'Something wasn't quite right': a novel phenomenological analysis of internet discussion posts detailing initial awareness of psychosis.

Introduction: A significant number of psychosis studies have focussed on and have attempted to model and frame the earliest psychosis experiences. Using a wide array of methodologies and targeting a variety of 'at risk' groups, researchers have offered much to inform our treatment responses, and understanding of psychosis onset and development.

Objectives: Due to the nature of scientific investigation however and investigator led exploration, those who experience psychosis are rarely afforded ultimate free rein to dictate and direct the exchange of information or to impose their unique narrative on that which is being explored. In an attempt to address this, the current study opportunistically harvested rich self-report data from replies to the question, "People that have been diagnosed with schizophrenia, what was the first time you noticed something wasn't quite right?" on the internet discussion forum Reddit.com.

Methods: User data was analysed using Interpretive Phenomenological Analysis to identify key themes in participants' first experiences and initial awareness of psychosis.

Results: While respondents varied widely in their recounted experiences and chose to describe these experiences in a variety of ways, analysis showed that (i) respondent distress was associated with psychosis onset timeframe, negative-voice auditory hallucinations, visual hallucinations, paranoid delusions, and insight (ii) early childhood psychosis experience resulted in novel explanatory schemas and psychosis/distress progression with contributory factors in adolescence and (iii) 41.3% of the sample reported self-realisation in gaining insight and greater insight was associated with help-seeking behaviour.

Conclusions: This novel use of publicly shared experiential data might enrich our existing qualitative literature concerning early psychosis.