Depression, illness beliefs and severity of illness

The relationship of effective status to abnormal illness behavior (AIB), locus of control and severity of illness was investigated in a series of patients seen for psychiatric consultation in a general hospital. Results showed no relationship between depression and the actual severity of illness, AIB dimensions or locus of control. Patients with chronic pain complaints, however, ascribed their problems to emotional factors and acknowledged affective distress more than those without chronic pain. More externally located individuals had greater hypochondriacal fear, disease conviction and affective distress. Thus, patients with chronic pain may 'organize' illness around psychosomatic constructs. The externally located patient's pessimism and feelings of physical vulnerability may require more active psychological support. Therapeutic implications are discussed.