Assessment and Evolution of Narrative Identity and Its Relationship to Subjective Multidimensional Well-being and Multidimensional Recovery in First Episode Psychosis (PEPID)

Évaluation et évolution de l'identité Narrative et de Son Lien Avec le Bien-être Multidimensionnel Subjectif et le rétablissement Multidimensionnel Dans le Premier épisode Psychotique

First episode psychosis (FEP) constitutes an important subgroup within psychotic disorders, as the acute impact of a disorder at the time of diagnosis may differ from its long-term impact over the following decades. Narrative is identified as a sense of personal agency, of belonging to a social group, metacognition, and well-being. Patients with schizophrenia have lower levels of agency and communion compared to HIV-positive participants. However, the themes of agency and communion and metacognition do not reflect all factors representing narrative identity. In order to measure well-being, it is also necessary to introduce a specific and multidimensional measure that will allow a more precise understanding of the phenomenon.

In FEP, a link has been demonstrated between the specificity of self-recollection and functional outcomes. Given that the transitional developmental stage between adolescence and adulthood is a key developmental window for narrative identity as well as psychotic disorders and that narrative identity is positively associated with mental health, this study will therefore focus on the acquisition of narrative identity in the FEP. It will investigate the extent to which narrative identity has an impact on multidimensional subjective well-being and whether it can predict multidimensional subjective well-being over time. The study investigators hypothesize that the levels of the various components of narrative identity would be lower in cases of FEP compared to patients with other "chronic" psychotic conditions and controls.

Study Overview

• Status: Not yet recruiting
• Conditions: Psychosis; Mental Disorder
• Intervention / Treatment: Other: Narrative identity task

• Study Type: Observational
• Enrollment (Estimated): 96

Contacts and Locations

• Study Contact: Name: Julie Jourdan; Phone Number: 04.66.68.34.26; Email: julie.jourdan@chu-nimes.fr

Study Locations

• France
  • Nîmes, France, 30029
    • CHU de Nîmes
    • Contact: Anissa Megzari; Phone Number: 04.66.68.42.36; Email: drc@chu-nimes.fr
    • Sub-Investigator: Aurélie Schandrin
    • Principal Investigator: Julie Jourdan

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

406 / 5,000

Three groups of participants will be formed:

1. a group of participants meeting the criteria for a FEP;
2. a group of "chronic" participants diagnosed with a psychotic disorder (recruited from patients at the Carémeau University Hospital in Nîmes); and
3. a control group of participants, representative of the general population (recruited through social media advertisements).

Description

Inclusion Criteria:

• Subject who has given their free and informed consent.
• Subject who has signed the consent form.
• Subject who is a member of or beneficiary of a health insurance plan.

For the FEP group:

• Patient treated in a psychiatric department (consultation or hospitalization) for a FEP defined by:
• Presence of positive psychotic symptoms (delusions and/or hallucinations and/or conceptual disorganization) evolving for at least one week, either every day or at least 3 times a week for at least one hour per occasion
• Never having taken neuroleptic treatment with an antipsychotic purpose (with the exception of antipsychotic treatment initiated for the current episode)
• Disorder meeting DSM 5 criteria from the following list: delusional disorder, brief psychotic disorder lasting more than 7 days, schizophreniform disorder, schizophrenia, schizoaffective disorder, substance-induced psychotic disorder lasting more than 7 days, other specific or non-specific schizophrenia spectrum disorder or other psychotic disorder, bipolar disorder I or II with mood-congruent and mood-incongruent psychotic features, substance-induced bipolar disorder with mood-congruent and mood-incongruent psychotic features, major depressive disorder with mood-congruent and mood-incongruent psychotic features

For the "Chronic" group:

• Patients diagnosed with a disorder meeting DSM-5 criteria for more than 18 months from the following list: delusional disorder, brief psychotic disorder lasting more than 7 days, schizophreniform disorder, schizophrenia, schizoaffective disorder, substance-induced psychotic disorder lasting more than 7 days, other specific or non-specific schizophrenia spectrum disorder or other psychotic disorder, bipolar I or II disorder with mood-congruent and mood-incongruent psychotic features, substance-induced bipolar disorder with mood-congruent and mood-incongruent psychotic features, major depressive disorder with mood-congruent and mood-incongruent psychotic features

Exclusion Criteria:

• The subject is participating in category 1 RIPH or a clinical drug trial or clinical investigation study, or is in a period of exclusion determined by a previous study
• The patient is unable to express consent
• It is impossible to give the subject informed information
• The patient is under safeguard of justice or state guardianship
• Pregnant or breastfeeding subject.
• Patient with a history of traumatic brain injury
• Patient with moderate to severe mental retardation (IQ ≤ 55)

For the FEP group:

• FEP related to a drug-induced psychotic disorder or due to another medical condition

For the "Control" group:

• Patient with lifetime experience of FEP
• Patient with a diagnosis of a disorder meeting DSM-5 criteria from the following list: delusional disorder, brief psychotic disorder lasting more than 7 days, schizophrenia-like disorder, schizophrenia, schizoaffective disorder, substance-induced psychotic disorder lasting more than 7 days, other specific or non-specific schizophrenia spectrum disorder or other psychotic disorder, bipolar I or II disorder with mood-congruent and mood-incongruent psychotic features, bipolar disorder with mood-congruent and mood-incongruent psychotic features substance-induced mood, major depressive disorder with psychotic features congruent and incongruent with mood

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Control	Other: Narrative identity task; Participants will be asked to elaborate five personal narratives in response to the different types of questions: trauma, transgression, negative memory, self-definition, and turning point.
First episode psychosis	Other: Narrative identity task; Participants will be asked to elaborate five personal narratives in response to the different types of questions: trauma, transgression, negative memory, self-definition, and turning point.
Chronic; participants diagnosed with a psychotic disorder	Other: Narrative identity task; Participants will be asked to elaborate five personal narratives in response to the different types of questions: trauma, transgression, negative memory, self-definition, and turning point.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Emotional valence according to the question: "When you think about this story in your life, how positive or negative is this story in your life?"	7-point scale ranging from -3 "Extremely negative" to 3 "Extremely positive"	Baseline (Day 0)
Emotional valence according to the question: "When you think about this story in your life, how positive or negative is this story in your life?"	7-point scale ranging from -3 "Extremely negative" to 3 "Extremely positive"	Month 6
Emotional valence according to the question: "When you think about this story in your life, how positive or negative is this story in your life?"	7-point scale ranging from -3 "Extremely negative" to 3 "Extremely positive"	Month 12
Emotional valence according to the question: "When you think about this story in your life, how positive or negative is this story in your life?"	7-point scale ranging from -3 "Extremely negative" to 3 "Extremely positive"	Month 18
Emotional valence according to the question: "When you think about this story in your life, how positive or negative is this story in your life?"	7-point scale ranging from -3 "Extremely negative" to 3 "Extremely positive"	Month 24
Emotional intensity according to the question: "When you think about this story in your life, how intense is this story in your life?"	7-point scale ranging from 1 "Not at all intense" to 7 "Extremely intense" -	Baseline (Day 0)
Emotional intensity according to the question: "When you think about this story in your life, how intense is this story in your life?"	7-point scale ranging from 1 "Not at all intense" to 7 "Extremely intense" -	Month 6
Emotional intensity according to the question: "When you think about this story in your life, how intense is this story in your life?"	7-point scale ranging from 1 "Not at all intense" to 7 "Extremely intense" -	Month 12
Emotional intensity according to the question: "When you think about this story in your life, how intense is this story in your life?"	7-point scale ranging from 1 "Not at all intense" to 7 "Extremely intense" -	Month 18
Emotional intensity according to the question: "When you think about this story in your life, how intense is this story in your life?"	7-point scale ranging from 1 "Not at all intense" to 7 "Extremely intense" -	Month 24
Emotional tone according to the question "When you think about this story in your life, is it generally negative, mixed, neutral, or positive?"	4-point scale ranging from 0 "Negative" to 4 "Positive."	Baseline (day 0)
Emotional tone according to the question "When you think about this story in your life, is it generally negative, mixed, neutral, or positive?"	4-point scale ranging from 0 "Negative" to 4 "Positive."	Month 6
Emotional tone according to the question "When you think about this story in your life, is it generally negative, mixed, neutral, or positive?"	4-point scale ranging from 0 "Negative" to 4 "Positive."	Month 12
Emotional tone according to the question "When you think about this story in your life, is it generally negative, mixed, neutral, or positive?"	4-point scale ranging from 0 "Negative" to 4 "Positive."	Month 18
Emotional tone according to the question "When you think about this story in your life, is it generally negative, mixed, neutral, or positive?"	4-point scale ranging from 0 "Negative" to 4 "Positive."	Month 24

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Narrative identity between groups	PERMA Profiler questionnaire; a 15-item scale in which higher scores indicate greater well-being	Baseline (Day 0)
Narrative identity between groups	PERMA Profiler questionnaire; a 15-item scale in which higher scores indicate greater well-being	Month 6
Narrative identity between groups	PERMA Profiler questionnaire; a 15-item scale in which higher scores indicate greater well-being	Month 12
Narrative identity between groups	PERMA Profiler questionnaire; a 15-item scale in which higher scores indicate greater well-being	Month 18
Narrative identity between groups	PERMA Profiler questionnaire; a 15-item scale in which higher scores indicate greater well-being	Month 24
General health-related quality of life between groups	EQ5D-5L questionnaire comprising five items representing the five dimensions, and a visual analog scale ranging from 0 to 100 (100 referring to the "best possible health state"). The responses are then into a 5-digit number describing the patient's health state (e.g "11111" indicates the absence of problems).	Baseline (day 0)
General health-related quality of life between groups	EQ5D-5L questionnaire comprising five items representing the five dimensions, and a visual analog scale ranging from 0 to 100 (100 referring to the "best possible health state"). The responses are then into a 5-digit number describing the patient's health state (e.g "11111" indicates the absence of problems).	Month 6
General health-related quality of life between groups	EQ5D-5L questionnaire comprising five items representing the five dimensions, and a visual analog scale ranging from 0 to 100 (100 referring to the "best possible health state"). The responses are then into a 5-digit number describing the patient's health state (e.g "11111" indicates the absence of problems).	Month 12
General health-related quality of life between groups	EQ5D-5L questionnaire comprising five items representing the five dimensions, and a visual analog scale ranging from 0 to 100 (100 referring to the "best possible health state"). The responses are then into a 5-digit number describing the patient's health state (e.g "11111" indicates the absence of problems).	Month 18
General health-related quality of life between groups	EQ5D-5L questionnaire comprising five items representing the five dimensions, and a visual analog scale ranging from 0 to 100 (100 referring to the "best possible health state"). The responses are then into a 5-digit number describing the patient's health state (e.g "11111" indicates the absence of problems).	Month 24
Health-related quality of life between groups	WHOQOL-Brief: a 26-item questionnaire including one item on overall quality of life, one item assessing general health, and one item from each of the 24 facets of the WHOQOL-100. Four types of five-point response scales measure intensity (Not at all-Extremely), capacity (Not at all-Completely), frequency (Never-Always), and evaluation (Very dissatisfied/Very poor-Very satisfied/Very good).	Baseline (day 0)
Health-related quality of life between groups	WHOQOL-Brief: a 26-item questionnaire including one item on overall quality of life, one item assessing general health, and one item from each of the 24 facets of the WHOQOL-100. Four types of five-point response scales measure intensity (Not at all-Extremely), capacity (Not at all-Completely), frequency (Never-Always), and evaluation (Very dissatisfied/Very poor-Very satisfied/Very good).	Month 6
Health-related quality of life between groups	WHOQOL-Brief: a 26-item questionnaire including one item on overall quality of life, one item assessing general health, and one item from each of the 24 facets of the WHOQOL-100. Four types of five-point response scales measure intensity (Not at all-Extremely), capacity (Not at all-Completely), frequency (Never-Always), and evaluation (Very dissatisfied/Very poor-Very satisfied/Very good).	Month 12
Health-related quality of life between groups	WHOQOL-Brief: a 26-item questionnaire including one item on overall quality of life, one item assessing general health, and one item from each of the 24 facets of the WHOQOL-100. Four types of five-point response scales measure intensity (Not at all-Extremely), capacity (Not at all-Completely), frequency (Never-Always), and evaluation (Very dissatisfied/Very poor-Very satisfied/Very good).	Month 18
Health-related quality of life between groups	WHOQOL-Brief: a 26-item questionnaire including one item on overall quality of life, one item assessing general health, and one item from each of the 24 facets of the WHOQOL-100. Four types of five-point response scales measure intensity (Not at all-Extremely), capacity (Not at all-Completely), frequency (Never-Always), and evaluation (Very dissatisfied/Very poor-Very satisfied/Very good).	Month 24
Anxiety and depression between groups	Hospital Anxiety and Depression Scale questionnaire where a higher score indicates greater distress	Baseline (Day 0)
Anxiety and depression between groups	Hospital Anxiety and Depression Scale questionnaire where a higher score indicates greater distress	Month 6
Anxiety and depression between groups	Hospital Anxiety and Depression Scale questionnaire where a higher score indicates greater distress	Month 12
Anxiety and depression between groups	Hospital Anxiety and Depression Scale questionnaire where a higher score indicates greater distress	Month 18
Anxiety and depression between groups	Hospital Anxiety and Depression Scale questionnaire where a higher score indicates greater distress	Month 24
Autobiographical memory between groups	Thinking About Life Experiences scale (TALE-15): 17-item questionnaire consists of two general questions followed by 15 specific items related to the functions of autobiographical memory, each composed of 5 sub-items. Responses are rated on a 5-point Likert scale ranging from "Almost never" to "Very frequently."	Baseline (day 0)
Autobiographical memory between groups	Thinking About Life Experiences scale (TALE-15): 17-item questionnaire consists of two general questions followed by 15 specific items related to the functions of autobiographical memory, each composed of 5 sub-items. Responses are rated on a 5-point Likert scale ranging from "Almost never" to "Very frequently."	Month 6
Autobiographical memory between groups	Thinking About Life Experiences scale (TALE-15): 17-item questionnaire consists of two general questions followed by 15 specific items related to the functions of autobiographical memory, each composed of 5 sub-items. Responses are rated on a 5-point Likert scale ranging from "Almost never" to "Very frequently."	Month 12
Autobiographical memory between groups	Thinking About Life Experiences scale (TALE-15): 17-item questionnaire consists of two general questions followed by 15 specific items related to the functions of autobiographical memory, each composed of 5 sub-items. Responses are rated on a 5-point Likert scale ranging from "Almost never" to "Very frequently."	Month 18
Autobiographical memory between groups	Thinking About Life Experiences scale (TALE-15): 17-item questionnaire consists of two general questions followed by 15 specific items related to the functions of autobiographical memory, each composed of 5 sub-items. Responses are rated on a 5-point Likert scale ranging from "Almost never" to "Very frequently."	Month 24
Personality type between groups	Big Five Inventory (BFI-10): assessing the five major personality traits: extraversion, agreeableness, conscientiousness, emotional stability, and openness.	Baseline (day 0)
Personality type between groups	Big Five Inventory (BFI-10): assessing the five major personality traits: extraversion, agreeableness, conscientiousness, emotional stability, and openness.	Month 6
Personality type between groups	Big Five Inventory (BFI-10): assessing the five major personality traits: extraversion, agreeableness, conscientiousness, emotional stability, and openness.	Month 12
Personality type between groups	Big Five Inventory (BFI-10): assessing the five major personality traits: extraversion, agreeableness, conscientiousness, emotional stability, and openness.	Month 18
Personality type between groups	Big Five Inventory (BFI-10): assessing the five major personality traits: extraversion, agreeableness, conscientiousness, emotional stability, and openness.	Month 24
Symptomatology of psychotic disorders in the FEP and chronic groups	Positive and negative symptom scale (PANSS). 30 items measuring 5 subscales: positive, negative, disorganization, hostility, and anxiety. Each item is rated on a 7-point Likert scale ranging from 1 (absent) to 7 (extreme). The positive subscale ranges from 7 to 49, the negative subscale from 8 to 56, the hostility subscale from 6 to 46, the disorganization subscale from 5 to 35, and the anxiety subscale from 4 to 28. The total score ranges from 30 to 210.	Baseline (day 0)
Symptomatology of psychotic disorders in the FEP and chronic groups	Positive and negative symptom scale (PANSS). 30 items measuring 5 subscales: positive, negative, disorganization, hostility, and anxiety. Each item is rated on a 7-point Likert scale ranging from 1 (absent) to 7 (extreme). The positive subscale ranges from 7 to 49, the negative subscale from 8 to 56, the hostility subscale from 6 to 46, the disorganization subscale from 5 to 35, and the anxiety subscale from 4 to 28. The total score ranges from 30 to 210.	Month 6
Symptomatology of psychotic disorders in the FEP and chronic groups	Positive and negative symptom scale (PANSS). 30 items measuring 5 subscales: positive, negative, disorganization, hostility, and anxiety. Each item is rated on a 7-point Likert scale ranging from 1 (absent) to 7 (extreme). The positive subscale ranges from 7 to 49, the negative subscale from 8 to 56, the hostility subscale from 6 to 46, the disorganization subscale from 5 to 35, and the anxiety subscale from 4 to 28. The total score ranges from 30 to 210.	Month 12
Symptomatology of psychotic disorders in the FEP and chronic groups	Positive and negative symptom scale (PANSS). 30 items measuring 5 subscales: positive, negative, disorganization, hostility, and anxiety. Each item is rated on a 7-point Likert scale ranging from 1 (absent) to 7 (extreme). The positive subscale ranges from 7 to 49, the negative subscale from 8 to 56, the hostility subscale from 6 to 46, the disorganization subscale from 5 to 35, and the anxiety subscale from 4 to 28. The total score ranges from 30 to 210.	Month 18
Symptomatology of psychotic disorders in the FEP and chronic groups	Positive and negative symptom scale (PANSS). 30 items measuring 5 subscales: positive, negative, disorganization, hostility, and anxiety. Each item is rated on a 7-point Likert scale ranging from 1 (absent) to 7 (extreme). The positive subscale ranges from 7 to 49, the negative subscale from 8 to 56, the hostility subscale from 6 to 46, the disorganization subscale from 5 to 35, and the anxiety subscale from 4 to 28. The total score ranges from 30 to 210.	Month 24
Overall functioning in the FEP and chronic groups	Global Assessment of Functioning (GAF). This numerical scale (from 0 to 100) subjectively assesses functioning in social, occupational, and psychological domains. Lower scores represent lower levels of functioning	Baseline (day 0)
Overall functioning in the FEP and chronic groups	Global Assessment of Functioning (GAF). This numerical scale (from 0 to 100) subjectively assesses functioning in social, occupational, and psychological domains. Lower scores represent lower levels of functioning	Month 6
Overall functioning in the FEP and chronic groups	Global Assessment of Functioning (GAF). This numerical scale (from 0 to 100) subjectively assesses functioning in social, occupational, and psychological domains. Lower scores represent lower levels of functioning	Month 12
Overall functioning in the FEP and chronic groups	Global Assessment of Functioning (GAF). This numerical scale (from 0 to 100) subjectively assesses functioning in social, occupational, and psychological domains. Lower scores represent lower levels of functioning	Month 18
Overall functioning in the FEP and chronic groups	Global Assessment of Functioning (GAF). This numerical scale (from 0 to 100) subjectively assesses functioning in social, occupational, and psychological domains. Lower scores represent lower levels of functioning	Month 24
Personal recovery in the FEP and chronic groups	Stage of recovery instrument (STORI): a 50-item questionnaire that evaluates the five stages of personal recovery. Ten themes are assessed, each containing five items ranging from 0 "Not at all true" to 5 "Completely true," corresponding to the five stages of personal recovery. A score is calculated for each stage, ranging from 0 to 50	Baseline (day 0)
Personal recovery in the FEP and chronic groups	Stage of recovery instrument (STORI): a 50-item questionnaire that evaluates the five stages of personal recovery. Ten themes are assessed, each containing five items ranging from 0 "Not at all true" to 5 "Completely true," corresponding to the five stages of personal recovery. A score is calculated for each stage, ranging from 0 to 50	Month 6
Personal recovery in the FEP and chronic groups	Stage of recovery instrument (STORI): a 50-item questionnaire that evaluates the five stages of personal recovery. Ten themes are assessed, each containing five items ranging from 0 "Not at all true" to 5 "Completely true," corresponding to the five stages of personal recovery. A score is calculated for each stage, ranging from 0 to 50	Month 12
Personal recovery in the FEP and chronic groups	Stage of recovery instrument (STORI): a 50-item questionnaire that evaluates the five stages of personal recovery. Ten themes are assessed, each containing five items ranging from 0 "Not at all true" to 5 "Completely true," corresponding to the five stages of personal recovery. A score is calculated for each stage, ranging from 0 to 50	Month 18
Personal recovery in the FEP and chronic groups	Stage of recovery instrument (STORI): a 50-item questionnaire that evaluates the five stages of personal recovery. Ten themes are assessed, each containing five items ranging from 0 "Not at all true" to 5 "Completely true," corresponding to the five stages of personal recovery. A score is calculated for each stage, ranging from 0 to 50	Month 24
Social and individual performance in the FEP and chronic groups	Personal and social performance scale (PSP): measures four domains of social and individual functioning (socially useful activities, personal and social relationships, self-care, disruptive and aggressive behaviors) and provides a score between 1 and 100, divided into 10 equal intervals to assess the degree of difficulty. Higher scores correspond to better personal and social functioning, with scores of 91 to 100 indicating more than adequate functioning, while scores below 30 indicate such poor functioning that intensive supervision is required.	Baseline (day 0)
Social and individual performance in the FEP and chronic groups	Personal and social performance scale (PSP): measures four domains of social and individual functioning (socially useful activities, personal and social relationships, self-care, disruptive and aggressive behaviors) and provides a score between 1 and 100, divided into 10 equal intervals to assess the degree of difficulty. Higher scores correspond to better personal and social functioning, with scores of 91 to 100 indicating more than adequate functioning, while scores below 30 indicate such poor functioning that intensive supervision is required.	Month 6
Social and individual performance in the FEP and chronic groups	Personal and social performance scale (PSP): measures four domains of social and individual functioning (socially useful activities, personal and social relationships, self-care, disruptive and aggressive behaviors) and provides a score between 1 and 100, divided into 10 equal intervals to assess the degree of difficulty. Higher scores correspond to better personal and social functioning, with scores of 91 to 100 indicating more than adequate functioning, while scores below 30 indicate such poor functioning that intensive supervision is required.	Month 12
Social and individual performance in the FEP and chronic groups	Personal and social performance scale (PSP): measures four domains of social and individual functioning (socially useful activities, personal and social relationships, self-care, disruptive and aggressive behaviors) and provides a score between 1 and 100, divided into 10 equal intervals to assess the degree of difficulty. Higher scores correspond to better personal and social functioning, with scores of 91 to 100 indicating more than adequate functioning, while scores below 30 indicate such poor functioning that intensive supervision is required.	Month 18
Social and individual performance in the FEP and chronic groups	Personal and social performance scale (PSP): measures four domains of social and individual functioning (socially useful activities, personal and social relationships, self-care, disruptive and aggressive behaviors) and provides a score between 1 and 100, divided into 10 equal intervals to assess the degree of difficulty. Higher scores correspond to better personal and social functioning, with scores of 91 to 100 indicating more than adequate functioning, while scores below 30 indicate such poor functioning that intensive supervision is required.	Month 24
Improvement of clinical state in the FEP and chronic groups	Clinical global impression (CGI): a global observer-rated assessment tool that measures a patient's clinical condition before and after medical treatment. It consists of two measures: Severity, which measures the severity of the patient's clinical condition; and Improvement, which assesses the improvement in the patient's clinical condition since the start of treatment, both on a scale of 1 to 7.	Baseline (day 0)
Improvement of clinical state in the FEP and chronic groups	Clinical global impression (CGI): a global observer-rated assessment tool that measures a patient's clinical condition before and after medical treatment. It consists of two measures: Severity, which measures the severity of the patient's clinical condition; and Improvement, which assesses the improvement in the patient's clinical condition since the start of treatment, both on a scale of 1 to 7.	Month 6
Improvement of clinical state in the FEP and chronic groups	Clinical global impression (CGI): a global observer-rated assessment tool that measures a patient's clinical condition before and after medical treatment. It consists of two measures: Severity, which measures the severity of the patient's clinical condition; and Improvement, which assesses the improvement in the patient's clinical condition since the start of treatment, both on a scale of 1 to 7.	Month 12
Improvement of clinical state in the FEP and chronic groups	Clinical global impression (CGI): a global observer-rated assessment tool that measures a patient's clinical condition before and after medical treatment. It consists of two measures: Severity, which measures the severity of the patient's clinical condition; and Improvement, which assesses the improvement in the patient's clinical condition since the start of treatment, both on a scale of 1 to 7.	Month 18
Improvement of clinical state in the FEP and chronic groups	Clinical global impression (CGI): a global observer-rated assessment tool that measures a patient's clinical condition before and after medical treatment. It consists of two measures: Severity, which measures the severity of the patient's clinical condition; and Improvement, which assesses the improvement in the patient's clinical condition since the start of treatment, both on a scale of 1 to 7.	Month 24
Awareness of the disorders in the FEP and chronic groups	Birchwood insight scale (BIS); multidimensional assessment of awareness of illness (insight) and includes 8 questions (3-point Likert scale: "agree," "disagree," or "uncertain"). The overall score ranges from 0 to 12, with a score above 9 indicating good insight.	Baseline (day 0)
Awareness of the disorders in the FEP and chronic groups	Birchwood insight scale (BIS); multidimensional assessment of awareness of illness (insight) and includes 8 questions (3-point Likert scale: "agree," "disagree," or "uncertain"). The overall score ranges from 0 to 12, with a score above 9 indicating good insight.	Month 6
Awareness of the disorders in the FEP and chronic groups	Birchwood insight scale (BIS); multidimensional assessment of awareness of illness (insight) and includes 8 questions (3-point Likert scale: "agree," "disagree," or "uncertain"). The overall score ranges from 0 to 12, with a score above 9 indicating good insight.	Month 12
Awareness of the disorders in the FEP and chronic groups	Birchwood insight scale (BIS); multidimensional assessment of awareness of illness (insight) and includes 8 questions (3-point Likert scale: "agree," "disagree," or "uncertain"). The overall score ranges from 0 to 12, with a score above 9 indicating good insight.	Month 18
Awareness of the disorders in the FEP and chronic groups	Birchwood insight scale (BIS); multidimensional assessment of awareness of illness (insight) and includes 8 questions (3-point Likert scale: "agree," "disagree," or "uncertain"). The overall score ranges from 0 to 12, with a score above 9 indicating good insight.	Month 24
Abstract verbal reasoning in the FEP and chronic groups	Similarities section of the Wechsler Adult Intelligence Scale (WAIS): For 18 pairs of words, the participant subject must identify the qualitative relationship between the two words	Baseline (day 0)
Abstract verbal reasoning in the FEP and chronic groups	Similarities section of the Wechsler Adult Intelligence Scale (WAIS): For 18 pairs of words, the participant subject must identify the qualitative relationship between the two words	Month 6
Abstract verbal reasoning in the FEP and chronic groups	Similarities section of the Wechsler Adult Intelligence Scale (WAIS): For 18 pairs of words, the participant subject must identify the qualitative relationship between the two words	Month 12
Abstract verbal reasoning in the FEP and chronic groups	Similarities section of the Wechsler Adult Intelligence Scale (WAIS): For 18 pairs of words, the participant subject must identify the qualitative relationship between the two words	Month 18
Abstract verbal reasoning in the FEP and chronic groups	Similarities section of the Wechsler Adult Intelligence Scale (WAIS): For 18 pairs of words, the participant subject must identify the qualitative relationship between the two words	Month 24
Non-verbal abstract problem solving in the FEP and chronic groups	Matrix reasoning section of the Wechsler Adult Intelligence Scale (WAIS); in which participants must identify patterns in drawings	Baseline (day 0)
Non-verbal abstract problem solving in the FEP and chronic groups	Matrix reasoning section of the Wechsler Adult Intelligence Scale (WAIS); in which participants must identify patterns in drawings	Month 6
Non-verbal abstract problem solving in the FEP and chronic groups	Matrix reasoning section of the Wechsler Adult Intelligence Scale (WAIS); in which participants must identify patterns in drawings	Month 12
Non-verbal abstract problem solving in the FEP and chronic groups	Matrix reasoning section of the Wechsler Adult Intelligence Scale (WAIS); in which participants must identify patterns in drawings	Month 18
Non-verbal abstract problem solving in the FEP and chronic groups	Matrix reasoning section of the Wechsler Adult Intelligence Scale (WAIS); in which participants must identify patterns in drawings	Month 24
Treatment adherence in the FEP and chronic groups	Medication adherence rating scale (MARS): 10-item questionnaire concerning medication adherence during the past week assessing behaviors, attitudes, and experiences related to the treatment.	Baseline (day 0)
Treatment adherence in the FEP and chronic groups	Medication adherence rating scale (MARS): 10-item questionnaire concerning medication adherence during the past week assessing behaviors, attitudes, and experiences related to the treatment.	Month 6
Treatment adherence in the FEP and chronic groups	Medication adherence rating scale (MARS): 10-item questionnaire concerning medication adherence during the past week assessing behaviors, attitudes, and experiences related to the treatment.	Month 12
Treatment adherence in the FEP and chronic groups	Medication adherence rating scale (MARS): 10-item questionnaire concerning medication adherence during the past week assessing behaviors, attitudes, and experiences related to the treatment.	Month 18
Treatment adherence in the FEP and chronic groups	Medication adherence rating scale (MARS): 10-item questionnaire concerning medication adherence during the past week assessing behaviors, attitudes, and experiences related to the treatment.	Month 24
Episodic memory between groups	California Verbal Learning Test--Second Edition (CVLT): in this word list recall and recognition test, the examiner reads a list of 16 nouns aloud at one-second intervals in a fixed order over five learning trials. The participant is asked to recall as many words as possible in any order (free recall). If subjects "cluster" words from each category, they are presumably using semantic organization. Free recall is tested immediately (short-term recall) and again after 20 minutes (long-term recall).	Baseline (day 0)
Episodic memory between groups	California Verbal Learning Test--Second Edition (CVLT): in this word list recall and recognition test, the examiner reads a list of 16 nouns aloud at one-second intervals in a fixed order over five learning trials. The participant is asked to recall as many words as possible in any order (free recall). If subjects "cluster" words from each category, they are presumably using semantic organization. Free recall is tested immediately (short-term recall) and again after 20 minutes (long-term recall).	Month 6
Episodic memory between groups	California Verbal Learning Test--Second Edition (CVLT): in this word list recall and recognition test, the examiner reads a list of 16 nouns aloud at one-second intervals in a fixed order over five learning trials. The participant is asked to recall as many words as possible in any order (free recall). If subjects "cluster" words from each category, they are presumably using semantic organization. Free recall is tested immediately (short-term recall) and again after 20 minutes (long-term recall).	Month 12
Episodic memory between groups	California Verbal Learning Test--Second Edition (CVLT): in this word list recall and recognition test, the examiner reads a list of 16 nouns aloud at one-second intervals in a fixed order over five learning trials. The participant is asked to recall as many words as possible in any order (free recall). If subjects "cluster" words from each category, they are presumably using semantic organization. Free recall is tested immediately (short-term recall) and again after 20 minutes (long-term recall).	Month 18
Episodic memory between groups	California Verbal Learning Test--Second Edition (CVLT): in this word list recall and recognition test, the examiner reads a list of 16 nouns aloud at one-second intervals in a fixed order over five learning trials. The participant is asked to recall as many words as possible in any order (free recall). If subjects "cluster" words from each category, they are presumably using semantic organization. Free recall is tested immediately (short-term recall) and again after 20 minutes (long-term recall).	Month 24

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Nīmes
• Investigators: Principal Investigator: Julie Jourdan, Centre Hospitalier Universitaire de Nimes

Study record dates

Study Major Dates

• Study Start (Estimated): January 1, 2026
• Primary Completion (Estimated): July 1, 2029
• Study Completion (Estimated): July 1, 2029

Study Registration Dates

• First Submitted: December 18, 2025
• First Submitted That Met QC Criteria: January 5, 2026
• First Posted (Actual): January 9, 2026

Study Record Updates

• Last Update Posted (Actual): January 9, 2026
• Last Update Submitted That Met QC Criteria: January 5, 2026
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Narrative identity
• Additional Relevant MeSH Terms: Schizophrenia Spectrum and Other Psychotic Disorders; Psychotic Disorders; Mental Disorders
• Other Study ID Numbers: LOCAL/2025/THESE/JJ-01

Drug and device information, study documents

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