Suffering is a core experience of FEP from which a range of positive changes can follow among service users and their families and friends. It may be beneficial for mental health services to specifically strive to promote these positive changes.

Varying perceptions of who should be responsible for supporting individuals with mental health problems may contribute to their needs remaining unmet. A qualitative descriptive design was used to explore these perceptions among key stakeholders. Focus groups were conducted with 13 service users, 12 family members, and 18 treatment providers from an early psychosis intervention program in Montreal, Canada. Individual interviews were conducted with six mental health policy-/decision-makers. Participants across stakeholder groups assigned a range of responsibilities to individuals with mental health problems, stakeholders in these individuals’ immediate and extended social networks (e.g., families), macro-level stakeholders with influence (e.g., government), and society as a whole. Perceived failings of the health care system and the need for greater sharing of roles and responsibilities also emerged as important themes. Our findings suggest that different stakeholders should collectively assume certain responsibilities and that systems-level failings may contribute to unmet needs for mental health support.

Objective: Diagnostic stability is an important indicator of the reliability and validity of psychiatric diagnoses and has implications in clinical practice and research. While several studies have investigated the diagnostic stability of first-episode psychosis (FEP) disorders, less is known about psychiatric comorbidity in FEP and the persistence of such comorbid conditions over time. Our study aimed to confirm the diagnostic stability of FEP disorders and determine the variation in persistence of comorbid substance use disorders (SUDs), mood disorders, and anxiety disorders over 1 year. Method:The Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition was conducted at first presentation and repeated after 1 year (or reconstructed) for 214 FEP patients at the Prevention and Early Intervention Program for Psychoses-Montreal.Results: Psychotic disorder diagnoses were retained by 76.2% of patients at 1 year, schizophrenia being the most stable diagnosis (92.1%). Most diagnostic shifts were to schizophrenia and schizophrenia spectrum disorders. Comorbid SUDs, anxiety disorders, and mood disorders persisted for 50.7%, 64.0%, and 16.7% of patients, respectively. Many new cases of each of these disorders also emerged at 1-year follow-up.Conclusions: These findings demonstrate the stability of primary psychotic disorder diagnoses and greater fluidity of comorbid psychiatric diagnoses, with anxiety disorders persisting as comorbid conditions more than mood disorders and SUDs. These results highlight the importance of repeating a structured diagnostic assessment longitudinally, especially for consideration of comorbid conditions. W W W Stabilité diagnostique des premiers épisodes de troubles psychotiques et persistance des troubles psychiatriques comorbides sur un anObjectif : La stabilité diagnostique est un important indicateur de la fiabilité et de la validité des diagnostics psychiatriques et elle a des implications dans la pratique clinique et la recherche. Bien que plusieurs études aient investigué la stabilité diagnostique du premier épisode des troubles psychotiques (PEP), on en sait moins sur la comorbidité psychiatrique du PEP et sur la persistance de ces affections comorbides avec le temps. Notre étude visait à confirmer la stabilité diagnostique du PEP et à déterminer la variation de la persistance des troubles liés à l'utilisation de substances (TUS), des troubles de l'humeur, et des troubles anxieux comorbides sur 1 an.Méthode : L'entrevue clinique structurée pour les troubles de l'axe I du DSM-IV-TRédition du patient a été menée à la première présentation et répétée après 1 an (ou reconstruite) auprès de 214 patients du PEP au Programme d'évaluation, d'intervention et de prévention des psychoses (PEPP-Montréal).Résultats : Les diagnostics de trouble psychotique étaient retenus par 76,2 % des patients, 1 an après, la schizophrénie étant le diagnostic le plus stable (92,1 %). La plupart des changements de diagnostic se sont faits vers la schizophrénie et les troubles du spectre

In addition to the negative aftermath of FEP, PTG may also occur. Evidence of PTG following FEP will be examined in a systematic review focused on the recovery and qualitative literature.