Discrepant illness perceptions, affect and expressed emotion in people with psychosis and their carers

Elizabeth Kuipers, Phil Watson, Juliana Onwumere, Paul Bebbington, Graham Dunn, John Weinman, David Fowler, Daniel Freeman, Amy Hardy, Philippa Garety

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46 Citations (Scopus)


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.

Method: 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.
Original languageEnglish
Pages (from-to)277-283
Number of pages7
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number4
Early online date13 Feb 2007
Publication statusPublished - Apr 2007

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