Psychosocial Status in Chronic Illness

Abstract

Assumptions that psychological attributes are specific to particular diagnoses characterize many investigations of chronically ill patients. We studied 758 patients, each of whom had one of six different chronic illnesses, to determine and compare their scores on the Mental Health Index. Five groups of physically ill patients (with arthritis, diabetes, cancer, renal disease, or dermatologic disorders) did not differ significantly from one another or from the general public, but all had significantly higher scores for psychological status when compared with the sixth group, patients under treatment for depression. There was a significant direct relation between higher mental-health scores and advancing age across all patient populations. Patients with recently diagnosed illness in all groups had poorer mental-health scores than did patients whose illness had been diagnosed more than four months previously. A direct relation between declining physical status and mental-health scores was observed. These results suggest that psychological adaptation among patients with chronic illnesses is remarkably effective and fundamentally independent of specific diagnosis.

Stress in chronic disease: Do the perceptions of patients and their general practitioners match?

“…Empirical studies have shown that, despite the incurability, treatment regimes, and reality of disability accompanying most chronic conditions, most patients adapt to a chronic disease. For example, Cassileth et al (1984) have shown that most outpatients with diabetes, cancer, and rheumatic, renal, and skin diseases do not report higher levels of stress and lower levels of well-being throughout the history of their disease in comparison to comparable healthy subjects, the exceptions being the initial-and end-stages of a disease. The population in this study generally scored rather low on the stressors assessed, indicating that they view their illness as not being very serious.…”

Experiences of stigma by association among family members of people with mental illness.

“…A higher score is indicative of greater psychological distress. The MHI is a valid and reliable measure of mental health that has been used extensively in both clinical and nonclinical samples (Cassileth et al, 1984;Heubeck & Neill, 2000;Rosenthal et al, 1991;Veit & Ware, 1983). It was also used previously to examine the impact of stigma on psychological distress (Stutterheim et al, 2009;Stutterheim et al, 2011).…”

Measurement of Psychological Distress and Well-Being

“…In the initial phase of an illness life events are often considered as part of the illness ('the umbrella of illness') while in the chronic phase of illness life events are ne glected [24], Side effects are in this phase of illness often confounded with life events.…”

“…Else where, it has been shown that the General Health Questionnaire also, and perhaps to a larger extent, covers these elements [22], In minor somatic disorders (e.g. neuras thenia [23]) and in major somatic disorders [24] the Beck Depression Inventory (BDI) has been found useful as an indicator of cop ing with illness. The BDI correlated signifi cantly with the General Well-Being Schedule as an index of mental health [24], In mental disorders, however, such ques tionnaires as GIIQ or BDI are problematic.…”

“…neuras thenia [23]) and in major somatic disorders [24] the Beck Depression Inventory (BDI) has been found useful as an indicator of cop ing with illness. The BDI correlated signifi cantly with the General Well-Being Schedule as an index of mental health [24], In mental disorders, however, such ques tionnaires as GIIQ or BDI are problematic. Thus, in borderline personality disorders (pseudoneurotics) the presence of anhedonia invalidates these scales.…”