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The subjective experience and phenomenology of depression following first episode psychosis: a qualitative study using photo-elicitation.

Amrita Sandhu, Jonathan Ives, Max Birchwood, Rachel Upthegrove

Journal of Affective Disorders July 2013 DOI: 10.1016/j.jad.2013.01.018 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Qualitative study Peer reviewed
Population People who had experienced a first episode of psychosis and reported subsequent depression
Topics Depression Philosophy of mind
Key findings Participants described post-psychotic depression as tied to the psychotic episode and recovery, framing the episode as traumatic and followed by doubt, shame, and embarrassment, with loss and social isolation central. Core biological symptoms of depression did not feature in their accounts.

Abstract

Depression following first episode psychosis (FEP) is a frequent occurrence, with profound impact on recovery and outcome. Whilst many theories exist about the causes of depression here, research to date has been based on nosology imported wholesale from affective disorder, with little primary research on the subjective experience. This study aimed to explore the subjective experience and phenomenological features of post-psychotic depression in FEP. A qualitative methodology, photo-elicitation, together with unstructured interviews, was used to characterise aspects of depression following FEP and analysed using contemporary framework analysis. Depression was reported by participants as linked to the experience of and recovery from psychosis. The psychotic episode was a traumatic event followed by subjective doubt, shame and embarrassment. Loss and social isolation were central. Core biological symptoms did not feature. Despite the relatively small sample size, this study was able to generate in-depth data that provides useful and novel insight. Whilst generalisability is incompatible with qualitative methodology, further research using the same methodology would generate a wider range of experiences and perspectives. Understanding this dimension of psychosis in and of itself has the potential to improve and aid development of more effective and appropriately targeted interventions and associated outcomes.

Comparable studies

Other qualitative studies on depression, most cited first.

Study Year Design Participants
Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression Patients with treatment-resistant depression enrolled in an open-label trial of psilocybin 2017 Qualitative study n = 20
An exploratory mixed methods study of the acceptability and effectiveness of mindfulness -based cognitive therapy for patients with active depression and anxiety in primary care Primary care patients with recurrent depression or recurrent depression and anxiety 2006 Exploratory mixed methods study n = 13
A qualitative study of mindfulness‐based cognitive therapy for depression Participants in mindfulness-based cognitive therapy in a mental-health context 2001 Qualitative study n = 7
Ketamine for Depression, 4: In What Dose, at What Rate, by What Route, for How Long, and at What Frequency? 2017 Qualitative review
Abnormal Time Experiences in Major Depression: An Empirical Qualitative Study Patients affected by affective and schizophrenic disorders 2016 Qualitative study n = 550

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