Fear of relapse in schizophrenia: a mixed-methods systematic review

Zukowska, Z., Allan, S., Eisner, E., Ling, L. and Gumley, A. (2022) Fear of relapse in schizophrenia: a mixed-methods systematic review. Social Psychiatry and Psychiatric Epidemiology, (doi: 10.1007/s00127-022-02220-2) (Early Online Publication)

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Abstract

Introduction: Fears of relapse in people diagnosed with schizophrenia have long been recognised as an impediment to recovery and wellbeing. However, the extent of the empirical basis for the fear of relapse concept is unclear. A systematic review is required to collate available evidence and define future research directions. Methods: A pre-registered systematic search (PROSPERO CRD42020196964) of four databases (PubMED, MEDLINE-Ovid, PsycINFO-Ovid, and Cochrane Central Register of Controlled Trials) was conducted from their inception to 05/04/2021. Results: We found nine eligible studies. Five were quantitative (4 descriptive and 1 randomised controlled trial), and four were qualitative. The available quantitative evidence suggests that fear of relapse may have concurrent positive relationships with depression (r = 0.72) and suicide ideation (r = 0.48), and negative relationship with self-esteem (r = 0.67). Qualitative synthesis suggests that fear of relapse is a complex phenomenon with behavioural and emotional components which has both direct and indirect effects on wellbeing. Conclusions: Evidence in this area is limited and research with explicit service user and carer involvement is urgently needed to develop new and/or refine existing measurement tools, and to measure wellbeing rather than psychopathology. Nonetheless, clinicians should be aware that fear of relapse exists and appears to be positively associated with depression and suicide ideation, and negatively associated with self-esteem. Fear of relapse can include fears of losing personal autonomy and/or social/occupational functioning. It appears to impact carers as well as those diagnosed with schizophrenia.

Item Type:Articles
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gumley, Professor Andrew and Allan, Ms Stephanie
Authors: Zukowska, Z., Allan, S., Eisner, E., Ling, L., and Gumley, A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
Journal Name:Social Psychiatry and Psychiatric Epidemiology
Publisher:Springer
ISSN:0933-7954
ISSN (Online):1433-9285
Published Online:13 February 2022
Copyright Holders:Copyright © The Author(s) 2022
First Published:First published in Social Psychiatry and Psychiatric Epidemiology 2022
Publisher Policy:Reproduced under a Creative Commons licence

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