Mental Disorder, Psychosis
Conditions
Keywords
Narrative identity
Brief summary
First episode psychosis (FEP) constitutes an important subgroup within psychotic disorders, as the acute impact of a disorder at the time of diagnosis may differ from its long-term impact over the following decades. Narrative is identified as a sense of personal agency, of belonging to a social group, metacognition, and well-being. Patients with schizophrenia have lower levels of agency and communion compared to HIV-positive participants. However, the themes of agency and communion and metacognition do not reflect all factors representing narrative identity. In order to measure well-being, it is also necessary to introduce a specific and multidimensional measure that will allow a more precise understanding of the phenomenon. In FEP, a link has been demonstrated between the specificity of self-recollection and functional outcomes. Given that the transitional developmental stage between adolescence and adulthood is a key developmental window for narrative identity as well as psychotic disorders and that narrative identity is positively associated with mental health, this study will therefore focus on the acquisition of narrative identity in the FEP. It will investigate the extent to which narrative identity has an impact on multidimensional subjective well-being and whether it can predict multidimensional subjective well-being over time. The study investigators hypothesize that the levels of the various components of narrative identity would be lower in cases of FEP compared to patients with other chronic psychotic conditions and controls.
Interventions
Participants will be asked to elaborate five personal narratives in response to the different types of questions: trauma, transgression, negative memory, self-definition, and turning point.
Sponsors
Centre Hospitalier Universitaire de Nīmes
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
16 Years to 30 Years
Inclusion criteria
* Subject who has given their free and informed consent. * Subject who has signed the consent form. * Subject who is a member of or beneficiary of a health insurance plan. For the FEP group: * Patient treated in a psychiatric department (consultation or hospitalization) for a FEP defined by: * Presence of positive psychotic symptoms (delusions and/or hallucinations and/or conceptual disorganization) evolving for at least one week, either every day or at least 3 times a week for at least one hour per occasion * Never having taken neuroleptic treatment with an antipsychotic purpose (with the exception of antipsychotic treatment initiated for the current episode) * Disorder meeting DSM 5 criteria from the following list: delusional disorder, brief psychotic disorder lasting more than 7 days, schizophreniform disorder, schizophrenia, schizoaffective disorder, substance-induced psychotic disorder lasting more than 7 days, other specific or non-specific schizophrenia spectrum disorder or other psychotic disorder, bipolar disorder I or II with mood-congruent and mood-incongruent psychotic features, substance-induced bipolar disorder with mood-congruent and mood-incongruent psychotic features, major depressive disorder with mood-congruent and mood-incongruent psychotic features For the Chronic group: • Patients diagnosed with a disorder meeting DSM-5 criteria for more than 18 months from the following list: delusional disorder, brief psychotic disorder lasting more than 7 days, schizophreniform disorder, schizophrenia, schizoaffective disorder, substance-induced psychotic disorder lasting more than 7 days, other specific or non-specific schizophrenia spectrum disorder or other psychotic disorder, bipolar I or II disorder with mood-congruent and mood-incongruent psychotic features, substance-induced bipolar disorder with mood-congruent and mood-incongruent psychotic features, major depressive disorder with mood-congruent and mood-incongruent psychotic features
Exclusion criteria
* The subject is participating in category 1 RIPH or a clinical drug trial or clinical investigation study, or is in a period of exclusion determined by a previous study * The patient is unable to express consent * It is impossible to give the subject informed information * The patient is under safeguard of justice or state guardianship * Pregnant or breastfeeding subject. * Patient with a history of traumatic brain injury * Patient with moderate to severe mental retardation (IQ ≤ 55) For the FEP group: • FEP related to a drug-induced psychotic disorder or due to another medical condition For the Control group: * Patient with lifetime experience of FEP * Patient with a diagnosis of a disorder meeting DSM-5 criteria from the following list: delusional disorder, brief psychotic disorder lasting more than 7 days, schizophrenia-like disorder, schizophrenia, schizoaffective disorder, substance-induced psychotic disorder lasting more than 7 days, other specific or non-specific schizophrenia spectrum disorder or other psychotic disorder, bipolar I or II disorder with mood-congruent and mood-incongruent psychotic features, bipolar disorder with mood-congruent and mood-incongruent psychotic features substance-induced mood, major depressive disorder with psychotic features congruent and incongruent with mood
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Emotional valence according to the question: When you think about this story in your life, how positive or negative is this story in your life? | Baseline (Day 0) | 7-point scale ranging from -3 Extremely negative to 3 Extremely positive |
| Emotional intensity according to the question: When you think about this story in your life, how intense is this story in your life? | Baseline (Day 0) | 7-point scale ranging from 1 Not at all intense to 7 Extremely intense - |
| Emotional tone according to the question When you think about this story in your life, is it generally negative, mixed, neutral, or positive? | Baseline (day 0) | 4-point scale ranging from 0 Negative to 4 Positive. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Anxiety and depression between groups | Baseline (Day 0) | Hospital Anxiety and Depression Scale questionnaire where a higher score indicates greater distress |
| Autobiographical memory between groups | Baseline (day 0) | Thinking About Life Experiences scale (TALE-15): 17-item questionnaire consists of two general questions followed by 15 specific items related to the functions of autobiographical memory, each composed of 5 sub-items. Responses are rated on a 5-point Likert scale ranging from Almost never to Very frequently. |
| Personality type between groups | Baseline (day 0) | Big Five Inventory (BFI-10): assessing the five major personality traits: extraversion, agreeableness, conscientiousness, emotional stability, and openness. |
| Symptomatology of psychotic disorders in the FEP and chronic groups | Baseline (day 0) | Positive and negative symptom scale (PANSS). 30 items measuring 5 subscales: positive, negative, disorganization, hostility, and anxiety. Each item is rated on a 7-point Likert scale ranging from 1 (absent) to 7 (extreme). The positive subscale ranges from 7 to 49, the negative subscale from 8 to 56, the hostility subscale from 6 to 46, the disorganization subscale from 5 to 35, and the anxiety subscale from 4 to 28. The total score ranges from 30 to 210. |
| Overall functioning in the FEP and chronic groups | Baseline (day 0) | Global Assessment of Functioning (GAF). This numerical scale (from 0 to 100) subjectively assesses functioning in social, occupational, and psychological domains. Lower scores represent lower levels of functioning |
| Personal recovery in the FEP and chronic groups | Baseline (day 0) | Stage of recovery instrument (STORI): a 50-item questionnaire that evaluates the five stages of personal recovery. Ten themes are assessed, each containing five items ranging from 0 Not at all true to 5 Completely true, corresponding to the five stages of personal recovery. A score is calculated for each stage, ranging from 0 to 50 |
| Narrative identity between groups | Baseline (Day 0) | PERMA Profiler questionnaire; a 15-item scale in which higher scores indicate greater well-being |
| Improvement of clinical state in the FEP and chronic groups | Baseline (day 0) | Clinical global impression (CGI): a global observer-rated assessment tool that measures a patient's clinical condition before and after medical treatment. It consists of two measures: Severity, which measures the severity of the patient's clinical condition; and Improvement, which assesses the improvement in the patient's clinical condition since the start of treatment, both on a scale of 1 to 7. |
| Awareness of the disorders in the FEP and chronic groups | Baseline (day 0) | Birchwood insight scale (BIS); multidimensional assessment of awareness of illness (insight) and includes 8 questions (3-point Likert scale: agree, disagree, or uncertain). The overall score ranges from 0 to 12, with a score above 9 indicating good insight. |
| Abstract verbal reasoning in the FEP and chronic groups | Baseline (day 0) | Similarities section of the Wechsler Adult Intelligence Scale (WAIS): For 18 pairs of words, the participant subject must identify the qualitative relationship between the two words |
| Non-verbal abstract problem solving in the FEP and chronic groups | Baseline (day 0) | Matrix reasoning section of the Wechsler Adult Intelligence Scale (WAIS); in which participants must identify patterns in drawings |
| Treatment adherence in the FEP and chronic groups | Baseline (day 0) | Medication adherence rating scale (MARS): 10-item questionnaire concerning medication adherence during the past week assessing behaviors, attitudes, and experiences related to the treatment. |
| Episodic memory between groups | Baseline (day 0) | California Verbal Learning Test--Second Edition (CVLT): in this word list recall and recognition test, the examiner reads a list of 16 nouns aloud at one-second intervals in a fixed order over five learning trials. The participant is asked to recall as many words as possible in any order (free recall). If subjects cluster words from each category, they are presumably using semantic organization. Free recall is tested immediately (short-term recall) and again after 20 minutes (long-term recall). |
| Social and individual performance in the FEP and chronic groups | Baseline (day 0) | Personal and social performance scale (PSP): measures four domains of social and individual functioning (socially useful activities, personal and social relationships, self-care, disruptive and aggressive behaviors) and provides a score between 1 and 100, divided into 10 equal intervals to assess the degree of difficulty. Higher scores correspond to better personal and social functioning, with scores of 91 to 100 indicating more than adequate functioning, while scores below 30 indicate such poor functioning that intensive supervision is required. |
| General health-related quality of life between groups | Baseline (day 0) | EQ5D-5L questionnaire comprising five items representing the five dimensions, and a visual analog scale ranging from 0 to 100 (100 referring to the best possible health state). The responses are then into a 5-digit number describing the patient's health state (e.g 11111 indicates the absence of problems). |
| Health-related quality of life between groups | Baseline (day 0) | WHOQOL-Brief: a 26-item questionnaire including one item on overall quality of life, one item assessing general health, and one item from each of the 24 facets of the WHOQOL-100. Four types of five-point response scales measure intensity (Not at all-Extremely), capacity (Not at all-Completely), frequency (Never-Always), and evaluation (Very dissatisfied/Very poor-Very satisfied/Very good). |
Countries
France
Contacts
Primary ContactJulie Jourdan
Outcome results
None listed