The Impact of Causal Explanations on Outcome in People Experiencing Psychosis: A Systematic Review

Carter, Lucy; Read, John; Pyle, Melissa; Morrison, Anthony P.

doi:10.1002/cpp.2002

Cited by 46 publications

(76 citation statements)

References 81 publications

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“…Although 49% of patients in our sample were on psychopharmacological medication, only a few stated biological factors like predisposition (2%) as one of the major three causal beliefs for their mental disorder. Using qualitative methods, similar findings were observed among patients with depression [12, 13] and patients with psychosis [10]. Using checklists contrasting results were found.…”

Section: Discussionsupporting

confidence: 65%

“…[7, 8, 10, 11, 14, 19, 20, 21]), because attention was payed to the causal beliefs most important from the patients’ perspective.…”

Section: Discussionmentioning

confidence: 99%

“…Studies showed that mentally ill patients’ causal beliefs are associated with impairment [7, 8], coping [1, 2, 9, 10] and outcome [8, 10, 11]: For instance, Cornwall, Scott (7) concluded that biological causal beliefs of patients with depression were associated with severity of depression. Broadbent, Kydd (2) reported that patients with psychotic or personality disorders who believed in psychosocial primary causes were more likely to attend their GP frequently than those who believed in behavioural causes [2].…”

Section: Introductionmentioning

confidence: 99%

“…[7, 8, 10, 11, 12, 13–18]). Mentally ill patients’ causal beliefs were most commonly measured through questionnaires and patients rate each cause from a giving list as regards to how much they agree with it (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Mentally ill patients’ causal beliefs were most commonly measured through questionnaires and patients rate each cause from a giving list as regards to how much they agree with it (e.g. [7, 8, 10, 11, 14, 19, 20, 21]). In these studies, patients diagnosed with mental disorders agreed with a variety of causal beliefs including biological (e.g.…”

Section: Introductionmentioning

confidence: 99%

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What Do Patients Think about the Cause of Their Mental Disorder? A Qualitative and Quantitative Analysis of Causal Beliefs of Mental Disorder in Inpatients in Psychosomatic Rehabilitation

2017

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BackgroundPatients’ causal beliefs about their mental disorders are important for treatment because they affect illness-related behaviours. However, there are few studies exploring patients’ causal beliefs about their mental disorder.Objectives(a) To qualitatively explore patients’ causal beliefs of their mental disorder, (b) to explore frequencies of patients stating causal beliefs, and (c) to investigate differences of causal beliefs according to patients’ primary diagnoses.MethodInpatients in psychosomatic rehabilitation were asked an open-ended question about their three most important causal beliefs about their mental illness. Answers were obtained from 678 patients, with primary diagnoses of depression (N = 341), adjustment disorder (N = 75), reaction to severe stress (N = 57) and anxiety disorders (N = 40). Two researchers developed a category system inductively and categorised the reported causal beliefs. Qualitative analysis has been supplemented by logistic regression analyses.ResultsThe causal beliefs were organized into twelve content-related categories. Causal beliefs referring to “problems at work” (47%) and “problems in social environment” (46%) were most frequently mentioned by patients with mental disorders. 35% of patients indicate causal beliefs related to “self/internal states”. Patients with depression and patients with anxiety disorders stated similar causal beliefs, whereas patients with reactions to severe stress and adjustment disorders stated different causal beliefs in comparison to patients with depression.LimitationsThere was no opportunity for further exploration, because we analysed written documents.ConclusionsThese results add a detailed insight to mentally ill patients’ causal beliefs to illness perception literature. Additionally, evidence about differences in frequencies of causal beliefs between different illness groups complement previous findings. For future research it is important to clarify the relation between patients’ causal beliefs and the chosen treatment.

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Section: Discussionsupporting

confidence: 65%

“…[7, 8, 10, 11, 14, 19, 20, 21]), because attention was payed to the causal beliefs most important from the patients’ perspective.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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What Do Patients Think about the Cause of Their Mental Disorder? A Qualitative and Quantitative Analysis of Causal Beliefs of Mental Disorder in Inpatients in Psychosomatic Rehabilitation

2017

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The clinical characterization of the patient with primary psychosis aimed at personalization of management

et al. 2021

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The current management of patients with primary psychosis worldwide is often remarkably stereotyped. In almost all cases an antipsychotic medication is prescribed, with second‐generation antipsychotics usually preferred to first‐generation ones. Cognitive behavioral therapy is rarely used in the vast majority of countries, although there is evidence to support its efficacy. Psychosocial interventions are often provided, especially in chronic cases, but those applied are frequently not validated by research. Evidence‐based family interventions and supported employment programs are seldom implemented in ordinary practice. Although the notion that patients with primary psychosis are at increased risk for cardiovascular diseases and diabetes mellitus is widely shared, it is not frequent that appropriate measures be implemented to address this problem. The view that the management of the patient with primary psychosis should be personalized is endorsed by the vast majority of clinicians, but this personalization is lacking or inadequate in most clinical contexts. Although many mental health services would declare themselves “recovery‐oriented”, it is not common that a focus on empowerment, identity, meaning and resilience is ensured in ordinary practice. The present paper aims to address this situation. It describes systematically the salient domains that should be considered in the characterization of the individual patient with primary psychosis aimed at personalization of management. These include positive and negative symptom dimensions, other psychopathological components, onset and course, neurocognition and social cognition, neurodevelopmental indicators; social functioning, quality of life and unmet needs; clinical staging, antecedent and concomitant psychiatric conditions, physical comorbidities, family history, history of obstetric complications, early and recent environmental exposures, protective factors and resilience, and internalized stigma. For each domain, simple assessment instruments are identified that could be considered for use in clinical practice and included in standardized decision tools. A management of primary psychosis is encouraged which takes into account all the available treatment modalities whose efficacy is supported by research evidence, selects and modulates them in the individual patient on the basis of the clinical characterization, addresses the patient’s needs in terms of employment, housing, self‐care, social relationships and education, and offers a focus on identity, meaning and resilience.

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The Illness Inquisition

Hunter

2018

Trauma and Madness in Mental Health Services

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The Impact of Causal Explanations on Outcome in People Experiencing Psychosis: A Systematic Review

Cited by 46 publications

References 81 publications

What Do Patients Think about the Cause of Their Mental Disorder? A Qualitative and Quantitative Analysis of Causal Beliefs of Mental Disorder in Inpatients in Psychosomatic Rehabilitation

What Do Patients Think about the Cause of Their Mental Disorder? A Qualitative and Quantitative Analysis of Causal Beliefs of Mental Disorder in Inpatients in Psychosomatic Rehabilitation

The clinical characterization of the patient with primary psychosis aimed at personalization of management

The Illness Inquisition

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