Change and continuity in patient theories of illness: The case of epilepsy

Lay concepts of health and illness have attracted much interest in medical sociology. Empirical research has shown that lay theories present coherent views of health and illness which are often not compatible with medical concepts, but influenced by them. Nevertheless, knowledge on the nature of medical influence on individual patient theories over time is scarce. This paper explores this issue by empirically analysing the illness theories of patients with epilepsy. In this qualitative study, the classification and description of illness theories is attempted through ideal types which describe theoretically significant properties of patient discourse. Data from a 4-year follow-up are compared with the original classification. While the continiuties in patient theories seem to be primarily due to continuities in the illness careers, the changes in the direction of psychosomatic theories seen in some patients favour the view that patient theories have dynamic structures which are heavily influenced also on the individual level by historical developments in clinical practice.