ABSTRACT

Background

Optimal intervention for people diagnosed with bipolar disorder (BD) is seen as a priority within early intervention psychosis services. This is the first study to explore the experience of first-episode psychotic mania and its aftermath for people diagnosed with BD, and the potential implications for treatment.

Method

Semi-structured interviews were conducted with 11 young adults following first-episode psychotic mania and analysed using Interpretative Phenomenological Analysis (IPA).

Results

Two overarching themes were identified: (i) “Changing states of self during first episode”; (ii) “Struggling with loss of self during episode aftermath”. Participants experienced exceptional, persecutory and angry states during psychotic mania, leading to identity disruption and low feelings or depression post-episode. Some mourned the loss of their exceptional manic self, and attempted to relapse into mania, while others struggled with the loss of who they had been prior to their episode.

Discussion

Results emphasise the importance of understanding identity change during first-episode psychotic mania and how that might be used to address identity disruption and low feelings during recovery. This process is likely to be pertinent to early intervention and prevention of manic relapse following first-episode BD.

中文翻译：

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第一集精神病性躁狂症及其后果：双相情感障碍患者的经历

摘要

背景

对被诊断患有双相情感障碍 (BD) 的人进行最佳干预被视为早期干预精神病服务的优先事项。这是第一项探索首发精神病性躁狂的经历及其对被诊断患有 BD 的人的后果，以及对治疗的潜在影响的第一项研究。

方法

在首发精神病性躁狂症后对 11 名年轻人进行了半结构化访谈，并使用解释现象学分析 (IPA) 进行了分析。

结果

确定了两个总体主题：（i）“第一集中改变自我状态”；(ii) “在情节后果期间与自我迷失作斗争”。参与者在精神病性躁狂症期间经历了异常、迫害和愤怒的状态，导致身份认同中断和情绪低落或发作后抑郁。一些人为失去他们异常狂躁的自我而哀悼，并试图再次陷入狂躁，而另一些人则在为失去发作前的自己而苦苦挣扎。

讨论

结果强调了理解首发精神病性躁狂期间身份变化的重要性，以及如何将其用于解决恢复过程中的身份中断和情绪低落问题。这一过程可能与早期干预和预防首发 BD 后的躁狂复发有关。