Explanatory models of illness in schizophrenia: Comparison of four ethnic groups

Background Explanatory models of illness may differ between ethnic groups and influence treatment satisfaction and compliance. Aims To compare explanatory models among people with schizophrenia from four cultural backgrounds and explore their relationship with clinical and psychological characteristics. Method Explanatory models, insight, treatment compliance, health locus of control, quality of life, treatment satisfaction, therapeutic relationships and symptomatology were assessed in UK Whites and Bangladeshis, African-Caribbeans and West Africans. Results When biological and supernatural causes of illness were compared, Whites cited biological causes more frequently than the three non-White groups, who cited supernatural causes more frequently. When biological and social causes were compared, Whites cited biological causes more frequently than African-Caribbeans and Bangladeshis, who cited social causes more frequently. A biological explanatory model was related to enhanced treatment satisfaction and therapeutic relationships but not treatment compliance. Conclusions Explanatory models of illness contribute to patient satisfaction with treatment and relationships with clinicians.

[1]  M. Weiss,et al.  Traditional concepts of mental disorder among Indian psychiatric patients: preliminary report of work in progress. , 1986, Social science & medicine.

[2]  Subjective illness theory and antipsychotic medication compliance by patients with schizophrenia , 2002 .

[3]  H. Hoek,et al.  Incidence of psychotic disorders in immigrant groups to The Netherlands. , 2001, The British journal of psychiatry : the journal of mental science.

[4]  Arthur Kleinman,et al.  Patients and Healers in the Context of Culture , 2023 .

[5]  R. McCabe,et al.  Is there a role for compliance in the assessment of insight in chronic schizophrenia? , 2000, Psychology, health & medicine.

[6]  J. Gold,et al.  Correlates of insight in serious mental illness. , 2001, The Journal of nervous and mental disease.

[7]  R. Littlewood,et al.  Patient Satisfaction: Ethnic Origin or Explanatory Model? , 1998, The International journal of social psychiatry.

[8]  G. Thornicroft,et al.  Ethnic differences in satisfaction with mental health services among representative people with psychosis in South London: PRiSM Study 4 , 1997, British Journal of Psychiatry.

[9]  T. Perneger.  What's wrong with Bonferroni adjustments , 1998, BMJ.

[10]  J. Persons,et al.  The effect of patients' beliefs about their illnesses on compliance in psychotherapy. , 1986, The American journal of psychiatry.

[11]  J. Gorman,et al.  Assessment of insight in psychosis. , 1993, The American journal of psychiatry.

[12]  D. Bhugra,et al.  Explanatory models for mental distress: Implications for clinical practice and research , 2002, British Journal of Psychiatry.

[13]  P. Jones,et al.  Increased incidence of psychotic disorders in migrants from the Caribbean to the United Kingdom , 1997, Psychological Medicine.

[14]  S. Evans,et al.  Application and Results of the Manchester Short Assessment of Quality of Life (Mansa) , 1999, The International journal of social psychiatry.

[15]  L. Beecham.  Public health will have priority under UK presidencyThe NHS has massive staff shortages, say Liberal DemocratsJuniors are concerned at new training proposals , 1998 .

[16]  Ralph L. Rosnow,et al.  Essentials of Behavioral Research: Methods and Data Analysis , 1984 .

[17]  N. Mukhopadhyay.  Probability and Statistical Inference , 1996, The Road to Quality Control.

[18]  S. Priebe,et al.  The Role of the Helping Alliance in Psychiatric Community Care: A Prospective Study , 1993, The Journal of nervous and mental disease.

[19]  H Gottesfeld,et al.  New developments in clinical psychology. , 1974, Transactions of the New York Academy of Sciences.

[20]  D. Healy,et al.  Perceptions of illness causation among new referrals to a community mental health team: "explanatory model" or "exploratory map"? , 2001, Social science & medicine.

[21]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[22]  R. Lewis‐Fernández,et al.  Methodological Challenges in Cross-Cultural Mental Health Research , 1997 .

[23]  O. Almeida,et al.  The Assessment of Insight in Psychosis , 1992, British Journal of Psychiatry.

[24]  R. McCabe,et al.  Assessing the stability of schizophrenia patients' explanatory models of illness over time , 2004 .

[25]  D. Bhugra,et al.  The development of the Short Explanatory Model Interview (SEMI) and its use among primary-care attenders with common mental disorders , 1998, Psychological Medicine.

[26]  Douglas G. Altman,et al.  Practical statistics for medical research , 1990 .

[27]  D. Bhugra,et al.  Transcultural psychiatry: do problems persist in the second generation? , 1998, Hospital medicine.

[28]  D. Owens.  Knowing Your Own Mind* , 2003, Dialogue.

[29]  M. Orrell,et al.  Patients' Views Towards Care Received from Psychiatrists , 1996, British Journal of Psychiatry.

[30]  S. Stansfeld,et al.  Ethnic variations in pathways to and use of specialist mental health services in the UK , 2003, British Journal of Psychiatry.

[31]  K. Wallston,et al.  Development and validation of the health locus of control (HLC) scale. , 1976, Journal of consulting and clinical psychology.

[32]  B. Pfefferbaum,et al.  The Brief Psychiatric Rating Scale for Children. , 1982, Psychopharmacology bulletin.

[33]  W. Shen,et al.  Screening for PTSD , 2002, British Journal of Psychiatry.