Facilitating recovery in people with psychosis

A psychotic disorder often has a severe impact on many aspects of the life of someone affected by it. Recovery of psychosis often meets obstacles and calls for the need of new therapeutic methods. This thesis contributes to the research on recovery in psychotic disorders from three perspectives: clinical (remission of symptoms), societal (functioning in society) and personal recovery (personal growth in overcoming the illness). These perspectives are explored in five scientific studies, with a main focus on personal recovery. In the first two chapters an eating club for people with psychosis is investigated. Although the feasibility study showed promising results, the subsequent multicenter trial did not reveal an effect on personal, clinical and societal recovery outcomes. Moreover, an evaluation of three personal recovery measures on reliability and validity aspects showed that overall differences between measures were minimal. In a meta-analytic study, the effects of physical exercise interventions on negative symptoms (clinical recovery) were evaluated. Physical exercise was effective when compared to standard care, but not statistically significant in comparison with active control groups. Furthermore, an evaluation of the relationship between social connectedness (an important aspect of personal recovery) and symptoms of psychosis (clinical recovery) showed that satisfaction with social connectedness is a predictor of symptoms of psychosis. In conclusion, this research shows that clear criteria for planning and evaluating personal recovery are needed for future research.