Discrepant illness perceptions, affect and expressed emotion in people with psychosis and their carers.
BACKGROUND
Illness perception, a measure of illness representations developed from physical medicine, has recently been applied to psychosis. We investigated how illness perceptions relate to affect and expressed emotion (EE) in carer-patient dyads, particularly if their perceptions differed.


METHODS
We interviewed 82 carer-patient dyads, after a relapse of psychosis. Carers were assessed for illness perceptions, distress, self-esteem and EE; patients for illness perceptions, depression, anxiety and self-esteem, in a cross sectional study.


RESULTS
Carers were more pessimistic than patients about illness persistence and consequences, and carers with low mood were particularly pessimistic about persistence and controllability. Discrepant views about illness consequences were related to greater anxiety, depression, and lower self-esteem in patients, while discrepant views on controllability were associated with greater distress, depression, and lower self-esteem in carers. Illness perceptions did not relate directly to EE.


CONCLUSIONS
In this sample, meta-cognitive carer representations of illness in psychosis are related to negative affective reactions in carers, but not to EE. Resolving discrepant illness perceptions between carers and patients might provide a way of improving family reactions to the health threat of psychosis.
Kuipers
Elizabeth
E
Department of Psychology, King's College London, Institute of Psychiatry, Box PO77, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK. e.kuipers@iop.kcl.ac.uk
Watson
Phil
P
Onwumere
Juliana
J
Bebbington
Paul
P
Dunn
Graham
G
Weinman
John
J
Fowler
David
D
Freeman
Daniel
D
Hardy
Amy
A
Garety
Philippa
P
D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology* / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy