Étude comparative du fonctionnement dans la communauté des jeunes adultes schizophrènes et de leurs pairs sans psychopathologie
Schizophrenia is a mental health disease that affects approximately one percent of the population and whose symptoms and associated deficits hinder community functioning in affected individuals. Over the last decade, specialized services in early detection and intervention of first-episode psychosis have been implemented in many countries. So far, these services have primarily targeted symptoms and use of psychiatric care as outcomes. The significant functional difficulties experienced by young adults with schizophrenia call for a shift in emphasis towards rehabilitative strategies. No study has documented the needs, preferences and priorities of this population in terms of rehabilitation services and of the influence of developmental characteristics of young adulthood on functional outcome.  This study aims to examine community functioning of young adults with schizophrenia after the first episode of psychosis and to compare it with community functioning of their unaffected peers. Community functioning is conceptualized from the perspective of person-environment interaction through the lens of the Model of Competence. A multiple case study is used within the canvas of a synthetic research approach. A concurrent, mixed methods design (qualitative and quantitative) is implemented for triangulation purposes (Creswell & Plano Clark, 2007).   Results indicate salient differences between the clinical and comparison groups in the areas of social and conjugal relationships, academic achievement as well as financial and residential independence. Qualitative data analyzed through a grounded theory approach (Glaser & Strauss, 1967) highlight the social processes through which young adults achieve developmental tasks. Personal and systemic conditions that constraint and facilitate processes are recognized. The results have implications for psychiatric practices. First, residential services should be adapted to the developmental characteristics of this age group. Second, supported education should be valued and implemented as a key service for young adults with schizophrenia. Third, friends and members of the social network should be included as early and intensively as possible in the rehabilitation process. Overall, this study leads to methodological innovations in the use of mixed methods in clinical research, to identification of needs and priorities in the design of rehabilitation strategies and to the recognition of the voices and input of young adults with schizophrenia.
Psychiatrie Evidence-based practices First-episode psychosis Human development Mental health Mixed methods Person-environment interaction Psychiatry Rehabilitation Schizophrenia Young adulthood