Meaning of psychoses as perceived by patients, their relatives and clinicians

Making sense of psychoses supports insight and personal recovery. Relatives' and clinicians' different perspectives on psychoses might impede such processes e.g., in family interventions. This study compares the meaning of psychosis as perceived by patients, their relatives and clinicians and investigates factors associated with discrepancies between them. Meaning of psychosis was assessed in 70 interrelated patients, relatives and clinicians with the SUSE-questionnaire. Severity of disorder, therapeutic relationship and other clinical variables were analysed in patient groups with deviant SUSE-ratings compared to their relative or clinician respectively. The majority of patient-relative- and patient-clinician-dyads made equal ratings of meaning of psychosis. Relatives and clinicians tended to have a less optimistic view on long-term-effects than patients. Discrepancy in ratings between patients and relatives was best explained by the family relationship (i.e. not being a parent) and between patients and clinicians by the severity of positive symptoms. Strong consensus was found among patients, relatives and clinicians about a relatively positive, meaningful picture of psychosis. Sufficient opportunities to discuss experiences and understanding of psychosis help to make sense of it consensually. If clinicians' attitudes towards psychosis are negatively biased by symptomatology, they will struggle to see and support personal recovery.