Aetiology of depression and schizophrenia: current views of British psychiatrists

Abstract

Aims and MethodA postal survey assessed current views of a random sample of 154 British psychiatrists on aetiological factors in depression and schizophrenia.ResultsGenetics, biochemical abnormalities and substance misuse were considered important factors in both illnesses. Beyond that, psychiatrists varied widely in their views. Depression was viewed as a more multifactorial condition with psychological/social factors more important, whereas biological factors were considered more important in schizophrenia. Aetiological factors were thought to vary more in depression than in schizophrenia and discussing them was seen as more important in patients with depression.Clinical ImplicationsPsychiatrists' attitudes are likely to influence treatment. Patients may encounter different views depending on their illness and on the particular psychiatrist's views.

Mental health clinicians’ beliefs about the causes of psychosis: Differences between professions and relationship to treatment preferences

“…hereditary and chemical imbalance). This is a particularly significant finding as it deviates from previous studies, which have tended to report a partiality for genetic factors within this population (Baillie et al, 2009; Kingdon, Sharma, & Hart, 2004; Van Dorn et al, 2005). This may reflect advances in therapeutic techniques over recent years, which has seen the evidence base for cognitive models of psychosis grow rapidly (Bentall, Corcoran, Howard, Blackwood, & Kinderman, 2001; Garety, Kuipers, Fowler, Freeman, & Bebbington, 2001; Morrison, 2001).…”

“…However, little is known about the beliefs of clinicians, particularly in relation to psychosis. Some studies report an overall preference for biological causes (Baillie, McCabe, & Priebe, 2009; Magliano, Fiorillo, De Rosa, Malangone, & Maj, 2004; Van Dorn, Swanson, Elbogen, & Swartz, 2005). For example, one study that explored the beliefs of 465 professionals found that 68% endorsed hereditary factors, compared to 36% who endorsed ‘psychological traumas’ (Magliano et al, 2004).…”

“…For example, one study that explored the beliefs of 465 professionals found that 68% endorsed hereditary factors, compared to 36% who endorsed ‘psychological traumas’ (Magliano et al, 2004). Similarly, another study of 154 psychiatrists reported that while 88% endorsed hereditary and biomedical causes, recent life events and childhood factors were considered relevant by only 25% and 20% of the sample, respectively (Baillie et al, 2009). Furthermore, research has indicated that clinicians appear to perceive different mental health problems as the result of different aetiological factors.…”

Stigma toward schizophrenia: do all psychiatrists behave the same? Latent profile analysis of a national sample of psychiatrists in Brazil

“…We argue that an important factor to be put into perspective regarding this issue is the heterogeneity of the professional class, especially of psychiatrists [31]. Previous studies of the same class have demonstrated that, in general, psychiatrists hold stigmatizing beliefs about individuals with schizophrenia [32].…”

Praying with a patient constitutes a breach of professional boundaries in psychiatric practice

“…Similarly, a recent survey of British psychiatrists’ beliefs on aetiological factors in depression and schizophrenia showed that a small number believe schizophrenia to be caused by supernatural factors. 15 Psychiatrists can believe whatever they want, but it would be entirely wrong to allow them to bring a belief in supernatural aetiology into their work. Cook has argued that demons are real spiritual entities and that the possibility of actual demonic possession should be taken into account in clinical assessment.…”