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Cult Med Psychiatry. 2009 Dec;33(4):608-22. doi: 10.1007/s11013-009-9150-6.

Early intervention in psychosis: a case study on normal and pathological.

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  • 1Department of Social Medicine, Harvard Medical School, Boston, MA 02115, USA. constantin.tranulis@gmail.com


Accumulating evidence suggests that delays in receiving treatment are associated with poorer prognosis and longer periods of unneeded suffering. The duration of untreated psychosis (DUP) is considered to be one of the most important determinants of outcome in the first episode of psychosis. However, the focus on decreasing the length of untreated illness tends to overlook the difficult task of making sense of psychotic experiences during a first episode. Using a qualitative analysis of narratives obtained from interviews with an individual and her husband, we examine what delayed her seeking help, how she became convinced that she needed treatment and what this meant for her and her husband. Additionally, we look at the five-year development of both a literal and a figurative space within which both the subject and her husband came to utilize, whether consciously or unconsciously, the 'stories' of her psychotic experiences to construct a shared and even 'safe' and familiar means of spousal connection. The exploration of this shared space reveals the normative and moral values embedded in the concept of DUP and suggests alternative ways of understanding the help-seeking behaviors in early psychosis.

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