Insight, duration of untreated psychosis and attachment in first-episode psychosis: prospective study of psychiatric recovery over 12-month follow-up

Andrew Gumley, Matthias Schwannauer, Angus MacBeth, Rebecca Fisher, Suzy Clark, Lucy Rattrie, Gillian Fraser, Robert McCabe, Alison Blair, Kate Davidson, Max Birchwood

Research output: Contribution to journalArticlepeer-review

54 Citations (Scopus)

Abstract

Background

Increasing evidence shows attachment security influences symptom expression and adaptation in people diagnosed with schizophrenia and other psychoses.

Aims

To describe the distribution of secure and insecure attachment in a cohort of individuals with first-episode psychosis, and to explore the relationship between attachment security and recovery from positive and negative symptoms in the first 12 months.

Method

The study was a prospective 12-month cohort study. The role of attachment, duration of untreated psychosis (DUP), baseline symptoms and insight in predicting and mediating recovery from symptoms was investigated using multiple regression analysis and path analysis.

Results

Of the 79 participants, 54 completed the Adult Attachment Interview (AAI): 37 (68.5%) were classified as insecure, of which 26 (48.1%) were insecure/dismissing and 11 (20.4%) insecure preoccupied. Both DUP and insight predicted recovery from positive symptoms at 12 months. Attachment security, DUP and insight predicted recovery from negative symptoms at 12 months.

Conclusions

Attachment is an important construct contributing to understanding and development of interventions promoting recovery following first-episode psychosis.
Original languageEnglish
Pages (from-to)60-67
Number of pages8
JournalBritish Journal of Psychiatry
Volume205
Issue number1
DOIs
Publication statusPublished - Jul 2014

Bibliographical note

Funding

The authors acknowledge the financial support of NHS Research Scotland (NRS), through the Chief Scientist Office (CZH/4/295), and of the Scottish Mental Health Research Network. M.B. was partly supported by the NIHR Birmingham and Black Country Collaboration for Leadership in Applied Healthcare Research (CLAHRC).

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