Insight, duration of untreated psychosis and attachment in first-episode psychosis: A prospective study of psychiatric recovery over 12-month follow-up

Background: Increasing evidence shows attachment security influences
symptom expression and adaptation in people diagnosed with schizophrenia
and other psychoses.
Aims: The study aimed to establish distributions of attachment in a cohort of
individuals with First Episode Psychosis (FEP), and explore the relationship
between attachment security and recovery from positive and negative
symptoms in the first 12-months.
Method: The study was a prospective 12-month cohort study. The role of
attachment, duration of untreated psychosis (DUP), baseline symptoms and
insight in predicting and mediating recovery of symptoms was investigated
using multiple regression analysis and path analysis.
Results: Of the 79 participants, 54 completed the Adult Attachent Interview
(AAI): 37 (68.5%) were classified as Insecure, of which 26 (48.1%) were
Insecure Avoidant and (11) 20.4% Insecure Preoccupied. DUP and insight
predicted recovery of positive symptoms at 12-months. Attachment security,
DUP and insight predicted recovery of negative symptoms at 12-months.
Conclusions: Attachment is an important construct contributing to
understanding and development of interventions promoting recovery
following FEP.