Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Int J Soc Psychiatry. 2023 Sep;69(6):1354-1368. doi: 10.1177/00207640231164526. Epub 2023 May 1.
Recovery in psychosis is a multidimensional construct. The numbers of studies specially focusing on the recovery aspects in patients with first episode psychosis (FEP) are limited, with no study from India. Further, no study has looked specifically into the variables that affect recovery process in patients with FEP and little is known about factors which influence recovery in patients with FEP.
To evaluate psychological recovery and its correlates in patients with FEP, currently in clinical remission.
One hundred three patients of FEP in clinical remission were assessed on Recovery Assessment Scale (RAS), Positive and Negative Syndrome Scale for Schizophrenia, Calgary Depression Rating Scale for Schizophrenia, Negative Symptom Assessment 16, Rosenberg Self-esteem Scale, Social and Occupational Functioning Assessment Scale, the Alcohol, Smoking and Substance Involvement Screening Test, Beck Cognitive Insight Scale, Internalized Stigma of Mental Illness Scale, the Everyday discrimination Scale, Subjective Scale to Investigate Cognition in Schizophrenia and social cognitive deficits in theory of mind was evaluated on the Social Cognition Rating Tools in Indian Setting-Theory of Mind. The needs of the participants were assessed on the Camberwell Assessment of Needs - Research version and Supplemental Assessment of Needs. Coping, social support, medication adherence were also assessed by standardized scales.
The mean weighted score was highest for goal and success orientation subscale followed by seeking and relying on social support, personal confidence and hope, overcome the illness and awareness and control over the illness as assessed by 41 items of the RAS. The main factors identified to affect psychological recovery in patients with FEP were duration of untreated psychosis, greater psychopathology, lower self-esteem, total unmet need, feeling of discrimination and stigmatization.
The present study suggests that treatment of FEP should be started at the earliest and issues such as residual psychopathology, lower self-esteem, total unmet need, feeling of discrimination and stigma during the remission phase should be addressed by psychosocial interventions to promote psychological recovery in patients with first episode psychosis.
精神分裂症的康复是一个多维的概念。专门针对首发精神分裂症（FEP）患者康复方面的研究数量有限，印度也没有相关研究。此外，没有研究专门研究影响 FEP 患者康复过程的变量，也很少了解影响 FEP 患者康复的因素。
评估目前处于临床缓解期的 FEP 患者的心理康复及其相关因素。
对 103 例处于临床缓解期的 FEP 患者进行康复评估量表（RAS）、阳性和阴性综合征量表用于精神分裂症、卡尔加里精神分裂症抑郁评定量表、16 项阴性症状评定量表、罗森伯格自尊量表、社会和职业功能评定量表、酒精、吸烟和物质参与筛查测试、贝克认知洞察力量表、精神疾病内化耻辱感量表、日常歧视量表、主观调查精神分裂症认知量表和社会认知理论中的心理理论社会认知缺陷在印度情境下的社会认知评定工具进行评估。使用 Camberwell 需求评估-研究版和补充需求评估对参与者的需求进行评估。还通过标准化量表评估应对方式、社会支持和药物依从性。
RAS 的 41 个项目评估的目标和成功导向子量表的加权平均得分最高，其次是寻求和依赖社会支持、个人信心和希望、克服疾病以及对疾病的意识和控制。确定影响 FEP 患者心理康复的主要因素是未治疗精神病的持续时间、更大的精神病理学、更低的自尊、总未满足的需求、歧视和污名化的感觉。
本研究表明，应尽早开始治疗 FEP，并在缓解期通过心理社会干预解决残留的精神病理学、较低的自尊、总未满足的需求、歧视和污名化的感觉等问题，以促进首发精神分裂症患者的心理康复。
