The subjective experience and phenomenology of depression following first episode psychosis: A qualitative study using photo-elicitation

Amrita Sandhu, Jonathan Ives, Maximillian Birchwood, Rachel Upthegrove*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)


Background: Depression following first episode psychosis (FEP) is a frequent occurrence, with profound impact on recovery and outcome. Whilst many theories exist about the causes of depression here, research to date has been based on nosology imported wholesale from affective disorder, with little primary research on the subjective experience. This study aimed to explore the subjective experience and phenomenological features of post-psychotic depression in FEP. Method: A qualitative methodology, photo-elicitation, together with unstructured interviews, was used to characterise aspects of depression following FEP and analysed using contemporary framework analysis. Results: Depression was reported by participants as linked to the experience of and recovery from psychosis. The psychotic episode was a traumatic event followed by subjective doubt, shame and embarrassment. Loss and social isolation were central. Core biological symptoms did not feature. Limitations: Despite the relatively small sample size, this study was able to generate in-depth data that provides useful and novel insight. Whilst generalisability is incompatible with qualitative methodology, further research using the same methodology would generate a wider range of experiences and perspectives. Conclusions: Understanding this dimension of psychosis in and of itself has the potential to improve and aid development of more effective and appropriately targeted interventions and associated outcomes.

Original languageEnglish
Pages (from-to)166-174
Number of pages9
JournalJournal of Affective Disorders
Issue number1-3
Early online date13 Feb 2013
Publication statusPublished - 1 Jul 2013


  • Depression
  • First episode
  • Qualitative
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology


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