Coping strategies and social support in old age psychosis

Background According to vulnerability– stress models of psychosis, cognitive and behavioural coping strategies can help mediate the potentially negative effects of daily stressors. The nature, frequency and effectiveness of coping have been studied in people with psychosis under 65 years of age. However, these findings may not generalise to older people with the diagnosis, as the nature of stressors and coping strategies may change with increasing age. This study therefore aimed to explore coping in older patients with psychosis. Methods A total of 48 older patients with psychosis (F20-29, ICD-10) and 25 nonclinical elderly controls were compared using selfreport measures of stressors, perceived control over stressors, coping strategies, perceived coping efficacy and social support. A regression analysis was used to explore predictors of dysfunctional coping in the patient group. Results Patients used a significantly higher proportion of problem-focused coping strategies, but they were more dysfunctional copers and rated their coping as less effective compared to controls. They also had fewer friends and less emotional support. Severity of symptoms was a significant predictor of dysfunctional coping when depression, cognitive impairment and functional disability were controlled. Conclusions Patients with psychosis coped less well with daily stressors than controls and patients with more severe symptoms were more dysfunctional copers. The findings highlight the potential benefit of psychosocial interventions in old age psychosis.