title: Rumination, depressive symptoms and awareness of illness in schizophrenia.
abstract: BACKGROUND
  Depressive symptoms are common in schizophrenia. Previous studies have observed that depressive symptoms are associated with both insight and negative appraisals of illness, suggesting that the way in which the person thinks about their illness may influence the occurrence of depressive responses. In affective disorders, one of the most well-established cognitive processes associated with depressive symptoms is rumination, a pattern of perseverative, self-focused negative thinking.
  
  
  OBJECTIVE
  This study examined whether rumination focused on mental illness was predictive of depressive symptoms during the subacute phase of schizophrenia.
  
  
  METHODS
  Forty participants with a diagnosis of schizophrenia and in a stable phase of illness completed measures of rumination, depressive symptoms, awareness of illness, and positive and negative symptoms.
  
  
  RESULTS
  Depressive symptoms were correlated with rumination, including when controlling for positive and negative symptoms. The content of rumination frequently focused on mental illness and its causes and consequences, in particular social disability and disadvantage. Depressive symptoms were predicted by awareness of the social consequences of mental illness, an effect that was mediated by rumination.
  
  
  CONCLUSIONS
  Results suggest that a process of perseveratively dwelling upon mental illness and its social consequences may be a factor contributing to depressive symptoms in people with chronic schizophrenia.
authors.affiliation: Monash Alfred Psychiatry Research Centre and Swinburne University, Melbourne, Australia.
authors.forename: Neil
authors.initials: N
authors.lastname: Thomas
authors.affiliation: University of Melbourne, Australia.
authors.forename: Darryl
authors.initials: D
authors.lastname: Ribaux
authors.affiliation: University of Melbourne, Australia.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Phillips
mesh_terms: D000328:Adult; D001288:Attention; D001364:Awareness; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D055809:Illness Behavior; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D013850:Thinking