Impact of a diagnosis of psychosis: user-led qualitative study

Abstract

Aims and MethodTo explore the impact of diagnosis on people who experience psychosis. Eight participants were interviewed about the impact that diagnosis had on them.ResultsThe research found that the impact of diagnosis can involve both positive and negative elements. It can be a ‘means of access’ as well as a ‘cause of disempowerment’. It can help by ‘naming the problem’ and hinder by ‘labelling the person’. It is a ‘cause of social exclusion’ for all, but despite this service users can be successful in ‘achieving social inclusion’.Clinical ImplicationsThe findings have implications for how diagnosis is imparted by psychiatrists if they are to help to facilitate recovery and social inclusion.

What is psychosis? A meta-synthesis of inductive qualitative studies exploring the experience of psychosis

“…Hallucinated voices can reinforce this hopelessness (Jarosinski, 2008). The mental health system can lead to loss of hope through biological determinism (Thornhill et al, 2004), pessimistic attitudes towards reemployment (Chernomas et al 2000;Marwaha et al, 2004) and recovery (Tooth et al, 2003), and diagnosis (Judge et al, 2008;Pitt et al, 2009;Wagner & King, 2004) particularly when communicated in the form of "You've got schizophrenia, you will be ill for the rest of your life" (Schulze et al, 2003, p. 304). Loss of hope often leads to a depressed, demotivated state (Bassett et al, 2001;Gould et al, 2005;Laliberte-Rudman et al, 2000), with one participant when asked what they saw themselves doing in the next five years, simply replying "nothing" (McCann & Clark, 2004, p. 789).…”

“…One's self-identity can also be lost, with diagnosis being associated with a change in identity (Pitt et al, 2009), such as a "dehumanizing and devaluing transformation from being a person to being an illness… to being 'a schizophrenic'" (Dilks et al, 2010, p. 98). Sideeffects of anti-psychotic medication can also lead to changes in both self-identity and selfesteem, often through weight gain and sexual dysfunction (Johnstone et al, 2009;Laithwaite et al, 2007;Roe et al, 2009).…”

“…(Mackrell & Lavender, 2004;Tooth et al, 2003;Shea et al, 2010) and demonstrate constancy (Lencucha et al, 2008). Friendships with people who shared similar psychotic experiences (Nixon et al, 2010a) can help give a valued sense of solidarity (Knight et al, 2003;Lencucha et al, 2008;Pitt et al, 2009). …”

Renaming ‘schizophrenia’: a step too far or not far enough?

“…The impact of identifying with the diagnosis can in itself have a detrimental impact on recovery (Link et al 2001). Although it is important to recognize that for some people the diagnosis confers benefits including naming the problem and providing a means of access to support (Pitt et al 2009), the implied permanence and severity of the supposed condition can be debilitating. A key question in all this is whether changing the name would be enough in itself to change public attitudes and reduce self-stigma, while hopefully maintaining any potential benefits, or would such stigma become re-aligned with the new diagnostic term.…”

Conceptualisation of recovery from psychosis: a service-user perspective

“…This has been illustrated in other service-user-led studies about recovery 5 and impacts of diagnosis. 34 This strength may also be a limitation. The service user's personal experiences will have influenced the direction and data extracted by the interview process.…”