Subjective experience of diagnosis and treatment in two adolescents with first-episode schizophrenia

Abstract

The results of a qualitative study on the subjective experience of two adolescents in treatment for first-episode schizophrenia (FESZ) are presented here. We reconstructed the relevant aspects of the diagnosis and treatment processes based on the elaboration of said experience carried out by the participants. We therefore incorporated the perspective of the patients, family members and psychotherapists. The recovery from FESZ, understood as a positive adaptation to the experience of psychosis, is closely connected with the possibility of the adolescent to re-embark on his/her biographical trajectory. In this sense, the concept of recovery from FESZ increasingly emphasizes the subjective dimension of this process. The aim of the study is to understand the subjective experience of diagnosis and treatment processes from the perspective of two patients with FESZ who received comprehensive treatment in the Chilean public health system, their family members and their psychotherapists. The study performed semi-structured interviews and a qualitative content analysis in order to understand and describe, from their perspectives, the subjective experiences associated with the processes of diagnosis and treatment of FESZ. The inclusion of patients, relatives and psychotherapists allowed complementing the perspectives on the phenomenon under study. The results suggest that the central phenomena of appropriation of FESZ and resistance to the appropriation of FESZ are relevant in the accounts of these two cases. The family's emotional climate associated with the experience of FESZ converge in these phenomena, as well as the participation of the adolescent in the processes of diagnosis and treatment, specifically as these processes favor or hinder an appropriation of the psychopathological experience and this enables the reestablishment of the autobiographical continuity. Appropriation of FESZ seems to rely on future prospects that preserve some possibility of performing prior potentialities and expectations, or at least to adapt them in a tolerable way for the adolescents and their environment. Such findings highlight the relevance of developing interventions that encourage more hopeful future perspectives for individuals facing a first psychotic episode and their families.