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Emotional dysfunction in schizophrenia spectrum psychosis: the role of illness perceptions

  • P. W. B. WATSON (a1), P. A. GARETY (a1), J. WEINMAN (a1), G. DUNN (a2), P. E. BEBBINGTON (a3), D. FOWLER (a4), D. FREEMAN (a1) and E. KUIPERS (a1)...

Background. Assessing illness perceptions has been useful in a range of medical disorders. This study of people with a recent relapse of their psychosis examines the relationship between illness perception, their emotional responses and their attitudes to medication.

Method. One hundred patients diagnosed with a non-affective psychotic disorder were assessed within 3 months of relapse. Measures included insight, self-reported illness perceptions, medication adherence, depression, self-esteem and anxiety.

Results. Illness perceptions about psychosis explained 46, 36 and 34% of the variance in depression, anxiety and self-esteem respectively. However, self-reported medication adherence was more strongly associated with a measure of insight.

Conclusions. Negative illness perceptions in psychosis are clearly related to depression, anxiety and self-esteem. These in turn have been linked to symptom maintenance and recurrence. Clinical interventions that foster appraisals of recovery rather than of chronicity and severity may therefore improve emotional well-being in people with psychosis. It might be better to address adherence to medication through direct attempts at helping them understand their need for treatment.

Corresponding author
Department of Psychology, PO 77, Henry Wellcome Building, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. (Email:
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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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