Publication #2

Background: Sense of coherence (SOC) is defined as a global orientation based on a person’s confidence that stimuli are structured and predictable, the resources needed to meet these demands are available, and these demands are seen as challenges, worthy of investment, and engagement. The SOC scale is an instrument measuring how people manage stressful situations and stay well. We aimed to assess the psychometric properties of its Greek version in two samples, people with and without long-term conditions (LTCs). Associations between sense of coherence and mental illness, suicidality, and quality of life were also investigated.

Methods: The Antonovski’s Sense of Coherence Scale (SOC-29) was administered to 374 participants; 245 patients with diabetes, chronic pulmonary obstructive disease and rheumatic diseases attending specialty clinics or the emergency department and 129 individuals without LTCs. Diagnosis of mental disorders was established by the Mini International Neuropsychiatric Interview. Associations with depressive symptom severity (PHQ-9), suicidal risk (RASS), and health-related quality of life (WHOQOL-BREF) were also investigated.

Results: The Greek version of SOC-29, when used as a whole, presented a coherent structure with remarkable stability in people with and without LTCs. Cronbach’s alphas were 0.89 for patients with LTCs and 0.91 for people without LTCs, being 0.90 for the entire sample. Greater levels of SOC were associated with better mental health, lower depressive symptom severity and better quality of life. Furthermore, greater levels of SOC were associated with lower suicidal risk even after adjustment for depressive symptom severity.

Conclusion: The results of the present study showed that the Greek version of SOC-29 may reliably assess SOC. Moreover, lower levels of SOC are associated with established mental disorders and increased suicidal risk, and thus may detrimentally impact mental health. These findings may have important clinical implications, especially as far as the prevention of suicidal risk is concerned.