Carers' experiences of seeking help for relatives with first-episode psychosis: a systematic review of qualitative evidence.

Abstract

Review question/objective The objective of this review is to synthesize the best available evidence on the lived experience of carers of a relative with a first-episode psychosis (FEP) and in particular their experience preceding and of seeking help. More specifically, the objectives are to explore: Perceived promoters and inhibitors to help-seeking during a FEP. Perceived barriers and facilitators to accessing services during a FEP. Inclusion criteria Types of participants This review will consider studies that include carers of a relative with a FEP. This means first presentation of psychotic symptoms with no limit to duration of untreated psychosis. Method of diagnosis may be according to any of the editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), International Statistical Classification of Diseases (ICD), research diagnostic criteria relevant to the country of study or confirmed by a psychiatrist or other health care professional. Psychotic symptoms may include hallucinations and delusions. Psychotic disorders may include: Schizophrenia Schizoaffective disorders Mania with psychotic symptoms Depression with psychotic symptoms Delusional disorders Acute and transient psychotic disorders Other and unspecified non-organic psychotic disorder. There will be no age restriction for the person experiencing the psychosis. Carers could be a parent, sibling, spouse or other relative of any age. Studies that predominantly include individuals in the prepsychotic or ultra high-risk stage of illness will be excluded due to the 'low' conversion rate to psychosis. Types of intervention(s)/phenomena of interest This review will consider studies that investigate the experience of carers of a relative with a first-episode psychosis, and in particular their experience preceding and of seeking help from both informal (family and friends) and formal (services) sources. Types of outcomes The review will consider research conducted in any mental health care setting including inpatient, outpatient and community.