ABSTRACT
This chapter considers the impact of emotional dysfunction on recovery in first episode of psychosis (FEP). Positive and negative symptoms of psychosis may have abated but post-psychotic depression can elicit a sense of overwhelming loss, an absence of hope, disempowerment, and entrapment. The prevalence of depression in FEP typically ranges from 15–83% depending on the stage of illness considered, heterogeneity in the samples, the assessment tools used, and the definitions of depression used. In the acute phase, a prevalence rate vary from 15–35% and is associated with more severe and distressing positive symptoms, including malevolent voices and impaired social and personal recovery. In the acute phase, depression sometimes reduces with medical treatment of positive symptoms alone. However when depression persists after the resolution of positive symptoms, the potential benefits of introducing an anti-depressant need to be weighed against the potential negative side effects.
