Patients’ Causal Representations of Mental Disorders

Abstract

Background: Illness representations are an important determinant of health outcomes. The cognitive representation includes personal ideas about causes of the illness. This study aimed at analyzing causal representations of patients with mental disorders. Methods: The open-ended response item on causal representation from the IPQ-R was answered by 648 patients (73% female, mean age 47 years, 52% diagnosed with depression) receiving psychotherapy. According to qualitative content analysis, 2 raters agreed on 9 main categories and coded 1771 responses (kappa= .88). Findings: Most frequently, respondents referred to “problems on the job†(47%) and “problems in the social environment†(44%) as causes for their mental disorder. Further relevant causes were “person-centered†(35%), “threatening life events†(29%), and “stress†(21%). Correlations were found between causal representation and demographic and clinical factors. Discussion: The analysis demonstrates the multifaceted causes patients attribute to their mental disorders. Demographic and clinical variables affect patients’ causal representations. Further analyses will be conducted related to causal representations and psychotherapy outcome.