Psychosis is the most ineffable experience of mental disorder. We provide here the first co-written bottom-up review of the lived experience of psychosis, whereby experts by experience primarily selected the subjective themes, that were subsequently enriched by phenomenologically-informed perspectives. First-person accounts within and outside the medical field were screened and discussed in collaborative workshops involving numerous individuals with lived experience of psychosis as well as family members and carers, representing a global network of organizations. The material was complemented by semantic analyses and shared across all collaborators in a cloud-based system. The early phases of psychosis (i.e., premorbid and prodromal stages) were found to be characterized by core existential themes including loss of common sense, perplexity and lack of immersion in the world with compromised vital contact with reality, heightened salience and a feeling that something important is about to happen, perturbation of the sense of self, and need to hide the tumultuous inner experiences. The first episode stage was found to be denoted by some transitory relief associated with the onset of delusions, intense self-referentiality and permeated self-world boundaries, tumultuous internal noise, and dissolution of the sense of self with social withdrawal. Core lived experiences of the later stages (i.e., relapsing and chronic) involved grieving personal losses, feeling split, and struggling to accept the constant inner chaos, the new self, the diagnosis and an uncertain future. The experience of receiving psychiatric treatments, such as inpatient and outpatient care, social interventions, psychological treatments and medications, included both positive and negative aspects, and was determined by the hope of achieving recovery, understood as an enduring journey of reconstructing the sense of personhood and re-establishing the lost bonds with others towards meaningful goals. These findings can inform clinical practice, research and education. Psychosis is one of the most painful and upsetting existential experiences, so dizzyingly alien to our usual patterns of life and so unspeakably enigmatic and human.

中文翻译：

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精神病的生活经历：由经验丰富的专家和学者共同撰写的自下而上的评论。


精神病是精神障碍中最难以形容的经历。我们在这里提供了第一个共同撰写的对精神病生活经历的自下而上的回顾，专家们根据经验主要选择了主观主题，随后通过现象学观点丰富了这些主题。医学领域内外的第一人称叙述在合作研讨会上进行了筛选和讨论，涉及众多有精神病经历的个人以及家庭成员和护理人员，代表了全球组织网络。该材料通过语义分析得到补充，并在基于云的系统中在所有协作者之间共享。研究发现，精神病的早期阶段（即病前和前驱阶段）的特征是核心存在主义主题，包括常识丧失、困惑和缺乏对世界的沉浸感，与现实的重要接触受损、高度显着以及感觉某事重要的事情即将发生，自我意识受到扰动，需要隐藏内心的动荡经历。第一发作阶段被发现表现为一些短暂的缓解，这些症状与妄想的出现、强烈的自我参照和渗透的自我世界边界、混乱的内部噪音以及社交退缩导致的自我意识消解有关。后期阶段（即复发和慢性）的核心生活经历包括悲伤的个人损失、感觉分裂，以及努力接受持续的内心混乱、新的自我、诊断和不确定的未来。 接受住院和门诊护理、社会干预、心理治疗和药物等精神治疗的经历包括积极和消极两方面，并由康复的希望决定，被理解为重建人格意识的持久旅程并重新建立与他人失去的联系，以实现有意义的目标。这些发现可以为临床实践、研究和教育提供信息。精神病是最痛苦、最令人不安的存在体验之一，它与我们平常的生活模式如此陌生，又如此难以言喻的神秘和人性化。