Representations and Strategies for Recovery (EPR)

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

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.

Study Overview

• Status: Completed
• Conditions: Personality Disorders; Anorexia; Bipolar Disorders; Schizophrenia, Undifferentiated
• Intervention / Treatment: Behavioral: Collection of the individual narrative, semi-directed interviews

Detailed Description

1. Elaboration of a semi directed grid (exploratory phase)
2. Collection of individual narratives

3. Data analysis, according to IPA method (interpretative phenomenological analysis)

   • On the basis of individual narratives
   • On the basis of a focus group
4. Publication of results

• Study Type: Interventional
• Enrollment (Actual): 37
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Rhone Alpes
    • Bron, Rhone Alpes, France, 69678
      • Vial Veronique

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: schizophrenia; 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; 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
Other: bipolar disorders; 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; 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
Other: eating disorders; 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; 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
Other: personality disorders; 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; 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

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Hôpital le Vinatier
• Investigators: Principal Investigator: MARTIN BRICE, MD/PhD, CH Le Vinatier

Study record dates

Study Major Dates

• Study Start (Actual): January 4, 2017
• Primary Completion (Actual): September 30, 2019
• Study Completion (Actual): March 31, 2020

Study Registration Dates

• First Submitted: January 17, 2017
• First Submitted That Met QC Criteria: January 20, 2017
• First Posted (Estimate): January 23, 2017

Study Record Updates

• Last Update Posted (Actual): June 17, 2020
• Last Update Submitted That Met QC Criteria: June 16, 2020
• Last Verified: June 1, 2020

More Information

Terms related to this study

• Keywords: schizophrenia; anorexia; personality disorders; bipolar disorders
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Signs and Symptoms, Digestive; Schizophrenia Spectrum and Other Psychotic Disorders; Bipolar and Related Disorders; Personality Disorders; Anorexia; Schizophrenia; Disease; Bipolar Disorder
• Other Study ID Numbers: 2016-A01049-42

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No