Serious Mental Health Problems in the Community: Policy, Practice, and Research

By Charlie Brooker; Julie Repper | Go to book overview

CHAPTER 10
Early Intervention in
Psychotic Relapse

Max Birchwood, Jo Smith, Fiona Macmillan and Dermot McGovern


KEY ISSUES

INTRODUCTION

The control of relapse is among many of the needs of people with psychosis. It is important, however, as each relapse brings with it an increased probability of future relapse and residual symptoms (McGlashan, 1988) as well as accelerating social disablement (Hogarty et al., 1991). Even an ideal combination of pharmacological and psychosocial intervention does not eliminate the potential for relapse (Hogarty et al., 1991).

These facts are not lost on those who themselves experience recurring psychotic symptoms. A survey by Meuser et al. (1992) found that patients expressed a strong interest in learning about 'early warning signs of the illness and relapse' and this was ranked second in importance out of an agenda of over forty topics. Their thirst for knowledge and understanding of this matter would seem to be driven by a perceived need for control rather than mere curiosity. In a study of 'secondary depression in schizophrenia' (Birchwood et al., 1993) it was found that 'perceived control over illness' was the variable most closely linked to depression, more so than illness variables, locus of control or self-evaluative beliefs derived from culture bound beliefs about mental illness (Box

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