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What people with schizophrenia think about the causes of their disorder

Published online by Cambridge University Press:  11 April 2011

Lorenza Magliano*
Affiliation:
Department of Psychiatry, University of Napoli SUN, Napoli (Italy)
Andrea Fiorillo
Affiliation:
Department of Psychiatry, University of Napoli SUN, Napoli (Italy)
Heidegret Del Vecchio
Affiliation:
Department of Psychiatry, University of Napoli SUN, Napoli (Italy)
Claudio Malangone
Affiliation:
Mental Health Centre of Ravello, Salerno (Italy)
Corrado De Rosa
Affiliation:
Mental Health Centre of Battipaglia, Salerno (Italy)
Carla Bachelet
Affiliation:
Mental Health Centre of Torino, Torino (Italy)
Elisabetta Truglia
Affiliation:
Mental Health Centre of Arezzo, Arezzo (Italy)
Rosa D'ambrogio
Affiliation:
Mental Health Centre of Rho, Milan (Italy)
Fabrizia Pizzale
Affiliation:
Mental Health Centre of Ferrara, Ferrara (Italy)
Franco Veltro
Affiliation:
Mental Health Centre of Campobasso, Campobasso (Italy)
Paola Zanus
Affiliation:
Mental Health Centre of Trieste, Trieste (Italy)
Rosaria Pioli
Affiliation:
Fatebenefratelli Institute of Brescia, Brescia (Italy)
Mario Maj
Affiliation:
Department of Psychiatry, University of Napoli SUN, Napoli (Italy)
*
Address for correspondence:Prof. L. Magliano, Department of Psychiatry, University of Napoli SUN, Largo Madonna delle Grazie, I- 80138, Napoli (Italy). Fax: +39-081-5666523 E-mail:lorenza.magliano@unina2.it

Summary

Aims – To describe what users with schizophrenia think about the causes of their disorder. Methods – In each of the 10 participating Italian mental health centres, 25 users with schizophrenia were consecutively recruited and asked to complete the Users' Opinions Questionnaire (UOQ). Results – 150 out of 198 respondents mentioned at least one social cause for their mental disorder, and 114 reported exclusively social causes. Family conflicts were the most frequently reported social cause (21%), followed by traumas (20%), work and study difficulties (17%), and psychological disturbances (17%). Ten percent of the respondents mentioned biological causes. Biological causes were more frequently reported by users who were aware of their diagnosis of schizophrenia, whereas social causes by those who just knew they suffered from a psychosis. Difficulties in social relationships were more frequently pointed out by respondents with an earlier onset of the illness and a higher number of compulsory admissions in the previous 12 months. These users expressed more scepticism about the usefulness of the treatments they received, and perceived a greater social distance. Conclusions – Users' beliefs about the causes of their disorder should be taken into account by psychiatrists in order to improve their working alliance with them.

Declaration of Interest: None of the authors has had any interest or he/she has received any form of support, including that from drug companies and honoraria for lectures and consultancies, potentially in conflict with this scientific work. None of the authors has received any form of fee for his/her participation in this study. This study was supported by a grant received from the “M. Lugli” Foundation (grant no. 2–18–8).

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

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References

Angermeyer, M.C. & Klusmann, D. (1988). The causes of functional psychosis as seen by the patients and their relatives. European Archives of Psychiatry Neurological Sciences 238, 4754.CrossRefGoogle Scholar
Becker, M.H. & Maimon, L.A. (1983). Models of health-related behaviour. In Handbook of Health, Health Care and the Health Professionals (ed. D., Mechanic). Free Press: New York.Google Scholar
Borkan, J., Reis, S., Hermoni, D. & Biderman, A. (1995). Talking about the pain: a patient-centred study of low back pain in primary care. Social Science and Medicine 40, 977988.Google Scholar
Chadwick, P., Birchwood, M. & Trower, P. (1996). Cognitive Therapy for Delusions, Voices and Paranoia. Wiley: Chichester.Google Scholar
Charles, H., Manoranjitham, S.D. & Jacob, K.S. (2007). Stigma and explanatory models among people with schizophrenia and their relatives in Vellore, South India. International Journal of Social Psychiatry 53, 325332.CrossRefGoogle ScholarPubMed
Colombo, A., Bendelow, G., Fulford, B. & Williams, S. (2003). Evaluating the influence of implicit models of mental disorder on processes of shared decision making within community-based multi-disciplinary teams. Social Science and Medicine 56, 15571570.CrossRefGoogle ScholarPubMed
Corrigan, P.W. & Watson, A.C. (2002). Understanding the impact of stigma on people with mental illness. World Psychiatry 1,1620.Google ScholarPubMed
Falloon, I.R.H. & Talbot, R.E. (1981). Persistent auditory hallucinations: coping mechanisms and implications for management. Psychological Medicine 11, 329339.Google Scholar
Fisher, J. & Farina, A. (1979). Consequences of beliefs about the nature of mental disorders. Journal of Abnormal Psychology 88, 320327.Google Scholar
Foulks, E.F., Persons, J.B. & Merkel, R.L. (1986). The effect of patients' beliefs about their illnesses and compliance in psychotherapy. American Journal of Psychiatry 143, 340344.Google Scholar
Haley, C.J., Drake, R.J., Bentall, R.P. & Lewis, S.W. (2003). Health beliefs link to duration of untreated psychosis and attitudes to later treatment in early psychosis. Social Psychiatry and Psychiatric Epidemiology 38, 311316.CrossRefGoogle ScholarPubMed
Holzinger, A., Muller, P., Priebe, S. & Angermeyer, M.C. (2001). Etiology of schizophrenia from the viewpoint of patient. Psychiatrische Praxis 28, 174179.CrossRefGoogle Scholar
Holzinger, A., Kilian, R., Lindenbach, I., Petscheleit, A. & Angermeyer, M.C. (2003). Patients' and their relatives' causal explanations of schizophrenia. Social Psychiatry and Psychiatric Epidemiology 38, 155162.Google Scholar
Kinderman, P., Setzu, E., Lobban, F. & Salmon, P. (2006). Illness beliefs in schizophrenia. Social Science and Medicine 63, 19001911.Google Scholar
Lobban, F., Barrowclough, C. & Jones, S. (2003). A review of the role of illness models in severe mental illness. Clinical Psychology Review 23, 171196.Google Scholar
Lobban, F., Barrowclough, C. & Jones, S. (2004). The impact of beliefs about mental health problems and coping on outcome in schizophrenia. Psychological Medicine 34, 11651176.Google Scholar
Magliano, L., Fiorillo, A., Malangone, C., De Rosa, C., & Maj, M. (2006). Patient functioning and family burden in a controlled, real-world trial of family psychoeducation for schizophrenia. Psychiatric Services 57, 17841791.Google Scholar
Magliano, L., Fiorillo, A., Malangone, C., Del, Vecchio H., & Maj, M. (2008). Views of persons with schizophrenia on their own disorder: an Italian participatory study. Psychiatric Services 59, 795799.Google Scholar
Magliano, L., Fiorillo, A., Del, Vecchio H., Malangone, C., De Rosa, C., Bachelet, C., Cesari, G., D'Ambrogio, R., Fulgosi, Cigala F., Veltro, F., Zanus, P., Pioli, R., Maj, M. (in press). Development and validation of a self-reported questionnaire on users' opinions about schizophrenia: a participatory research. International Journal of Social Psychiatry.Google Scholar
Maher, E.J. & Kroska, A. (2002). Social status determinants of control in individuals' accounts of their mental illness. Social Science and Medicine 55, 949961.CrossRefGoogle ScholarPubMed
Mak, W.M.S. & Wu, C.F.M. (2006). Cognitive insights and causal attribution in the development of self-stigma among individuals with schizophrenia. Psychiatric Services 57, 18001802.Google Scholar
McCabe, R. & Priebe, S. (2004). Explanatory models of illness in schizophrenia: comparison of four ethnic groups. British Journal of Psychiatry 185, 2530.Google Scholar
McGlashan, T.H., Levy, S.T. & Carpenter, W.T., Jr. (1975). Integration and sealing over. Clinically distinct recovery styles from schizophrenia. Archives of General Psychiatry 32, 12691272.CrossRefGoogle ScholarPubMed
Moodley, P. & Perkins, R. (1993). Perceptions of problems in psychiatric inpatients: denial, race and service usage. Social Psychiatry and Psychiatric Epidemiology 28, 189193.Google Scholar
Noiseux, S. & Ricard, N. (2008). Recovery as perceived by people with schizophrenia, family members and health professionals: a grounded theory. International Journal of Nursing Studies 45, 11481162.Google Scholar
Pennebaker, J.W. (1982). The Psychology of Physical Symptoms. Springer-Verlag: New York.Google Scholar
Perlin, L.I. & Schooler, C. (1978). The structure of coping. Journal of Personality and Social Psychology 19, 221.Google Scholar
Peters, S., Stanley, I., Rose, M. & Salmon, P. (1998). Patients with medically unexplained symptoms: sources of patients' authority and implications for demands on medical care. Social Science and Medicine 46, 559565.CrossRefGoogle ScholarPubMed
Read, J., Mosher, L.R. & Bentall, R.P. (2004). Models of Madness. Psychological, Social and Biological Approaches to Schizophrenia. Brunner-Routledge: Hove.Google Scholar
Read, J., Haslam, N., Sayce, L. & Davies, E. (2006). Prejudice and schizophrenia: a review of the “mental illness is an illness like any other” approach. Acta Psychiatrica Scandinavica 114, 303318.Google Scholar
Salmon, P. & May, C. (1995). Patients’ influence on doctors’ behaviour: a case study of patient strategies in somatisation. International Journal of Psychiatry in Medicine 25, 309319.Google Scholar
Saravanan, B., Jacob, K.S., Johnson, S., Prince, M., Bhugra, D. & David, A.S. (2007a). Assessing insight in schizophrenia: East meets West. British Journal of Psychiatry 190, 243247.CrossRefGoogle ScholarPubMed
Saravanan, B., Jacob, K.S., Johnson, S., Prince, M., Bhugra, D. & David, A.S. (2007b). Belief models in first episode schizophrenia in South India. Social Psychiatry and Psychiatric Epidemiology 42, 446451.Google Scholar
Schomerus, G. & Angermeyer, M. (2008). Stigma and its impact on helpseeking for mental disorders: what do we know? Epidemiologia e Psichiatria Sociale 17, 3137.Google Scholar
Sevy, S., Nathanson, K., Visweswaraiah, H., & Amador, X. (2004). The relationship between insight and symptoms in schizophrenia. Comprehensive Psychiatry 45, 1619.CrossRefGoogle ScholarPubMed
SPSS (2002). SPSS for Windows, release 11.5.1. SPSS: Chicago.Google Scholar
Wearden, A.J., Tarrier, N., Barrowclough, C., Zastowny, T.R., & Rahill, A.A. (2000). A review of expressed emotion research in health care. Clinical Psychology Review 20, 633666.Google Scholar
Zubin, J. & Spring, B. (1977). Vulnerability – a new view of schizophrenia. Journal of Abnormal Psychology 86, 103126.CrossRefGoogle Scholar