title: Qualitative investigation of targets for and barriers to interventions to prevent psychosis relapse.
abstract: BACKGROUND
  Early signs based relapse prevention interventions for psychosis show promise. In order to examine how they might be improved we sought to better understand the early relapse process, service users' abilities to identify early signs, and any potential facilitators and barriers to early signs interventions.
  
  
  METHODS
  Data from in-depth interviews with a convenience sample of service users with psychosis varying in gender, age, duration of mental health problems, and time since last relapse were analysed using a thematic approach. Interview transcripts were coded inductively and relationships between emerging themes were examined by the research team to provide a thorough synthesis of the data.
  
  
  RESULTS
  Three central themes emerged from the analysis: 1) recognising risk factors (how risk factors were identified and linked to relapse, and reactions to such risk factors); 2) identifying early signs (issues related to both recognising and recalling signs of relapse); 3) reacting to deterioration (participants' thoughts and feelings in response to early signs, including help seeking and its challenges).
  
  
  CONCLUSIONS
  There was considerable variation in the attention participants had paid to pre-relapse signs, the ease with which they were able to recall them, and their reactions to them. For many, there were substantial barriers to help seeking from services. A family or friend confidant was an important means of assistance, although the supportive presence of significant others was not always available. Based on these results, a number of recommendations about facilitating service users' recognition of early signs and targeting potential accelerants of relapse are made.
authors.affiliation: Clinical Psychology Department, Zochonis Building (2nd Floor), University of Manchester, Oxford Road, Manchester M13 9PL, UK. emily.eisner@manchester.ac.uk.
authors.forename: Emily
authors.initials: E
authors.lastname: Eisner
authors.forename: Christine
authors.initials: C
authors.lastname: Barrowclough
authors.forename: Fiona
authors.initials: F
authors.lastname: Lobban
authors.forename: Richard
authors.initials: R
authors.lastname: Drake
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000517:prevention & control*; D012008:Recurrence; D012307:Risk Factors; D055815:Young Adult