Gain from illness may also affect adherence to anti-psychotic medications, which primarily target the reduction of positive symptoms. A plethora of factors have been implicated in medication adherence, including lack of insight and side effects (Higashi et al., 2013 Kim et al., 2020). With rates of medication discontinuation reaching 50–75 %, medication non-adherence is a serious obstacle in the treatment of patients with psychosis (Kim et al., 2020). Rather, psychotic symptoms may be experienced on a spectrum from a distressing to a welcomed occurrence. This counters the popularly held belief that individuals with psychosis solely suffer from psychotic symptoms. Although most participants (74.3 %–85.7 %) indicated that symptoms had primarily a negative impact on daily life, up to one quarter reported that symptoms had either no or even a positive impact on daily life. In a study examining gain from illness among participants with symptoms of psychosis recruited from online forums utilizing the Subjective Perception of Psychotic Symptoms (SUPPOSY) scale, up to 72.4 % of patients indicated that they may at times miss symptoms if they were to disappear (Moritz et al., 2015). Within this context, gain from illness refers to the extent to which a symptom of psychosis is appraised as (at least partially) positive, pleasant or beneficial (Moritz et al., 2015). Reported positive qualities of auditory hallucinations include feelings of importance, safety and amusement or facilitating personal growth (Lorente-Rovira et al., 2020 Valavanis et al., 2019). Voice-hearing is also experienced positively by some patients (Jenner et al., 2008 Sanjuan et al., 2004 Valavanis et al., 2019), especially those who attempt to form positive relationships with voices by making meaning of them (Jackson et al., 2011). Feelings of companionship and positive attention have also been attributed to delusions (Sundag et al., 2015). For example, delusions, particularly those that impart patients with a feeling of special importance or involve being the object of another person's desire, serve to bolster self-esteem (Garety et al., 2013 Moritz et al., 2010 Sundag et al., 2015). Up to half of individuals with psychosis experience adequate quality of life despite the presence of symptoms (Karow et al., 2014) and it is now clear that some individuals with psychosis welcome the presence of at least some positive symptoms or express ambivalence towards them (Moritz et al., 2015). Although the distressing aspects of positive symptoms of psychosis have been well-documented (Griffiths et al., 2019 Smith et al., 2006 Upthegrove et al., 2016) and are often the focus of psychiatric treatment (Bruijnzeel et al., 2014), pleasant or beneficial experiences with positive symptoms are also reported (Copolov et al., 2004 Jenner et al., 2008 Valavanis et al., 2019). Indeed, psychosis is associated with lower quality of life (Dong et al., 2019), repeated hospitalizations (Correll et al., 2018), comorbid depression (Li et al., 2020) and increased disability (Vos et al., 2012). In the psychiatric care of patients with psychosis, emphasis is often placed on the suffering that these individuals experience.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |