Sleep and emotional distress in early psychosis

Psychosis includes hearing distressing voices, paranoia, and thought disorder, which can develop into schizophrenia. Schizophrenia is associated with complex mental health, comorbid physical health conditions and premature mortality. Schizophrenia has a mean incidence of 15 per 100, 000 but a first episode of psychosis (FEP) is more common (86 per 100,000 adolescents) and stigma can lead to treatment delays which adversely affect outcomes. However, early intervention can prevent poor outcomes and significant financial cost to society. Such services are therefore crucial to prevent long-term mental health issues developing, with their associated emotional and financial impact on individuals, their family and society. As poor sleep is linked to poorer mental and physical health outcomes, targeting sleep problems could be a useful pathway towards improving early intervention and recovery, with sleep problems relatively less stigmatised. Sleep problems are common in psychosis, with a strong relationship between sleep and emotional distress. Emotional distress impacts recovery, in terms of increased rates of anxiety and depression and suicidal thinking, and contributes to more severe and persistent psychosis. Thus the main aim of the research is to investigate the relationship between sleep, emotional distress and psychotic experiences in young people. My research programme will be formed by three interlinked studies. In Study 1, I will investigate perspectives of doctors, nurses and psychologists about the importance of sleep problems and interventions to improve sleep in FEP. These findings will aid the implementation of the results (Studies 2 and 3) and support the future development of a sleep intervention programme for FEP. In Study 2 I will investigate sleep patterns in young people known to be at ultra-high risk of developing a FEP. This study will contribute important knowledge about poor sleep as a risk factor for young people developing psychosis.