Effects of illness attribution and depression on the quality of life among persons with serious mental illness.

Attributing one's problems to a mental illness is associated with reduced subjective quality of life (QOL) among persons with schizophrenia, controlling for a broad range of socio-demographic, social, clinical, and psychosocial variables. Persons who attributed their problems to a 'physical, medical, or biological' problem in contrast to a 'mental illness' reported more positive social relations and higher overall quality of life. Much of the negative effect of mental illness attributions is explained by perceived stigma, lower self-esteem, and a higher level of depressive symptomatology. Depressive symptoms have an independent negative effect on QOL net of all other variables. These findings have important implications for the appropriate rehabilitation of persons with mental illness and require further scrutiny with prospective data.