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Jordan G, Bassetto S, DeLuca J, Dobbs MF, Florence A, Allemang B, O'Keeffe D, Basile M, Funaro MC, Davidson L, Ben-David S, Shah J. Personal Recovery Among People at Risk for Developing Serious Mental Health Problems: A Qualitative Systematic Review. Psychiatr Serv 2024; 75:778-788. [PMID: 38410038 DOI: 10.1176/appi.ps.20230133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
OBJECTIVE Personal recovery refers to a person's pursuit of a full, meaningful life despite the potentially debilitating impact of a mental illness. An evidence base describing personal recovery among people at risk for developing a mental illness is lacking, limiting the potential for mental health services to support personal recovery. To address this gap, the authors synthesized the extant research describing personal recovery among people at risk for developing a mental illness. METHODS A systematic search of several literature databases (MEDLINE, Embase, APA PsycInfo, Web of Science Core Collection, and Cochrane Library) was conducted to retrieve qualitative and case studies and first-person accounts. The Joanna Briggs Institute guidelines for systematic reviews were followed. Included studies reported on participants at variable risk for developing a schizophrenia spectrum, bipolar, major depressive, or borderline personality disorder. Articles were retrieved through a librarian-assisted search and through use of additional strategies (e.g., expert consultation). Abstracts were screened by the research team, and themes were developed by using thematic synthesis. RESULTS The 36 included articles were synthesized, and six themes were generated: difficulties and challenges; establishing an understanding of, and finding ways to cope with, one's mental health challenges; reestablishing a sense of agency and personhood; receiving support from people and services, as well as restoring relationships; reestablishing hope, meaning, and purpose; and overcoming stigma and destigmatizing mental illness in others. CONCLUSIONS These findings provide a conceptual foundation that can guide future research on personal recovery and clinical interventions that foster it among people at risk for mental illness.
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Affiliation(s)
- Gerald Jordan
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
| | - Stella Bassetto
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
| | - Joseph DeLuca
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
| | - Matthew F Dobbs
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
| | - Ana Florence
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
| | - Brooke Allemang
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
| | - Donal O'Keeffe
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
| | - Mikaela Basile
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
| | - Melissa C Funaro
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
| | - Larry Davidson
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
| | - Shelly Ben-David
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
| | - Jai Shah
- Institute for Mental Health, Centre for Urban Wellbeing, School of Psychology, University of Birmingham, Birmingham, United Kingdom (Jordan); Department of Psychiatry, McGill University, Montreal (Bassetto, Shah); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City (DeLuca, Dobbs); Department of Psychological & Brain Sciences, Fairfield University, Fairfield, Connecticut (DeLuca); New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York City (Florence); Faculty of Social Work, University of Calgary, Calgary, Canada (Allemang); ARCHES Recovery College, Mental Health Ireland, Dublin (Ó'Keeffe); School of Social Work, University of British Columbia, Kelowna, Canada (Basile, Ben-David); Harvey Cushing/John Hay Whitney Medical Library (Funaro) and Yale Program for Recovery and Community Health, Department of Psychiatry (Davidson), Yale University, New Haven
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Lo Buglio G, Pontillo M, Cerasti E, Polari A, Schiano Lomoriello A, Vicari S, Lingiardi V, Boldrini T, Solmi M. A network analysis of anxiety, depressive, and psychotic symptoms and functioning in children and adolescents at clinical high risk for psychosis. Front Psychiatry 2022; 13:1016154. [PMID: 36386985 PMCID: PMC9650363 DOI: 10.3389/fpsyt.2022.1016154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Youths at clinical high risk for psychosis (CHR-P) are characterized by a high prevalence of anxiety and depressive disorders. The present study aimed at developing and analyzing a network structure of CHR-P symptom domains (i.e., positive, negative, disorganization, and general subclinical psychotic symptoms), depressive and anxiety symptoms, and general functioning. Methods Network analysis was applied to data on 111 CHR-P children and adolescents (M age = 14.1), who were assessed using the Structured Interview for Prodromal Syndromes, the Children's Depression Inventory, the Children's Global Assessment Scale, and the Multidimensional Anxiety Scale for Children. Results In the network, negative and disorganization symptoms showed the strongest association (r = 0.71), and depressive and anxiety symptoms showed dense within-domain connections, with a main bridging role played by physical symptoms of anxiety. The positive symptom cluster was not associated with any other node. The network stability coefficient (CS) was slightly below 0.25, and observed correlations observed ranged from 0.35 to 0.71. Conclusion The lack of association between subclinical positive symptoms and other network variables confirmed the independent nature of subclinical positive symptoms from comorbid symptoms, which were found to play a central role in the analyzed network. Complex interventions should be developed to target positive and comorbid symptoms, prioritizing those with the most significant impact on functioning and the most relevance for the young individual, through a shared decision-making process. Importantly, the results suggest that negative and disorganization symptoms, as well as depressive and anxiety symptoms, may be targeted simultaneously.
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Affiliation(s)
- Gabriele Lo Buglio
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Maria Pontillo
- Child Psychiatry Unit, Department of Neuroscience Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Erika Cerasti
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
- Istituto Nazionale di Statistica (Istat), Rome, Italy
| | - Andrea Polari
- Orygen Specialist Programs, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | | | - Stefano Vicari
- Child Psychiatry Unit, Department of Neuroscience Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Science and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Tommaso Boldrini
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Marco Solmi
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, ON, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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