Positive and negative caregiver experiences in first-episode psychosis: emotional overinvolvement, wellbeing and metacognition.

OBJECTIVES: While caregivers of persons with first-episode psychosis often report a range of negative experiences, little is known about what psychological factors are involved. The aim of this study was to examine how caregivers' general wellbeing, emotional overinvolvement and metacognition influenced their reports of both positive and negative caregiving experiences.

DESIGN: A prospective consecutive cross-sectional study.

METHODS: Forty caregivers of patients with first-episode psychosis were interviewed using semi-structured interview and questionnaires.

RESULTS: Greater levels of distress and overinvolvement were associated with more negative experiences of caregiving while greater metacognitive capacity was associated with more positive experiences of caregiving.

CONCLUSIONS: The experience of positive and negative aspects of caregiving seems to be associated with different variables. Greater metacognitive capacity does not necessarily alleviate the suffering and distress, which is a healthy and normal reaction to having a close one suffering from psychosis. But it might help broaden the perspective, allowing for both negative and positive experiences. Clinical implications in terms of expanding the range of therapeutic interventions are discussed.

PRACTITIONER POINTS: Assessing the capacity for metacognition in a non-clinical population. Understanding what factors are involved in positive and negative caregiver experiences in first-episode psychosis. A broadening of family interventions by encompassing the concept of metacognition.