Depression in first episode psychosis

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http://eprints.org/relation/isVolatileVersionOf http://etheses.bham.ac.uk/id/document/3778 http://eprints.org/relation/ispreviewThumbnailVersionOf http://etheses.bham.ac.uk/id/document/3778 http://eprints.org/relation/isVersionOf http://etheses.bham.ac.uk/id/document/3778 archive 4031 disk0/00/00/16/50 2011-06-21 15:43:46 2019-01-23 09:54:35 2011-07-19 16:39:49 thesis show 0 Upthegrove Rachel Oyebode Femi University of Birmingham Depression in first episode psychosis unpub RC0321 BF HV 10col_mede There has been renewed interest into affective symptoms and psychological approaches to schizophrenia and other psychosis, yet no in-depth investigation as to the course, consequences or indeed psychological causes of depression in a phase specific manner in the important first episode. Our understanding of risk and aetiological processes in psychotic illness will only advance once we accurately identify the “end phenotype” of psychotic illness. This series of studies investigates the course of depression in first episode psychosis, its significance in terms of suicidal thinking, and relation to both diagnosis and other symptom domains. Depression in the acute and post psychotic phases is explored, through the importance of the awareness and appraisal of positive symptoms, and diagnosis itself. Significant findings include a pervasive nature of depression throughout the course of first episode psychosis, the predictive nature of prodromal depression and the high prevalence of suicidal acts. Appeasement and engagement with voices, subordination to persecutors and the (ineffective) use of safety behaviours drive a position of entrapment, demoralization and a lack of control. In addition negative illness appraisals are stable and may vary between cultural groups. Implications are explored, in terms of clinical practice, aetiological pathways, potential treatments and intervention strategies 2011-07 2010-12 graduation eng author unchecked This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder. public 191 University of Birmingham School of Clinical and Experimental Medicine d_ph na 2011-07 graduation