Consistent with the common-sense model of self-regulation, illness representations are considered the key to improving health outcomes for medically unexplained symptoms and illnesses (MUS). Which illness representations are related to outcomes and how they are related is not well understood. In response, we conducted a meta-analysis of the relationship between illness representations, self-management/coping, and health outcomes (perceived disease state, psychological distress, and quality of life) for patients with MUS. We reviewed 23 studies and found that threat-related illness representations and emotional representations were related to worse health outcomes and more negative coping (moderate to large effect). Generally, increases in negative coping mediated (with a moderate to large effect) the relationship of threat/emotional illness representations and health outcomes. Protective illness representations were related to better health outcomes, less use of negative coping and greater use of positive coping (small to moderate effect). The relationship of protective illness representations to better health outcomes was mediated by decreases in negative coping (moderate to large effect) and increases in positive coping (moderate effect). Perceiving a psychological cause to the MUS was related to more negative health outcomes (moderate to large effect) and more negative emotional coping (small effect). The relationship of perceiving a psychological cause and more negative health outcomes was mediated by increases in negative emotional coping. Improving our understanding of how illness representations impact health outcomes can inform efforts to improve treatments for MUS. Our results suggest behavioural treatments should focus on reducing threat-related illness representations and negative coping.

与自我调节的常识模型一致，疾病表征被认为是改善医学上无法解释的症状和疾病（MUS）的健康结果的关键。哪些疾病代表与结局有关，以及它们如何联系尚不清楚。作为回应，我们对MUS患者的疾病表现，自我管理/应对和健康结局（感知的疾病状态，心理困扰和生活质量）之间的关系进行了荟萃分析。我们回顾了23项研究，发现与威胁相关的疾病表征和情绪表征与更差的健康结果和更多的负面应对措施（中度到较大效果）有关。一般来说，负面应对的介导（具有中等到较大的影响）的增加，威胁/情绪疾病的表征与健康结果之间的关系。保护性疾病的表现与更好的健康结果，更少使用消极应对措施和更多使用积极应对措施有关（效果小至中等）。保护性疾病代表与更好的健康结果之间的关系是由消极应对（中度到大效应）的减少和积极应对（中度效应）的增加所介导的。感知MUS的心理原因与更多负面健康结果（中度到重大影响）和更多负面情绪应对（小影响）有关。负面情绪应对的增加介导了感知心理原因和负面健康结果之间的关系。增进我们对疾病表征如何影响健康结果的理解，可以为改善MUS治疗提供参考。我们的结果表明，行为治疗应着重于减少与威胁有关的疾病的表现和负面应对。