The Paradox of Help-Seeking Behaviour in Psychosis
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The Paradox of Help-Seeking Behaviour in Psychosis. / Nordgaard, Julie; Nilsson, Lars Siersbaek; Gulstad, Karina; Buch-Pedersen, Marlene.
I: Psychiatric Quarterly, Bind 92, 2021, s. 549–559.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - The Paradox of Help-Seeking Behaviour in Psychosis
AU - Nordgaard, Julie
AU - Nilsson, Lars Siersbaek
AU - Gulstad, Karina
AU - Buch-Pedersen, Marlene
PY - 2021
Y1 - 2021
N2 - Little is known about which factors actually motivate individuals with psychosis to seek help or how psychosis may complicate the help-seeking process. The aim of this article is to examine the steps of this process and how psychopathological experiences might affect and interfere with it. In this qualitative study we interviewed nine patients with a first episode of psychosis. The interviews were transcribed and analysed according to the principles of thematic analysis using inductive as well as deductive methods. The crucial step in help-seeking behaviour seemed to be for the patients to identify the kind of problem they were facing. None of them clearly recognized their psychotic or otherwise anomalous experiences as symptoms of a mental disorder, and most of them did not seriously question the reality status of these experiences. For most of the patients it was an untenable social situation that caused them to seek help. When they did seek help the majority did not initially contact the psychiatric services. It seems paradoxical to expect patients who experience symptoms of psychosis for the first time to be able to unambiguously identify them as being exactly that and accordingly seek out psychiatric help, as diminished insight into illness is an inherent feature of psychosis. However, the phenomenon of ‘double bookkeeping’ seemed to provide an opening for seeking help from psychiatry in spite of compromised insight. This observation should be included in everyday clinical work and in future information campaigns.
AB - Little is known about which factors actually motivate individuals with psychosis to seek help or how psychosis may complicate the help-seeking process. The aim of this article is to examine the steps of this process and how psychopathological experiences might affect and interfere with it. In this qualitative study we interviewed nine patients with a first episode of psychosis. The interviews were transcribed and analysed according to the principles of thematic analysis using inductive as well as deductive methods. The crucial step in help-seeking behaviour seemed to be for the patients to identify the kind of problem they were facing. None of them clearly recognized their psychotic or otherwise anomalous experiences as symptoms of a mental disorder, and most of them did not seriously question the reality status of these experiences. For most of the patients it was an untenable social situation that caused them to seek help. When they did seek help the majority did not initially contact the psychiatric services. It seems paradoxical to expect patients who experience symptoms of psychosis for the first time to be able to unambiguously identify them as being exactly that and accordingly seek out psychiatric help, as diminished insight into illness is an inherent feature of psychosis. However, the phenomenon of ‘double bookkeeping’ seemed to provide an opening for seeking help from psychiatry in spite of compromised insight. This observation should be included in everyday clinical work and in future information campaigns.
KW - Double bookkeeping
KW - Early detection
KW - Insight
KW - Psychosis
KW - Qualitative
U2 - 10.1007/s11126-020-09833-3
DO - 10.1007/s11126-020-09833-3
M3 - Journal article
C2 - 32821995
AN - SCOPUS:85089741420
VL - 92
SP - 549
EP - 559
JO - Psychiatric Quarterly
JF - Psychiatric Quarterly
SN - 0033-2720
ER -
ID: 260195419