Abstract
BackgroundThere is a cultural variability around the perception of what causes the syndrome of schizophrenia. Generally patients with schizophrenia are considered dangerous. They are isolated and treatment is delayed. Studies have shown favorable prognosis with good family and social support, early diagnosis and management. Duration of untreated psychosis is a bad prognostic indicator. We aimed to determine the perceptions regarding the etiology of schizophrenia and the subsequent help seeking behavior.MethodsThis cross-sectional study was carried out on a sample of 404 people at the out patient departments of Aga Khan University Hospital Karachi. Data was collected via a self-administered questionnaire. Questions were related to a vignette of a young man displaying schizophrenic behavior. Data was analyzed on SPSS v 14.ResultsThe mean age of the participants was 31.4 years (range = 18–72) and 77% of them were males. The majorities were graduates (61.9%) and employed (50%). Only 30% of the participants attributed 'mental illness' as the main cause of psychotic symptoms while a large number thought of 'God's will' (32.3%), 'superstitious ideas' (33.1%), 'loneliness' (24.8%) and 'unemployment' (19.3%) as the main cause. Mental illness as the single most important cause was reported by only 22%. As far as management is concerned, only 40% reported psychiatric consultation to be the single most important management step. Other responses included spiritual healing (19.5%) and Sociachanges (10.6) while 14.8% of respondents said that they would do nothing. Gender, age, family system and education level were significantly associated with the beliefs about the cause of schizophrenia (p < 0.05). While these variables plus 'religious inclination' and 'beliefs about cause' were significantly associated with the help seeking behavior of the participants.ConclusionDespite majority of the study population being well educated, only a few recognized schizophrenia as a mental illness and many held superstitious beliefs. A vast majority of Pakistanis have non-biomedical beliefs about the cause of schizophrenia. Their help seeking behavior in this regard is inappropriate and detrimental to the health of schizophrenic patients. Areas for future research have been identified.
Highlights
There is a cultural variability around the perception of what causes the syndrome of schizophrenia
Most of the participants were well educated and 62% of them had at least a bachelor's degree
Cause of schizophrenia The participants gave highly variable responses to the question that assessed their opinion about the cause of schizophrenia demonstrating that many held multiple explanatory models to this
Summary
There is a cultural variability around the perception of what causes the syndrome of schizophrenia. They are isolated and treatment is delayed. Schizophrenia is a severe mental illness characterized by fundamental disturbances in thoughts, emotions and perceptions. Schizophrenic patients place a significant burden on mental health delivery system through chronic disability, social dysfunction, frequent hospitalizations, substance abuse and overall poor compliance[2]. The families and caregivers of schizophrenic patients bear the weight of its negative social and financial influences. Schizophrenia imposes huge economic impact on individuals, families, and communities [3]. It is a disease that affects the individual but bears an impact on the whole society
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