Personal explanations for psychosis : a systematic review and thematic synthesis

Abstract

BACKGROUND AND HYPOTHESIS: Psychosis refers to the state whereby one's experience of reality differs from those around them. The ineffability of psychosis does not render the experience void of meaning, and the ways individuals integrate their experiences of psychosis into their life narratives cannot be dismissed. Meaning is an essential part of recovery. This review aimed to identify categories of personal explanations that people with psychosis use to explain their experiences. STUDY DESIGN: This systematic review is based on a preregistered protocol (CRD42023421125). Four databases, MEDLINE, Embase, Scopus, and PsycINFO, and 5 journals were searched April to November 2023. Qualitative and mixed-methods studies that explored the personal explanations employed by adults who experience psychosis, regardless of diagnostic status, were included. STUDY RESULTS: Twenty-five studies met the inclusion criteria, representing the views of 682 participants from 15 countries. Included studies were appraised using the CASP Qualitative Studies Checklist. RESULTS: were synthesized using thematic analysis. Personal explanations for psychosis experiences were grouped into 5 themes: Physical and psychiatric; Traumatic and adversarial; Emotional; Religious, spiritual, and magical; No explanation. Participants reported multiple explanations for their experiences. CONCLUSIONS: Individuals with experience of psychosis seek to explain these experiences, and these personal explanations may be multiple and complex in nature. The identified personal explanations can be used to further explore the ways that people situate their experiences into their personal context. This understanding should be utilized by professionals to support the provision of recovery-oriented care, with implications for assessment, treatment, intervention, and recovery outcomes.