The relationships between patients’ and caregivers’ beliefs about the causes of schizophrenia and clinical outcomes in Latin American countries

Abstract

Beliefs about the causes of schizophrenia are thought to impact treatment outcomes. We investigated 3 theoretically opposing belief systems (biological, psychosocial, magical-religious) in relation to the severity of positive and negative symptoms and to attitudes towards medications. We recruited 253 patients with schizophrenia and their primary caregivers from public mental health clinics in Bolivia, Chile, and Peru. We assessed patients’ and caregivers’ beliefs about the causes of schizophrenia, which were used as predictors of symptom severity and medication attitudes in linear regression analyses. Patients’ scores on biological, psychosocial, and magical-religious beliefs were positively correlated with one another, indicating that these domains were not, as anticipated, “opposing.” Patients with higher levels of biological and psychosocial beliefs had significantly lower levels of positive and negative symptoms; in contrast, higher levels of magical-religious beliefs were associated with increased positive symptoms and less favorable attitudes towards medications. Patients’ belief systems are significant predictors of symptom severity and medication attitudes. Research is needed on the extent to which psychotherapeutic treatments for schizophrenia should bolster patients’ beliefs in the biological and psychosocial domains and weaken beliefs in the magical-religious domain; this research should also attend to the ethical considerations involved in intervening on belief systems cross-culturally.

Medication nonadherence among South American patients with schizophrenia

“… 59 Previous studies reported the importance of respecting and considering patients’ belief systems to improve medication attitudes. 22 Other sociodemographic and clinical variables were not related to adherence, as obtained by Lacro et al 5 This result is similar to previous studies as well that the side effects to the medication had impact on DAI-10 scores. 11 , 17 , 63 – 65 …”

“…Other differences are associated with psychiatric care facilities: per 100,000 inhabitants, Bolivia has 0.1 psychiatric hospitals, Peru has 0.01, and Chile has 0.003 (this country has a greater number of outpatient institutions), mental health staff (the number of psychiatrists in Bolivia is 0.1; Peru: 0.1 and Chile: 0.6 per 100,000 inhabitants); lack of day hospitals (Bolivia, 0.1; Peru, 0; and Chile, 0.5), and residential care (Bolivia, 0; Peru, without data; and Chile, 103). 21 , 22 …”

Factors affecting quality of life in children and adolescents with hypermobile Ehlers‐Danlos syndrome/hypermobility spectrum disorders

“…Casual beliefs are known to influence an individual's health status, management behaviors, lifestyle decisions, and disease outcomes (Caqueo‐Urízar, Boyer, Baumstarck, & Gilman, ; Fleary & Ettienne, ; Petrie, Jago, & Devcich, ; Wisdom & Green, ). The majority of child participants felt that factors beyond their control, such as genetics, were responsible for their symptoms; this is not surprising, given that most patients are counseled that hEDS is a genetic disorder.…”

Are carer attitudes toward medications related to self-reported medication adherence amongst people with mental illness?

“…Other research has shown an association between carer and consumer attitudes about their illness or treatment and found that carer attitudes can impact consumer outcomes. A Latin American study of consumers with schizophrenia and their carers investigated the association between causal belief of schizophrenia with attitudes toward medicine and symptoms (Caqueo-Urizar et al, 2015). Consumer and carer causal beliefs shared small to moderate correlations (e.g., biological causal belief r=.45).…”