Denial of illness in medical rehabilitation populations: Theory, research, and definition

Objectives: (a) To trace the historical roots of denial of illness in order to understand how the construct of denial developed; (b) to review the literature based on proposed theses; and (c) to propose a taxonomy of the unawareness syndromes. Method: Review of the literature and theory and presentation of a new theoretical model. Results: Evidence from the literature demonstrated that (a) denial and anosognosia are two forms of unawareness syndromes; (b) denial is a multidimensional construct; (c) the use of denial can be both adaptive and maladaptive; and (d) denial interacts with time to have a differential impact on outcomes. Conclusion: A taxonomy is proposed that includes anosognosia (complete and partial) and denial of illness (complete and partial).