Why is this happening to me? – a comparison of illness representations between Iranian and German people with mental illness

Judith Reichardt, Amrollah Ebrahimi, Hamid Nasiri Dehsorkhi, Ricarda Mewes, Cornelia Weise, Hamid Afshar, Peyman Adibi, Said Moshref Dehkordy, Gholamreza Yeganeh, Hanna Reich, Winfried Rief

Due to an increase in migration and globalization, cross-cultural encounters in health care are also becoming more frequent. As psychotherapy is grounded in a cultural context and must be congruent with the patient's cultural beliefs of his or her illness in order to be effective, the consideration of cross-cultural differences in illness representations becomes increasingly important. Especially research on illness representations concerning mental disorders is scarce. The aim of the current study was to compare illness representations between Iranian (N = 87) and German (N = 90) patient samples as well as subclinical samples (Iranian N = 264, German N = 102) using a multivariate analysis of covariance (MANCOVA). Illness representations were measured using the Illness Perception Questionnaire Revised (IPQ-R). Initially, a factor analysis was conducted in order to ensure comparability of the IPQ-R between the Iranian and the German sample. The factor analysis already revealed differences in item compositions of the IPQ-R subscales indicating differences of the conception of illness representations between the samples. Further, the Iranian samples showed a significantly higher amount of supernatural causal beliefs and emotional representation of the illness than the German samples. Surprisingly, the Iranian patient sample showed the highest amount of illness coherence. The current paper contributes to a deeper understanding of cross-cultural differences in illness representations regarding mental disorders. Nevertheless, further research is needed to confirm current findings and to further elaborate on the relationships found.