Talking about Life after Early Psychosis: The Impact on Occupational Performance

Abstract

Integration of developmental frameworks, focus on productive roles, and thoughtful application of client-centred practice emerge as issues with important practice implications as individuals develop awareness of disability and strive to maintain control over occupational choices and, ultimately, their lives.

Engagement in Activities and Occupations by People Who Have Experienced Psychosis: A Metasynthesis of Lived Experience

“…The participants in JA Brown's (2011) study were worried that their capacity to enjoy life had been permanently damaged by their development of a psychotic illness. Deegan (2002) related her negative experiences to the dehumanising approach initially taken by medical staff, explaining how she gradually internalised the stigma.…”

“…Happiness is gone (JA Brown 2011) Excitement (Emerson et al 1998) Accomplishment (Emerson et al 1998) Relaxation (Emerson et al 1998) Being interested (Emerson et al 1998) I am more than a schizophrenic (Deegan 2002) Overcoming internalised stigma (Deegan 2002) Wasting my life away (Legault and Rebeiro 2001) Reasons for engagement (Legault and Rebeiro 2001) Internal factors (Chugg and Craik 2002) Engagement as a means to self-actualisation (Hitch 2009) Factors that helped -internal (Cook and Self-care strategies that work for me (Deegan 2002) Tolerating discomfort while engaging (Deegan 2002) Recovery as a process of transformation (Deegan 2002) Drug use to cope (Deegan 2002) Coping with schizophrenia (Legault and Rebeiro 2001) Using drugs and alcohol (Legault and Rebeiro 2001) Individualised coping strategies (Legault and Rebeiro 2001) Health (Chugg and Craik 2002) Self-assessing/self-monitoring mental health (Woodside et al 2006) Working to maintain and improve mental health (Woodside et al 2006) Factors that hindered -internal Being in good physical health (Eklund et al 2012) Having good mental health (Eklund et al 2012) Relationships with family okay, but no intimate relationships (JA Brown 2011) Social connectedness (Emerson et al 1998) Importance of maintaining relationships (Deegan 2002) Feeling connected to others (Woodside et al 2006) Engagement as an interpersonal relationship (Hitch 2009) Important that staff and services show they value the person Having contacts with others (Eklund et al 2012) Being part of a social context (Eklund et al 2012) Little effect on self-care, but developmental progress to independent living disrupted ( JA Brown 2011) Productivity important as other areas are lost (JA Bro...…”

“…JA Brown (2011) .....................Phenomenology and occupational life history.........2..............3.................20s.............Canada.......................Yes................. Chugg and Craik (2002)...........Not specified -semi-structured interviews............4..............4...............23-49...............UK...........................Yes.................…”

Aripiprazole Long-Acting Injection During First Episode Schizophrenia—An Exploratory Analysis

“…When gradual, young adults may present with slow and progressive social isolation, deterioration in functioning, and development of positive symptoms over several months or years (1,7,8). Despite the possible lack of clear psychotic symptoms (9), often young adults may show a change in self experience, associated with a progressive decline in vocational activities and decreased professional or academic performance (10,11). With acute onset, abrupt social isolation and disengagement from work and school may arise simultaneously with delusions and hallucinations (10)(11)(12)(13)(14)(15) and one symptom may trigger the other or constitute a milieu into which other symptoms may be embedded (16).…”

“…Despite the possible lack of clear psychotic symptoms (9), often young adults may show a change in self experience, associated with a progressive decline in vocational activities and decreased professional or academic performance (10,11). With acute onset, abrupt social isolation and disengagement from work and school may arise simultaneously with delusions and hallucinations (10)(11)(12)(13)(14)(15) and one symptom may trigger the other or constitute a milieu into which other symptoms may be embedded (16). Abnormal self experience may reset brain activity, thus mediating the onset of positive symptoms and the first psychotic outbreak (17).…”