Why illness perceptions matter.

Untreated depression in patients with physical illness causes distress, amplifies physical symptoms and is more predic-tive of functional impairment over time than severity of physical illness. For example, patients with rheumatoid arthritis who become depressed may present with increasingly painful joints in the absence of increased disease activity. Also, diabetic patients with depression have worse glucose control and are more likely to have diabetic complications. It is therefore important that all clinicians should be aware of the frequency of depression in physical illness, be able to recognise it and have an understanding of its management.Are you depressed?' Screening for depression in the terminally ill. A et al. Long-term medical conditions and major depression: strength of association for specific conditions in the general population. A systematic review of the treatment of depression with antidepres-sant drugs in patients who also have a physical illness. When patients are diagnosed with an illness they generally develop an organ-ised pattern of beliefs about their condition. These views are key determinants of behaviour directed at managing illness. It is a dynamic process which changes in response to shifts in patients' perceptions and ideas about their illness. These illness perceptions or cognitive representations directly influence the individual's emotional response to the illness and their coping behaviour such as adherence to treatment. Despite their importance , patients' views of their illness or symptoms are rarely sought in medical interviews and patients tend not to bring up their illness beliefs with doctors. This paper discusses why illness perceptions matter and how a greater awareness of patients' beliefs can improve both communication in medical consultations and also illness outcomes. When faced with a new health threat such as a new symptom or diagnosis, individuals will actively build cognitive models of this threat and this mental representation will determine how they respond. 1 These models are based on their own medical knowledge or from personal experience of others such as family members with similar symptoms or diagnoses. The patient's model of his or her illness will guide the patient to reduce the danger of the symptoms or illness and simultaneously to guide coping strategies designed to reduce the emotional response to the threat. Researchers have noticed that there is often a symmetry between bodily symptoms and illness labels. 2 When patients have symptoms there is a pressure for them to find a label or explanation for their ill health. Conversely, when …