Are negative beliefs about psychosis associated with emotional distress in adults and young people with such experiences? A meta‐analysis

OBJECTIVE: Emotional distress, including depression and anxiety, is commonly reported amongst individuals experiencing psychosis. The beliefs individuals hold about the meaning of their psychosis may explain the distress they experience. The current meta‐analysis aimed to review the association between beliefs about psychosis experiences and emotional distress. METHOD: Three electronic databases (PsycINFO, MEDLINE, and CINAHL) were searched using keywords and controlled vocabulary (e.g., Medical Subject Headings) from date of inception to August 2019. A total of 19 eligible papers were identified. RESULTS: Our random‐effects meta‐analysis revealed that depression and anxiety held moderate association with psychosis beliefs, with perceptions concerning a lack of control over experiences having the strongest association with distress. Longitudinal studies suggest that negative beliefs at baseline are associated with depressive symptoms at follow‐up. CONCLUSIONS: The results suggest that the endorsement of negative beliefs about psychosis is associated with current level of depression and anxiety. The results are consistent with theories of emotional distress in psychosis. However, the small number of longitudinal papers limits what can be concluded about the direction or other temporal characteristics of these relationships. Therapies that target unhelpful beliefs about psychosis may beneficial. PRACTITIONER POINTS: Negative beliefs about experiences of psychosis are associated with greater emotional distress such as depression and anxiety. Beliefs about a lack of control over experiences had the strongest association with distress. Interventions that aim to modify or prevent the formation of unhelpful beliefs about psychosis may be beneficial for this population.