Representations and Strategies for Recovery

Study Overview
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Brief Summary
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In the recent context of deinstitutionalization and longitudinal studies pointing to a large number of positive long-term outcommes for people affected by a psychiatric disorder (schizophrenia, bipolar disorder, eating disorder, severe personality disorder, etc.), the possibility of overcoming the consequences of a psychiatric pathology emerges as a solid fact. Therefore, the existence of this possibility calls for the identification of the determinants underlying of the various outcomes over time of those affected by a severe psychiatric disorder, in particular those likely to underpin the most positive developments. While it is well known from a medical point of view that certain dimensions affect the prognosis of persons affected by a severe psychiatric disorder (such as the persistence of negative symptoms or cognitive disorders in schizophrenic disorders), prognosis from a purely medical perspective (and putting aside the role of the person and his environment) seems to be able to account only for a modest proportion of the prognosis of people affected by a serious psychiatric disorder. It is this fact that has gradually led to the emergence of complementary models capable of enriching the understanding of the determinants of the future of people affected by a severe psychiatric disorder, in particular models inviting to separate becoming of the person from the  psychiatric disorder to take into account the personal role of the person in his or her own healing. This perspective is the recovery perspective. Recovery process is defined as a personal trajectory which includes the person's experiences and the reactions of his / her environment following the installation of a psychiatric disorder, which can support a mode of release of the status of psychiatric patient. Recovery thus implies an approach underpinned by the understanding of the human response to pathology (Noiseux) and, one might add, of its environment. However, while these studies point to a number of crucial dimensions involved in the recovery of a severe psychiatric disorder, one of the important limitations of these studies is the distance from any psychopathological consideration, thus setting aside the possibility of specific processes of recovery depending of the pathology. The identification of recurrent experiential logics specific to the various psychiatric disorders therefore appears to be an important field of investigation. It would potentially be able to guide the development of new therapeutic devices based on the recovery model.

Detailed Description
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Elaboration of a semi directed grid (exploratory phase) Collection of individual narratives Data analysis, according to IPA method (interpretative phenomenological analysis) On the basis of individual narratives On the basis of a focus group Publication of results

Official Title
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Representations, Strategies and Identity Redefinition in the Recovery Process: Exploratory Study

Conditions
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Schizophrenia, Undifferentiated, Anorexia, Bipolar Disorders, Personality Disorders

Intervention / Treatment
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* Behavioral: Collection of the individual narrative, semi-directed interviews


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18 to 80 years Psychiatric diagnosis according to DSM V critera of schizophrenia, eating disorder, bipolar disorder, personality disorder In recovery scale Informed of their diagnosis Exclusion Criteria: Acute psychiatric state Poor understanding of french language

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: schizophrenia<br>Exploring and understanding, through a multidisciplinary exploration (medical, anthropological and sociological) representations and recovery strategies in schizophrenia | Behavioral: Collection of the individual narrative, semi-directed interviews<br>* Visit one : individual interview Individual narrative Passing Psychometric Measurement Scales of Recovery: Score at Warwick and Wellness Scale Andreasen scale score Visit two Focus group<br>|
| Other: bipolar disorders<br>Exploring and understanding, through a multidisciplinary exploration (medical, anthropological and sociological) representations and recovery strategies in bipolar disorders | Behavioral: Collection of the individual narrative, semi-directed interviews<br>* Visit one : individual interview Individual narrative Passing Psychometric Measurement Scales of Recovery: Score at Warwick and Wellness Scale Andreasen scale score Visit two Focus group<br>|
| Other: eating disorders<br>Exploring and understanding, through a multidisciplinary exploration (medical, anthropological and sociological) representations and recovery strategies in eating disorders | Behavioral: Collection of the individual narrative, semi-directed interviews<br>* Visit one : individual interview Individual narrative Passing Psychometric Measurement Scales of Recovery: Score at Warwick and Wellness Scale Andreasen scale score Visit two Focus group<br>|
| Other: personality disorders<br>Exploring and understanding, through a multidisciplinary exploration (medical, anthropological and sociological) representations and recovery strategies in personality disorders | Behavioral: Collection of the individual narrative, semi-directed interviews<br>* Visit one : individual interview Individual narrative Passing Psychometric Measurement Scales of Recovery: Score at Warwick and Wellness Scale Andreasen scale score Visit two Focus group<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Collection of individual narratives to understand the recovery process | Semi-directed maintenance grid | one year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in the Quality of Well-Being at one year | Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) | one year | 
| Change from baseline in measures of psychological recovery at one year | Stages of recovery instrument (STORI ANDREASEN) | one year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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schizophrenia, anorexia, bipolar disorders, personality disorders