Coping strategies among the long-term mentally ill: categorization and clinical determinants

The aim of this study was to explore strategies for coping with symptoms in 98 long-term mentally ill patients. The following characteristics of the strategies were investigated: level, effectiveness, target symptom and problem orientation. In addition, we studied the association between measures of coping and psychopathology. An average of 3.8 coping strategies per patient was reported, and strategies involving behavioural change were most common (48%), followed by changes in socialization (24%) and in cognitive control (15%). Coping efforts were most commonly directed towards non-psychotic symptoms. A high load of general and affective symptoms, few negative symptoms and a high level of illness awareness predicted the total number of coping strategies. Separate analysis of active and passive strategies, including increased and decreased socialization, respectively, revealed very different patterns of clinical predictors. These results are discussed with reference to community-care programmes.