Longitudinal changes in personal recovery in individuals with psychotic disorders through hospitalisation in a psychiatric ward: preliminary findings

Abstract

Background This study aimed to investigate whether personal recovery indices in individuals with psychotic disorders would change through hospitalisation in a psychiatric ward and to identify factors associated with these changes. Methods Participants underwent assessments for personal recovery using the Questionnaire about the Process of Recovery, Recovery Assessment Scale, and Self-Identified Stage of Recovery Part A and B; clinical symptoms using the Positive And Negative Syndrome Scale; self-efficacy using the General Self-Efficacy Scale; and self-esteem using the Rosenberg Self-Esteem Scale at baseline and before hospital discharge. Wilcoxon signed-rank tests were administered for longitudinal comparisons between baseline and follow-up. Spearman’s rank correlation tests were conducted to assess correlations of longitudinal changes in personal recovery with baseline values of personal recovery as well as baseline values or changes in the Positive And Negative Syndrome Scale, General Self-Efficacy Scale, and Rosenberg Self-Esteem Scale. Results Thirty-four individuals with psychotic disorders completed the assessments. The average duration of the current hospitalisation was 81.9 days (SD, 15.3; median, 85.0; range, 51–128 days). No significant changes were observed in personal recovery, self-efficacy, and self-esteem, although clinical symptoms significantly improved. Significant correlations were found between positive changes in the Recovery Assessment Scale and improvements in negative symptoms; between positive changes in the General Self-Efficacy Scale and those in personal recovery assessed with the Questionnaire about the Process of Recovery, Recovery Assessment Scale, and Self-Identified Stage of Recovery part A; and between positive changes in the Rosenberg Self-Esteem Scale and those in the Self-Identified Stage of Recovery part B. Conclusion This study revealed longitudinal relationships between changes in personal recovery and amelioration of negative symptoms or enhancement of self-efficacy and self-esteem through moderate length of hospitalisation in individuals with psychotic disorders. Considering the small sample size in this study, further studies with a larger sample size are needed to confirm the present finding. Trial registration The protocol of this study is registered in the UMIN Clinical Trials Registry (UMIN-CTR; ID: UMIN000035131).

Personal meaning of recovery among persons with schizophrenia

“…The themes of the current study ‘no symptom domination’, ‘regain functioning’, and ‘emotional stability’ validate the above findings. However, a recent meta-analysis on factors associated with recovery indicates personal recovery factors are not related to symptoms (Leendertse et al, 2021) and perception of personal recovery did not change although clinical symptoms improved during hospitalization (Mitsunaga-Ohmuro & Ohmuro, 2021).…”

Relationship between personal recovery, autobiographical memory, and clinical recovery in people with mental illness in the acute phase

“…Third, the cross-sectional design of this study limited the significance of the findings. A previous study conducted in Japanese acute care wards that focused on medication [ 39 ] found no longitudinal changes in personal recovery. Therefore, the effects of personal narratives shared within psychosocial treatment interventions on personal recovery have not been examined and should be evaluated longitudinally.…”

“…However, most participants in the current study were hospitalized patients with relatively mild psychiatric symptoms who were participating in psychiatric rehabilitation. Decreased autonomy and decision-making in the inpatient setting have been noted in the past [ 39 ], and it is possible that the participants in this study were more controlled in terms of their environment. Along with the psychopathological heterogeneity of the participants, this environmental specificity may explain the difference between our results and previous findings.…”