Sociocultural and Clinical Aspects of Recovery from First Episode Psychosis in Java, Indonesia: A Follow-Up Case Study

Abstract

Researchers have observed high rates of recovery from first episode psychosis in some cultural settings. This study explores the course and long-term outcome of a small set of cases of first episode psychoses, focusing on clinical predictors of outcome and local cultural processes supporting recovery in Javanese society in Indonesia. Researchers followed nine individuals with a first episode of psychosis intensively during one year of ethnographic research and measured clinical markers of the outcome at onset and at two- and 14-year follow-ups. Despite some relapses, a majority of individuals substantially recovered at one year and continued to function near-normal at 14 years; two cases represent long-term illness. Clinical factors associated with recovery included the acute onset of illness and short duration of untreated psychosis. Ethnographic research identified cultural models, linked to Javanese folk stories and local Islamic ideas, and social and cultural processes supportive of recovery from psychosis.