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Söderström, Ola
Résultat de la recherche
Urban remediation: a new recovery-oriented strategy to manage urban stress after first-episode psychosis
2019-10-9, Baumann, Philipp S., Söderström, Ola, Abrahamyan Empson, Lilith, Söderström, Dag, Codeluppi, Zoé, Golay, Philippe, Birchwood, Max, Conus, Philippe
Purpose : Urban living is a major risk factor for psychosis. Considering worldwide increasing rates of urbanization, new approaches are needed to enhance patients’ wellbeing in cities. Recent data suggest that once psychosis has emerged, patients struggle to adapt to urban milieu and that they lose access to city centers, which contributes to isolation and reduced social contacts. While it is acknowledged that there are promising initiatives to improve mental health in cities, concrete therapeutic strategies to help patients with psychosis to better handle urban stress are lacking. We believe that we should no longer wait to develop and test new therapeutic approaches. Method : In this review, we first focus on the role of urban planning, policies, and design, and second on possible novel therapeutic strategies at the individual level. We review how patients with psychosis may experience stress in the urban environment. We then review and describe a set of possible strategies, which could be proposed to patients with the first-episode psychosis. Results : We propose to group these strategies under the umbrella term of ‘urban remediation’ and discuss how this novel approach could help patients to recover from their first psychotic episode. Conclusion : The concepts developed in this paper are speculative and a lot of work remains to be done before it can be usefully proposed to patients. However, considering the high prevalence of social withdrawal and its detrimental impact on the recovery process, we strongly believe that researchers should invest this new domain to help patients regain access to city centers.
Unpacking ‘the City’: An experience-based approach to the role of urban living in psychosis
2016-11, Söderström, Ola, Abrahamyan Empson, Lilith, Codeluppi, Zoé, Söderström, Dag, Baumann, Philipp S., Conus, Philippe
Primarily on the basis of epidemiological studies, recent research in psychiatry has established a robust link between urban living and psychosis. This paper argues first, that an experienced-based approach, moving beyond epidemiology, is needed in order to enable more fine-grained understandings of the city/psychosis nexus. The second part of the paper presents preliminary fieldwork results based on video-elicitation sessions with first-episode patients with psychotic disorders. These results lead to the generation of a series of hypotheses for further research on the role of density, sensory overload and social interaction as factors in the onset of non-affective psychoses. The conclusion discusses the insights gained from viewing the city as an experiential milieu rather than as a set of substances. We argue that such insights enable, on the one hand, observation of the role of specific places and situations - and thus to unpack ‘the city’; and, on the other, to envisage the urban milieu as a nexus of possible sites of recovery.
City Avoidance in the Early Phase of Psychosis: A Neglected Domain of Assessment and a Potential Target for Recovery Strategies
2019-6-3, Conus, Philippe, Empson, Lilith Abrahamyan, Codeluppi, Zoé, Baumann, Philipp Sebastien, Söderström, Ola, Söderström, Dag, Golay, Philippe
Background: A considerable amount of research has explored the link between living in an urban environment during childhood and the increased risk to develop psychosis. However, the urban milieu is more than a risk factor as it is also a place for socialization and enrichment. The aims of the current study were to explore, in a large sample of early psychosis (EP) patients, their pattern of use of the city, their perception when exposed to various critical stressors, and their sensitivity to diverse forms of stimuli. Methods: We sent a questionnaire (based on previous work conducted in a group of patients, including video-recorded walk-along in the city and a literature review) to 305 EP patients and to 220 medical students. Results: Response rate in patients was low (38%). City avoidance and negative perceptions towards the urban environment increased in patients after onset of psychosis. Patients’ tendency to avoid city center correlates with both problematic social interactions and stimuli perceived as unpleasant. Patients seemed less likely to enjoy urban spaces considered as relaxing, suggesting a lower capacity to benefit from positive aspects of this environment. Conclusions: The development of psychosis influences the way EP patients perceive the city and their capacity to feel at ease in the urban environment, leading to a high rate of city avoidance. Considering the possible influence of city avoidance on social relations and the recovery process, the development of strategies to help patients in this regard may have a significant effect on their recovery process.
Emplacing recovery: How persons diagnosed with psychosis handle stress in cities
2017-7-19, Söderström, Ola, Söderström, Dag, Codeluppi, Zoé, Abrahamyan Empson, Lilith, Conus, Philippe
The background of this study is recent work on the correlation between urban living and psychosis. It is part of a larger interdisciplinary research project using an experience-based approach to the city-psychosis nexus. The aim of this paper is to investigate how, soon after a first episode of psychosis, patients manage urban factors of stress. Methodologically, it is based on video-elicitation interviews of urban walks and ethnographic observations in a community care centre in the city of Lausanne, Switzerland. It shows that patients use three tactics: creating sensory bubbles; programming mobility; and creating places of comfort. On the basis of these findings, the paper discusses how the approach and results of our study can inform strategies of recovery that are both user-driven and take into consideration the importance of places and situations in the city in the phase following a first episode.