Investigating the psychological typology of social recovery in individuals with first episode psychosis

Hodgekins, Joanne (2012) Investigating the psychological typology of social recovery in individuals with first episode psychosis. Doctoral thesis, University of East Anglia.

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Abstract

Background
Social disability has long been linked with psychosis. However, at what stage
disability occurs, whether it exists for all individuals, and factors predicting outcome are
still under debate. Assessing social functioning in first episode psychosis (FEP) presents
a methodological challenge as many existing tools were developed for chronic
schizophrenia and are confounded with psychotic symptoms.
Aims
This study explored the prevalence and typology of social disability in FEP.
Different trajectories of social recovery were examined as well as predictors of
outcome.
Method
A sample of 878 individuals with FEP were assessed upon entry into Early
Intervention for Psychosis (EIP) services and followed up over 12 months. Social
disability was assessed using weekly hours engaged in structured activity on the Time
Use Survey (TUS). Recovery profiles were examined using two approaches: transition
between clinical and non-clinical cut-off scores on the TUS, and Latent Class Growth
Analysis. Baseline predictors of outcome were examined using ordinal and multinomial
regression.
Results
At baseline, over 80% of participants scored below the non-clinical cut-off of 45
hours per week in structured activity. Male gender and poor premorbid adjustment in
adolescence predicted baseline levels of social disability. Over 50% of participants
remained socially disabled following 12 months of EIP service provision. Social
recovery over the 12 month study period was predicted by baseline time use, gender,
Typology of Social Recovery from FEP J. Hodgekins
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ethnicity, age of onset of psychosis, duration of untreated psychosis, negative
symptoms, and premorbid adjustment in adolescence.
Conclusion
Social disability is prevalent in FEP, although a significant minority do not
experience any social disability and make a full social recovery. Where social disability
is present upon entry into EIP services it can remain stable over time. Social disability
may occur in adolescence, even before the onset of psychotic symptoms. The clinical
and theoretical implications of the findings are discussed.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Brian Watkins
Date Deposited: 15 May 2013 08:15
Last Modified: 10 Jun 2013 15:36
URI: https://ueaeprints.uea.ac.uk/id/eprint/42396
DOI:

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