Clinical Correlates of Coping Strategies employed by Patients with Severe Mental Illness

Background: Coping strategies are the behavioural and cognitive efforts directed to manage stressful demands of life. Coping is generally believed to be a constructive and adaptive effort, which an individual consciously employs to minimize or reduce stress. The aim of the study was to assess the coping strategies employed by patients with Severe Mental Illness (SMI) and evaluate the relationship between the level of insight, the severity of illness and socio-occupational functioning with coping strategies. Method: This cross-sectional study was conducted with 60 outpatients of SMI who were inducted from the rehabilitation subunit of the Department of Psychiatry of Government Medical College & Hospital, Sector 32, Chandigarh. Patients were assessed on Ways of Coping Checklist-Hindi Adaptation (WCC-HA), Brief Psychiatric Rating Scale (BPRS), Schedule for Assessment of Insight (SAI-E), Global Assessment of Functioning (GAF) and Socio-occupational Functioning Scale (SOFS). Results: On the WCC-HA scale, the mean score of seeking social support was10.48± 3.80, avoiding situation 15.11 ± 5.43 and problem-focused 5.03 ± 3.11. There was no significant difference between the types of coping employed by patients with SMI on ANOVA. Avoiding Situation strategies of coping shows a significant positive correlation (r = 0.465, p = 0.01) with the severity of illness (BPRS). Adaptive coping strategies showed a significant positive correlation [seeking social support (r = 0.430), and problem-focused (r = 0.546) both at p = 0.01] with insight of illness (SAI- E). No significant correlation was found between coping and socio-occupational functioning of patients of SMI. [avoiding situation (r =.239), seeking social support (r = .025), problem-focused (r = -.429)] Conclusion: Coping strategies of patients SMI varied with their levels of psychopathology and insight. Those with comparatively severe psychopathology and poorer insight tended to use avoidant or maladaptive coping strategies more often. Keywords: severe mental illness, coping strategies, insigh