No abstract

Recovery from a psychotic episode is a dynamic process after the devastating effects of being diagnosed with a serious mental illness, or the trauma of being hospitalized, rather than a cure or the absence of symptoms. Psychological recovery implies finding and maintaining hope, the reestablishment of a positive identity, finding meaning in life, and taking responsibility for one's life. Objective: The stages of the subjective psychological process of recovery after the first psychotic episode were explored; since psychological functioning, as well as symptoms and social functioning in the critical period probably are the most important long-term outcome predictor variables. Methods: The RSQ (Drayton, et al., 1998) and the STORI (Andresen, et al., 2006) were used to assess 30 patients (72.4% males) recovering from the first episode of a non-affective psychosis, 3 to 9 months after their clinical discharge. The mean age was 24.34 (SD=4.5, range=17-34). Results: The RSQ stages of recovery were: Tendency toward sealing-over (7.7%), Mixed, sealing-over predominates (42.3%), Mixed, integration predominates (38.5%), and Tendency toward integration (11.5%). The STORI stages of recovery were: Moratorium (11.5%), Awareness (31.0%), Preparation (27.0%), Rebuilding (11.5%), and Growth (19.0%). Significant correlations were found between better recovery stages and patient's adherence to treatment (χ 2 = 9.579, p = 0.008). Correlations between recovery stages and symptoms, neuropsychological functioning, and other variables were also explored. Conclusions: Recovery styles of Integration and Growth significantly correlate with treatment adherence, a better symptomatic (less negative and general symptoms) and functional recovery, but not with DUP, stigma, or neuropsychological variables.

Objective: Folie á deux is a rare mental syndrome, firstly described by Falret in France on 1997, and renamed in the DSM-IV as shared psychotic disorder, and in the ICD-10 as induced delusional disorder; in which a paranoid or delusional belief is shared by two people with a very close relationship, and usually belonging to the same family. Social withdrawal is a common characteristic of both persons during the initial stage of the disorder. Method: A 16 years-old adolescent boy, born in Russia, and having this syndrome is presented in this study. After his arrival to Spain, he lived with his father with important social isolation for six months, and he begun to report delusional ideas with mystical-religious and ufological content. His father was diagnosed as having a delusional disorder with the same contents. Both patients received behaviouralcognitive therapy (CBT) with the aim of modifying their delusional beliefs, even that they went on living together. No antipsychotic medication was needed. Results: Clear changes were observed in their delusional system, particularly in the degree of conviction, as well as in distress, thought interference, and anxiety, and also an improvement was observed in the understanding of their beliefs, and in their social relationship with peers. Conclusions: Social withdrawal as well as cultural differences associated to their immigrant condition played a critical role in the establishment of the induced delusional disorder, and CBT modified the delusional system, even father and son continued living together.