Posttraumatic growth and recovery following a first episode of psychosis: a narrative review of two concepts

ABSTRACT

A first episode of psychosis is often a traumatic experience that leads to significant life disruptions. However, many young people recover following a first episode of psychosis. Two types of recovery from psychosis have been described in the literature: clinical recovery (i.e. the resolution of symptoms and resumption of social, occupational or educational goals) and personal recovery (i.e. finding a way to live a meaningful life despite the limitations of having a mental illness). Further, some young people may experience posttraumatic growth (i.e. positive psychological changes following the struggle with psychosis). It is unclear how posttraumatic growth and recovery are similar or distinct. This conceptual ambiguity may limit both theoretical and empirical work in the field. The purpose of this narrative review is to help resolve this ambiguity by describing similarities and differences in the historical roots, phenomenology, and predictors of recovery (both clinical and personal) and posttraumatic growth within the context of a first episode of psychosis. Our review concludes that personal recovery may be best understood as a broader construct under which clinical recovery is subsumed, and that posttraumatic growth may be a phenomenon that is related to, yet distinct from, personal recovery. Future empirical studies are needed to disentangle these phenomena.

KEYWORDS:

• Posttraumatic growth
• clinical recovery
• personal recovery
• first episode psychosis
• early intervention services for psychosis

Disclosure statement

Unrelated to the present study, Ashok Malla has received research funding from BMS and Lundbeck as well as honoraria related to CME lectures, research consultation, and advisory board participation from Otsuka and Lundbeck.