The Danish National Schizophrenia project (DNS): Interpersonal self-image as predictor for outcome in first-episode psychosis (FEP)

Abstract

Background

Several studies have indicated that a person's self-image is of central importance for psychological well being and mental health. A negative self-image has been associated with many mental health problems, but knowledge about self-image in psychosis is sparse. The present study examined self-image in psychosis and its importance for recovery from psychosis (Harder, 2006).

Method

The sample (N=97) was a subsample from the DNS-sample. The patients recieved supportive psychodynamic psychotherapy in combination with standard treatment. Self-image was measured by SASB-Intrex questionnaire (Benjamin, 1989) and outcome measures were PANNS Positive and Negative Symptom Scale) and GAF (Global Assessment of Functioning).

Results

Self-image at baseline was found to be a strong predictor for outcome in positive psychotic symptoms, negative psychotic symptoms and social functioning both one and two years later. Patients with presence of grandiosity and reduced acknowledment of actual illness had a more positive self-image at their percieved worst state, which was associated with better outcome.

Conclusion

This finding of a strong relationship between self-image and outcome has important implications for treatment, because preserving and enhancing self-image during treatment might help improve recovery from psychosis. Grandiosity and reduced acknowledment of actual illness might serve to protect the self-image, and reduce stress related to very negative aspects of self-image.