The Lived Experiences of People with Schizophrenia Taking Antipsychotics

Abstract

Purpose: Traditionally, schizophrenia has been medicalised as a significant and severe mental illness, and antipsychotic treatment has been justified as the cornerstone treatment for symptom alleviation and relapse prevention. Despite the efforts of researchers to unlock the myth of the client’s unsatisfactory compliance rate, this study aimed to understand the first-person experiences of people with schizophrenia taking long-term antipsychotic therapy.

Methods: Semi-structured interviews guided by a descriptive phenomenological approach were used to interview 33 informants regarding their experiences of living with antipsychotic treatment. The Moustakas analytic model was adopted to identify the themes and uncover the textural and structural essence of these experiences.

Results: Five major themes and the essence of the experience were identified. The five themes represent patterns of informants’ stories, which include a perception of being thrown into life with antipsychotics, soliciting compliance, manifesting uniqueness, encumbering life progression, and negotiating a long-term commitment. The constituted essence of antipsychotic experiences depicts a suddenness of the intrusion of antipsychotics into life. Once it enters the body, the clients cannot control the antipsychotics’ undesirable physical effects. When mentally stabilised, clients are struggling with a decision to continue with antipsychotic treatment for a long time or choose to stop. The informants are ambivalent about the benefits and harms of the antipsychotic treatment, continuously struggling with the need for treatment maintenance. The informants also revealed an important framework to constitute the meaning of antipsychotic treatment. That framework consists of the informants’ significant relationships, activities and life projects being engaged by the informants at a particular period.

Conclusion and Implications: The findings highlighted a need to shift the focus of antipsychotic treatment from mainly managing symptoms to considering the existential possibilities for clients with schizophrenia. A psychopharmacological practice characterised by empathetic dialogues addressing what matters to the client’s personalised lifeworld is advocated, such as showing concerns about the client’s life projects and significant activities. Implications for clinical practice addressing the adjustment needs of clients faced with a sudden loss of mental health and the intrusion of antipsychotic treatment into life are espoused. To cultivate a caring culture that shifts from symptom remediation to addressing existential possibilities through empathy, the study proposes related educational preparation for healthcare professionals attending the lifeworld of clients. The therapeutic use of phenomenological approaches is also advocated to assist clients in making sense of illness and treatment experiences as long-term support for the client’s chronic condition.

Date of Award	14 Dec 2023
Original language	English
Awarding Institution	City University of Hong Kong
Supervisor	Yu Lung Marcus CHIU (Supervisor) & Chi Kin KWAN (Supervisor)