Insight, duration of untreated psychosis and attachment in first-episode psychosis: prospective study of psychiatric recovery over 12-month follow-up
Open accessAbstract
Background: Increasing evidence shows attachment security influences symptom expression and adaptation in people diagnosed with schizophrenia and other psychoses. Aims: To describe the distribution of secure and insecure attachment in a cohort of individuals with first-episode psychosis, and to explore the relationship between attachment security and recovery from positive and negative symptoms in the first 12 months. Method: The study was a prospective 12-month cohort study. The role of attachment, duration of untreated psychosis (DUP), baseline symptoms and insight in predicting and mediating recovery from symptoms was investigated using multiple regression analysis and path analysis. Results: Of the 79 participants, 54 completed the Adult Attachment Interview (AAI): 37 (68.5%) were classified as insecure, of which 26 (48.1%) were insecure/dismissing and 11 (20.4%) insecure preoccupied. Both DUP and insight predicted recovery from positive symptoms at 12 months. Attachment security, DUP and insight predicted recovery from negative symptoms at 12 months. Conclusions: Attachment is an important construct contributing to understanding and development of interventions promoting recovery following first-episode psychosis.
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Better insight predicts reduced risk of relapse and improvement in positive and negative symptoms.
“Evidence that insight influences symptoms includes findings that better insight predicts reduced risk of relapse 54 and improvement in positive and negative symptoms 55 .”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [55]
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- Authors
- Gumley, A. I., Schwannauer, M., Macbeth, A., Fisher, R., Clark, S., Rattrie, L., Fraser, G., McCabe, R., Blair, A., Davidson, K., & Birchwood, M.
- Affiliations
- NHS Lothian (GB)
- Corresponding author
- Gumley, A. I.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2014-07
- Volume
- 205
- Issue
- 1
- Pages
- 60-67
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2167697759
- Cited by
- 63
- References
- 38
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 5 · 2022: 7 · 2021: 3 · 2020: 5 · 2019: 9 · 2018: 8 · 2017: 4 · 2016: 4 · 2015: 10 · 2014: 4
- FWCI
- 5.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Stirling Online Research Repository (University of Stirling) (submittedVersion, public-domain)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Funders
- National Institute for Health and Care Research (WMCLAHRC-2014-1)
- Scottish Mental Health Research Network
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- first-episode psychosis, attachment security, insecure attachment, duration of untreated psychosis, insight, mental health recovery, positive symptoms, negative symptoms, Adult Attachment Interview, schizophrenia
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Male, Object Attachment, Prognosis, Prospective Studies, Psychotic Disorders, Treatment Outcome, Recovery of Function, Symptom Assessment
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