57 Affective symptoms and personal recovery Negative (ΔF (1,31) = 0.118, p=0.733) and positive symptoms (ΔF (1,30) = 1.744, p=0.197) did not significantly add to the model. DISCUSSION This study was performed to evaluate the relationship between clinical and personal recovery in patients with severe mental illness (SMI) by investigating specific associations between the severity of different symptom domains and reported personal recovery. Previous research has mainly focused on patients with schizophrenia spectrum disorders, but chronic care is mostly not organised by diagnosis, but by type of care needed. That is why research in patients with all SMIs is desirable. A multiple regression analysis showed that only affective symptoms significantly predicted personal recovery, whereas neither positive, nor negative symptom severity added to the explained variance in the model. It is known that depressive symptoms have a high prevalence in patients with schizophrenia spectrum disorders, with estimates of 80% (31). Earlier studies in patients with schizophrenia spectrum disorders, as well as with affective disorders, have found that affective symptoms correspond more closely to personal recovery than psychotic symptoms (20-23). However, post hoc analyses of the current sample revealed that severity of affective symptoms was more strongly related to personal recovery in patients with a non-psychotic disorder than in patients with schizophrenia. We propose that the association is related to partly overlapping expressions in depressive mood and personal recovery. It is evident that a depressive mood is associated with a decreased sense of hope and optimism which are also important aspects of personal recovery (11, 21, 32). Earlier studies have also found a relationship between affective symptoms and constructs related to personal recovery, such as quality of life, selfesteem, hopelessness and stigma (19, 33-35). In contrast, positive and negative symptoms were not associated with overall personal recovery. This finding is in line with literature regarding patients with schizophrenia spectrum disorders, which also reported non-significant or small associations (17, 18, 36). If we look into the subscales of the MHRM, there is a clear relationship between selfempowerment and affective symptoms. The questions of the MHRM that address empowerment mostly concern believing in, and being positive about oneself. These notions are influenced by a depressive mood. The main implication of our findings for clinical practice is that for SMI patients treated in F-ACT teams, not only attention to positive and negative symptoms, but 3
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