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    • Qualitative Study to Explore the Perspectives and Mental Health Experiences of First Episode Psychosis Patients and Their Caregivers in North India

    Mamta Sood,Rakesh K. Chadda,Nishtha Chawla,Tulika Shukla,Vaibhav Patil,Dhriti Ratra,Pallavi Rajhans,R. Padmavati,Rangaswamy Thara,Vijaya Raghavan,Mohapradeep Mohan,Srividya Iyer,Jai Shah,Jason Madan,Max Birchwood,Caroline Meyer, R. J. Lilford,Vivek Furtado,Graeme Currie,Swaran P. Singh

    Asian Journal of Psychiatry（2024）

    All India Inst Med Sci | Schizophrenia Res Fdn | Kings Coll London | Douglas Mental Hlth Univ Inst | Univ Warwick | Univ Birmingham

    Cited 0|Views8
    Abstract
    BACKGROUND:The onset of psychosis brings unfamiliar experiences that can be disturbing for patients and their caregivers. Few studies from India (only one from North India) have examined these experiences from the perspective of the patient and caregiver. We explored experiences of first episode psychosis (FEP) patients and their caregivers within a North Indian context. METHOD:Semi-structured interviews were conducted in 2019 with ten FEP patients and their caregivers (total n=20) receiving out-patient care in a tertiary care centre. Topic guides focused on concerns/complaints, symptoms, help-seeking, and barriers and facilitators to treatment. Interviews were audio recorded, transcribed, and analysed using qualitative content analysis. RESULTS:Main categories of responses from patients and caregivers included: initial complaints for seeking help, initial emotional response, barriers to seeking treatment, perceived dysfunction and improvement, experienced stigma, understanding about illness, early follow-up, preventive measures and awareness programs. Caregivers undergo myriad of emotional reactions including anger, anxiety, guilt, and confusion. Symptoms other than psychotic symptoms were the primary complaint upon seeking help, and there was lack of understanding about the psychosocial model of care (role of medications acknowledged with little awareness regarding psychosocial interventions in recovery). Persisting occupational dysfunction despite perceived symptomatic improvement was described by both patients and caregivers. CONCLUSION:North Indian patients with FEP lack awareness of symptoms. Therefore, onus for seeking help often falls on their caregivers. Psychoeducation from first contact with services and increasing awareness about psychotic illness within the community might help address lack of awareness about symptoms, mental health services, early signs of relapse, and importance of psychosocial interventions in achieving functional recovery.
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    India,Qualitative,Semi-structured interviews,FEP patients,Caregiver
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    【要点】：本研究探讨了北印度首次发作精神病患者及其护理者在经历精神疾病过程中的看法和心理健康体验，发现患者对症状缺乏认知，护理者承担了寻求帮助的主要责任。
    

    【方法】：通过半结构式访谈的方式，对10名接受门诊治疗的首次发作精神病患者及其护理者（共计20人）进行了调查，并采用定性内容分析方法对访谈资料进行了分析。
    

    【实验】：2019年进行的访谈被录音、转录，并使用定性内容分析方法进行分析，数据集为访谈转录文本。结果显示，患者和护理者的主要反馈包括：求助的初始投诉、初始情绪反应、治疗障碍、感知功能障碍与改善、经历的耻辱、对疾病的理解、早期随访、预防措施和意识项目。护理者经历了多种情绪反应，包括愤怒、焦虑、罪恶感和困惑。在寻求帮助时，非精神病症状是主要投诉，且对心理社会治疗模式的理解不足。尽管症状有所改善，患者和护理者仍描述了持续的职业功能障碍。