Abstract
Background
Existing evidence indicates that dissonance between patients’ and professionals’ explanatory models affects engagement of patients with psychiatric services in Western and non-Western countries.
Aims
To assess qualitatively the explanatory models (EMs) of psychosis and their association with clinical variables in a representative sample of first episode patients with schizophrenia in South India.
Method
One hundred and thirty one patients with schizophrenia presenting consecutively were assessed. Measures included the patient’s explanatory models, and clinician ratings of insight, symptoms of psychosis, and functioning on standard scales.
Results
The majority of patients (70%) considered spiritual and mystical factors as the cause of their predicament; 22% held multiple models of illness. Patients who held a biomedical concept of disease had significantly higher scores on the insight scale compared to those who held non-medical beliefs. Multivariate analyses identified three factors associated with holding of spiritual/mystical models (female sex, low education and visits to traditional healers); and a single factor (high level of insight) for the endorsement of biological model.
Conclusions
Patients with schizophrenia in this region of India hold a variety of non-medical belief models, which influence patterns of health seeking. Those holding non-medical explanatory models are likey to be rated as having less insight.
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Acknowledgements
BS was supported by a grant from the Wellcome Trust, London. We also thank the participants and support staff of Christian Medical College, Vellore, for their cooperation and commitment to completion of the study.
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Saravanan, B., Jacob, K., Johnson, S. et al. Belief models in first episode schizophrenia in South India. Soc Psychiat Epidemiol 42, 446–451 (2007). https://doi.org/10.1007/s00127-007-0186-z
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DOI: https://doi.org/10.1007/s00127-007-0186-z