Qualitative investigation of targets for and barriers to interventions to prevent psychosis relapse

Abstract

BackgroundEarly signs based relapse prevention interventions for psychosis show promise. In order to examine how they might be improved we sought to better understand the early relapse process, service users’ abilities to identify early signs, and any potential facilitators and barriers to early signs interventions.MethodsData from in-depth interviews with a convenience sample of service users with psychosis varying in gender, age, duration of mental health problems, and time since last relapse were analysed using a thematic approach. Interview transcripts were coded inductively and relationships between emerging themes were examined by the research team to provide a thorough synthesis of the data.ResultsThree central themes emerged from the analysis: 1) recognising risk factors (how risk factors were identified and linked to relapse, and reactions to such risk factors); 2) identifying early signs (issues related to both recognising and recalling signs of relapse); 3) reacting to deterioration (participants’ thoughts and feelings in response to early signs, including help seeking and its challenges).ConclusionsThere was considerable variation in the attention participants had paid to pre-relapse signs, the ease with which they were able to recall them, and their reactions to them. For many, there were substantial barriers to help seeking from services. A family or friend confidant was an important means of assistance, although the supportive presence of significant others was not always available. Based on these results, a number of recommendations about facilitating service users’ recognition of early signs and targeting potential accelerants of relapse are made.

A qualitative analysis of relatives’, health professionals’ and service users’ views on the involvement in care of relatives in Bipolar Disorder

“…This study set out to identify the B&Fs to relatives’ involvement in the treatment of BD as experienced by relatives, HPs and SUs. Overall, narratives in this study confirmed difficulties in involving relatives described in the literature for both BD [ 50 ] and psychosis [ 51 ]. Participants recognised that there are opportunities for support for relatives to be involved, which are in keeping with existing clinical guidelines [ 23 ] and some evidence [ 32 ].…”

Developing a Hypothetical Implementation Framework of Expectations for Monitoring Early Signs of Psychosis Relapse Using a Mobile App: Qualitative Study

“…Commonly, relapses are preceded by so-called early warning signs (EWS) that reflect a combination of symptoms such as anxiety, depression, suspiciousness, and uniquely personal experiences. EWS-based prevention strategies assume that identifying relapse early enough enables preventative action and averts full relapse [5]. Guidelines for psychosis in both Scotland, the United Kingdom, [2] and Australia [6] recommend early signs-based strategies as crucial for relapse prevention in routine psychosis care.…”

The Effectiveness of Relapse Prevention Intervention on the Ability of Patients and Their Families to Prevent Psychotic symptoms of Relapse among Patients with Schizophrenia: Systematic Literature Review

“…The seventh study was done in England at a mental health clinic. A thematic approach was used in a qualitative study to analyze data from in-depth interviews with psychosis patients (20-25 participants) and to improved understand the early relapse phase, the willingness of patients and their families to recognize early signs and any possible barriers and facilitators to early sign interviewing 28 . The final study was performed in Southwestern Ethiopia at a special hospital.…”