Early detection of psychosis: helpful or stigmatizing experience? A qualitative study

Abstract

The results suggest that early detection services help individuals cope with symptoms and potential stigmatization rather than enhancing or causing the latter. More emphasis should be put on the subjective experiences of those concerned when debating the advantages and disadvantages of early detection with regard to stigma. There was no evidence for increased perceived stigma and discrimination as a result of receiving information about the ARMS.

"I Want to Go Home, but I Need to Stay": The Transition to become Ready for Discharge from Acute Psychiatric Wards, as Narrated by Persons Who Experienced Acute Psychotic Illness

“…The rich detailed descriptions presented in our results allow the reader to consider the transferability of the results to other contexts and may, thus, contribute to the development of nurses' transitional care to help persons for discharge and return home. Aspects of our results are consistent with previous research describing transitions in persons' psychotic illness experiences [53,54] and provide new knowledge. The new knowledge informs about the transitional period when persons psychotic symptoms decreased and about their needs of nurses transitional care.…”

Should we be concerned about stigma and discrimination in people at risk for psychosis? A systematic review

“…Out of 38 studies included in this systematic review, 7 specifically focused on internalized stigma (Table 1). However, two studies are not analytic, being in one case a descriptive study (Uttinger et al, 2018) and in the other a case report (Baer, Shah, & Lepage, 2019). Three studies compare PR individuals with a control group of (i) healthy subjects with reference to multiple sources of stigma other than mental health such as appearance, age, gender, ethnicity, skin color, religion, disability, and sexual orientation (Saleem et al, 2014), (ii) an impaired sample with non-psychotic disorders (Yang et al, 2015), and (iii) PR individuals receiving cognitive therapy (Morrison et al, 2013) (Table 2).…”

“…Also, the higher the stereotype awareness, the higher is the agreement with them, which in turn is associated with the experience of negative emotions (Yang et al, 2015). Complementary evidence from semi-structured interviews indicates high levels of internalized stigma in PR individuals (Uttinger et al, 2018). PR individuals reporting internalized stigma, negative appraisals of their unusual experiences, reduced social acceptance of such experiences, and shame are more likely to experience high levels of distress related to their condition (Baer et al, 2019; Pyle et al, 2015) and to misattribute fear to non-fearful stimuli (Larsen et al, 2019).…”

“…This review identified four studies specifically assessing whether PR individuals perceive discrimination in the society because of their condition (Georgopoulos et al, 2019; Rusch et al, 2014a; Saleem et al, 2014; Uttinger et al, 2018) (Table 1). All of them indicate that discrimination plays an important role in the experience of a PR state.…”

Impact of “psychosis risk” identification: Examining predictors of how youth view themselves

“…Conveying PR to youth may bring relief and encourage healthpromoting behaviors (Yang et al, 2015). Conversely, conveying PR to youth may activate stigma via an additional psychiatric "label" of PR (Yang et al, 2015;Tsuang et al, 2013), thus eliciting distressing negative stereotypes associated with psychosis (Uttinger et al, 2015). Approximately 30-35% of CHR youth may develop threshold psychosis within 2-2½ years of identification, meaning that a majority thus identified could be exposed to potential stigma for a condition that in some cases will never develop (Fusar-Poli et al, 2012).…”