Exploring romantic relationships in the context of psychosis: a mixed methods approach

Abstract

Background: Romantic relationships are a fundamental part of human life, but people with psychosis are often without such relationships. Whilst it is generally acknowledged that supportive relationships facilitate recovery from psychosis, the effect of romantic relationships specifically is currently unknown. Furthermore, mental health services habitually fail to address this area of need. Aims: To better understand the associations between romantic relationships, mental wellbeing, and clinical outcomes in individuals with psychosis. To explore how people with psychosis view romantic relationships; understand what support, if any, they want from mental health services in this area of their lives and identify the barriers and facilitators to providing this support. Methods: A systematic review synthesised existing quantitative evidence about the influence of romantic relationships on wellbeing. A cross-sectional study (n =188) explored the association between satisfaction with relationship status, mental wellbeing and psychosis, via mediator variables (self-esteem, loneliness and internalised stigma). Finally, two qualitative studies aimed to understand service user (n=10) and professionals’ (n=20) opinions on the provision of support in this area. Results: The systematic review included 58 papers. Findings highlighted possible associations between relationship status and outcomes of clinical interest. The cross-sectional study found self-esteem, loneliness and internalised stigma mediated the relationship between relationship status satisfaction and mental wellbeing. Mental health professionals identified concerns about risk and lack of guidance as key barriers to providing support around romantic relationships. Service users were generally opposed or unsure about support from mental health services but identified abusive relationships as an area of need where interventions would be appropriate. They were clear that any interventions in this area should maintain their autonomy. Conclusion: Despite associations between romantic relationships and positive wellbeing outcomes, this is an area often neglected by service providers. Service users want support around abusive relationships, but interventions should not compromise their autonomy.

Date of Award	31 Dec 2021
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Gillian Haddock (Supervisor), Filippo Varese (Supervisor) & Maria Haarmans (Supervisor)