Strategies used by psychotic individuals to cope with life stress and symptoms of illness: a systematic review

Psychological models of schizophrenia and other psychotic disorders suggest that poor coping responses to life stressors and to symptoms of illness is central to their development and maintenance and influences recovery. These models are widely accepted and inform psychological treatments for psychotic disorders. In this paper, 85 studies that explore how individuals with established psychotic disorders cope with symptoms associated with their illness, and with independent life events and stressors are comprehensively reviewed. Reviewed research included cross-sectional and longitudinal investigations of self-initiated coping. Despite limitations in the existing research, it is concluded that most individuals experiencing psychosis implement at least one strategy to cope with symptoms, and life events and most implement more than one strategy. It appears that having a repertoire of strategies to employ leads to greater effectiveness than simply relying on one strategy. This suggests that treatment strategies that aim to enhance the coping of individuals with psychosis should emphasize the development of a range of coping strategies. It also seems that there is no one coping strategy that is universally effective and situational, or other factors may influence both the choice of coping strategy implemented and its efficacy.