Illness representations in depression and their association with clinical and treatment outcomes: A systematic review of the literature

Mavroeides, Giorgos; Koutra, Katerina

doi:10.1016/j.jadr.2021.100099

Cited by 7 publications

(3 citation statements)

References 45 publications

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“…Although the participants attributions were specific for the prison situation, they took on a stable attributional characteristic since the consequences of prisonization on mental health are believed to endure after release. Holding pessimistic beliefs about the consequences and duration of various mental health problems is associated with a poor outcome ( 67 , 68 ). Accordingly, simply believing that the effects of imprisonment on mental health are persistent could have negative long-term effects on the well-being and motivation for rehabilitation in incarcerated individuals.…”

Section: Discussionmentioning

confidence: 99%

Beliefs about mental health in incarcerated males: a qualitative interview study

Solbakken,

Bergvik,

Wynn

2023

Front. Psychiatry

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IntroductionBeliefs about mental health are shaped by the sociocultural context. Prisons have unique environmental and social features, and the prevalence of mental health problems in incarcerated populations is exceptionally high. These features make prisons especially interesting settings for exploring health beliefs. The aim of this study was to explore the conceptualizations of mental health and coping preferences in a prison environment.MethodsIndividual in-depth interviews were conducted with fifteen incarcerated males from three prisons in Northern Norway. The design draws on central elements from Grounded Theory.ResultsMental health was perceived as distinct from mental illness by many of the participants. They coped with the prison environment by focusing on the things that gave them a sense of meaning and autonomy – this also formed their conceptualization of mental health. Furthermore, social interaction and activities were perceived as important to enhance and maintain mental well-being, however there were institutional barriers to using these coping strategies. The prison environment was integrated in the participants conceptualizations of mental health problems, and psychosocial stressors were emphasized in causal attributions. Biological and dispositional factors were less frequently mentioned. The participants preferred non-medical management for mental health problems and most displayed a reserved attitude towards psychotropic medications. The exception was attention-deficit hyperactivity disorder, for which they held neurobiological causal beliefs, together with a corresponding preference for medication as treatment.ConclusionThe main finding was a firm integration of the prison context in in the participants’ beliefs about mental health. We theorize that fusion of prison conditions and mental health beliefs were brought on by the processes of prisonization, observing mental distress in peers and attempts to protect self-esteem by externalizing the causes for mental health problems. Access to activities, social time, and “someone to talk to” were perceived to be crucial for improving and preserving mental health.

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Section: Discussionmentioning

confidence: 99%

Beliefs about mental health in incarcerated males: a qualitative interview study

Solbakken,

Bergvik,

Wynn

2023

Front. Psychiatry

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“…In a similar vein, healthy levels of family cohesion were found to decrease maladaptive coping through lowering MDD impact representations. This finding is important since emerging data suggest that adaptive illness-related self-regulation processes are a protective factor in MDD [30], although the role of family functioning in the development of self-regulation skills is understudied. Maladaptive coping encompasses behavioral disengagement, denial, self-distraction, self-blame, substance use, and venting, while it has been associated with high levels of psychological distress, such as symptoms of anxiety and MDD, in various populations [60][61][62], as well as with MDD status and outcomes [47,63].…”

Section: Interpreting Research Findings Under the Light Of Literaturementioning

confidence: 99%

“…Illness representations have been established as significant determinants of clinical outcomes in MDD [25][26][27][28][29]. According to a recent systematic review by Mavroeides and Koutra [30], illness representations were found to be associated with a variety of clinical and treatment-related outcomes in patients with MDD, including MDD symptom severity, levels of perceived stress and anxiety, psychosocial functioning, comorbidity, and medication adherence. More specifically, research suggests that maladaptive illness representations may directly impair MDD patients' mental health [26,28,31], while negative perceptions about MDD may impact patients' self-management [32] and decision making about their treatment [33,34].…”

Section: Self-regulation Processes In Mddmentioning

confidence: 99%

Family Functioning, Illness-Related Self-Regulation Processes, and Clinical Outcomes in Major Depression: A Prospective Study in Greece

Koutra,

Mavroeides,

Basta

et al. 2023

Healthcare

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Major depressive disorder (MDD) is a common, seriously impairing, and often recurrent mental disorder. Based on the predictions of the Circumplex Model of Marital and Family Systems and the Common-Sense Self-Regulation Model, the aim of the present prospective study is to examine the predictive value of clinical outcomes of a process model in which associations between perceived family functioning and patient’s clinical outcomes (i.e., symptom severity and suicide risk) are mediated by illness representations and coping strategies. A total of 113 patients with a clinical diagnosis of MDD (16.8% males and 83.2% females) aged 47.25 ± 13.98 years and recruited from the outpatient department and the mobile mental health unit of the Psychiatric Clinic of the University Hospital of Heraklion in Crete, Greece, and from a Greek online depression peer-support group participated in the study. Family functioning was assessed in terms of cohesion and flexibility (Family Adaptability and Cohesion Evaluation Scales IV) at baseline. Illness representations (Illness Perception Questionnaire–Mental Health) and coping strategies (Brief Cope Orientation to Problems Experienced) were measured about five months later (5.04 ± 1.16 months). Symptom severity (Beck Depression Inventory) and suicidality (Risk Assessment Suicidality Scale) were measured about 10 months after the baseline assessment (9.56 ± 2.52 months). The results indicated that representations about MDD impact and symptom severity serially mediated the association between family cohesion and suicide risk in MDD. Furthermore, family cohesion was found to be linked with maladaptive coping through MDD impact representations. Family-based psychotherapeutic interventions specifically designed to target unhealthy family functioning, along with negative illness perceptions and dysfunctional coping, could be further developed and explored as adjunctive therapy to standard treatment in MDD.

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Prospective Associations Between Personality Traits and Major Depressive Disorder Symptom Severity: The Mediating Role of Illness Representations

Mavroeides,

Basta,

Vgontzas

et al. 2024

Psychiatr Q

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Illness representations in depression and their association with clinical and treatment outcomes: A systematic review of the literature

Cited by 7 publications

References 45 publications

Beliefs about mental health in incarcerated males: a qualitative interview study

Beliefs about mental health in incarcerated males: a qualitative interview study

Family Functioning, Illness-Related Self-Regulation Processes, and Clinical Outcomes in Major Depression: A Prospective Study in Greece

Prospective Associations Between Personality Traits and Major Depressive Disorder Symptom Severity: The Mediating Role of Illness Representations

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