A good life with psychosis: rate of positive outcomes in first-episode psychosis at 10-year follow-up

Simonsen, Carmen; Åsbø, Gina; Slade, Mike; Wold, Kristin Fjelnseth; Widing, Line; Flaaten, Camilla Bärthel; Engen, Magnus Johan; Lyngstad, Siv Hege; Gardsjord, Erlend; Bjella, Thomas; Romm, Kristin Lie; Ueland, Torill; Melle, Ingrid

Abstract

Background
More knowledge about positive outcomes for people with first-episode psychosis (FEP) is needed. An FEP 10-year follow-up study investigated the rate of personal recovery, emotional wellbeing, and clinical recovery in the total sample and between psychotic bipolar spectrum disorders (BD) and schizophrenia spectrum disorders (SZ); and how these positive outcomes overlap.

Methods
FEP participants (n = 128) were re-assessed with structured clinical interviews at 10-year follow-up. Personal recovery was self-rated with the Questionnaire about the Process of Recovery-15-item scale (total score ⩾45). Emotional wellbeing was self-rated with the Life Satisfaction Scale (score ⩾5) and the Temporal Experience of Pleasure Scale (total score ⩾72). Clinical recovery was clinician-rated symptom-remission and adequate functioning (duration minimum 1 year).

Results
In FEP, rates of personal recovery (50.8%), life satisfaction (60.9%), and pleasure (57.5%) were higher than clinical recovery (33.6%). Despite lower rates of clinical recovery in SZ compared to BD, they had equal rates of personal recovery and emotional wellbeing. Personal recovery overlapped more with emotional wellbeing than with clinical recovery (χ2). Each participant was assigned to one of eight possible outcome groups depending on the combination of positive outcomes fulfilled. The eight groups collapsed into three equal-sized main outcome groups: 33.6% clinical recovery with personal recovery and/or emotional wellbeing; 34.4% personal recovery and/or emotional wellbeing only; and 32.0% none.

Conclusions
In FEP, 68% had minimum one positive outcome after 10 years, suggesting a good life with psychosis. This knowledge must be shared to instill hope and underlines that subjective and objective positive outcomes must be assessed and targeted in treatment.

Citation

Simonsen, C., Åsbø, G., Slade, M., Wold, K. F., Widing, L., Flaaten, C. B., Engen, M. J., Lyngstad, S. H., Gardsjord, E., Bjella, T., Romm, K. L., Ueland, T., & Melle, I. (2024). A good life with psychosis: rate of positive outcomes in first-episode psychosis at 10-year follow-up. Psychological Medicine, 54(9), 2112-2121. https://doi.org/10.1017/s0033291724000205

• Journal Article Type: Article
• Acceptance Date: Jan 22, 2024
• Online Publication Date: Feb 23, 2024
• Publication Date: Feb 23, 2024
• Deposit Date: Feb 23, 2024
• Publicly Available Date: Feb 23, 2024
• Journal: Psychological Medicine
• Print ISSN: 0033-2917
• Electronic ISSN: 1469-8978
• Publisher: Cambridge University Press
• Peer Reviewed: Peer Reviewed
• Volume: 54
• Issue: 9
• Pages: 2112-2121
• DOI: https://doi.org/10.1017/s0033291724000205
• Keywords: clinical recovery; emotional wellbeing; life satisfaction; positive feelings; personal recovery
• Public URL: https://nottingham-repository.worktribe.com/output/31616104
• Publisher URL: https://www.cambridge.org/core/journals/psychological-medicine/article/good-life-with-psychosis-rate-of-positive-outcomes-in-firstepisode-psychosis-at-10year-followup/C4B9226581F6A02E5D3DE3323421DD69
• Additional Information: Copyright: Copyright © The Author(s), 2024. Published by Cambridge University Press; License: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.; Free to read: This content has been made available to all.