants reported benefiting from their current services and believed that earlier support of some kind would have been beneficial. These findings support previous research on subjective barriers to early detection and treatment seeking in young adults experiencing psychosis. Implications and future research directions include further efforts to differentiate the struggles unique to early psychosis from psychosocial risk factors and other challenges of young adulthood.
越来越多的证据表明,早期干预能为近期首发精神病的年轻人带来更好的临床和功能预后。作为一项大型早期检测活动的一部分,本研究旨在调查未治疗精神病持续时间(DUP),即精神病发作至治疗接触之间的时间内的主观体验。参与者为10名参与精神病早期干预服务的年轻成年人。在标准化基线评估中估计出DUP后,参与者进行了定性访谈,重点是他们治疗前及直至当下的生活经历。混合方法数据分析将标准化DUP估计值与参与者的主观叙述进行了比较。研究结果显示,参与者经历并概念化了一个更长的主观困难轨迹(TSD),该轨迹始于标准化DUP估计之前,并延伸至其之后。参与者强调追求独立和社会归属感。大多数参与者报告称从目前的服务中受益,并认为早期获得某种形式的支持会有益处。这些发现支持了先前关于年轻精神病患者早期检测和寻求治疗的主观障碍的研究。其意义和未来研究方向包括进一步努力,将早期精神病特有的挣扎与心理社会风险因素及青年期的其他挑战区分开来。