University students' understanding and perceptions of schizophrenia in the UK: a qualitative study

Hermeneutic Phenomenological Approach to the Experiences of the Individuals Living with Schizophrenia: A Qualitative Study

Background

Schizophrenia affects various spheres of life causing so many difficulties and burden, but the studies focusing on the experience of individuals living with schizophrenia with reference to the Tamil Nadu context are sparse.

Material and Methods

A qualitative interview based on a hermeneutic phenomenological approach was conducted with 10 individuals living with Schizophrenia and was recorded. The responses were transcribed and coded. Based on codes, domains and subdomains were identified.

Results

Six themes were identified, under which the participant's burden was described. Participants expressed a deep longing for love and care. They were deprived of family's affection. Participants felt economically insecured, which was owing to their unemployment. Participants had many physical complaints including sleep disturbance and fatigue. Participants expressed that they had failing memory, concentration issues, and difficulty in planning. Most of the participants felt isolated by family and kin. They did not participate in much social activities due to the fear of judgment and stigmatization.

Conclusion

The experience of individuals living with Schizophrenia revealed that they experienced a series of burdens owing to their illness and its impacts that were categorized into various themes including physical, vocational, cognitive, psychological, personal, and social factors.

The role of culture on the phenomenology of hallucinations and delusions, explanatory models, and help-seeking attitudes: A narrative review

AIM

Culture has been posited to be involved in the formation and maintenance of delusions and hallucinations. The extent of these differences and how they affect explanatory models of psychosis and help-seeking attitudes remains to be understood. This review aims to present a cultural formulation to account for psychosis onset, symptom maintenance, and help-seeking attitudes.

METHODS

A narrative review was conducted to summarize the existing evidence base regarding cross-cultural differences in hallucinatory and delusional prevalence, explanatory models, and help-seeking attitudes in First Episode Psychosis (FEP) and Non-FEP Schizophrenia samples.

RESULTS

Sixteen studies were eligible for inclusion. In terms of positive symptom specificity, cross-cultural differences were found. Specifically, auditory and visual hallucinations occurred most frequently in African patients, persecutory and grandiose delusions occurred at higher rates in African, Pakistani, and Latino patients, while delusions of reference were most prevalent in White-British groups. Three explanatory models were identified. Westerners tended to endorse a bio-psychosocial explanation, which was associated with increased help-seeking, engagement, and positive medication attitudes. Asian, Latino, Polish, and Māori patients endorsed religious-spiritual explanatory models, while African patients opted for a bewitchment model. The religious-spiritual and bewitchment models were associated with a longer duration of untreated psychosis (DUP) and poorer engagement with mental health services.

CONCLUSIONS

These findings highlight the important influence of culture in the formation and maintenance of positive symptoms of psychosis, engagement, and help-seeking attitudes across different ethnic groups. The incorporation of cultural beliefs in formulation development could facilitate enriched CBTp practices and improved engagement amongst different cultural groups with Early Intervention Services.

The Stigmatizing Attitudes of Syrian University Students Toward Schizophrenia

Background: Stigma is frequently considered an obstacle to schizophrenia treatment and recovery. However, little is known regarding the stigma experienced by persons with schizophrenia among Syrian college students.

Methods: A total of 963 students from Syrian colleges and universities participated in this study, using a questionnaire with a case vignette illustrating schizophrenia. The questionnaire inquired about people's attitudes toward schizophrenia and their desire to avoid contact with people with schizophrenia. The current study investigated college students' stigma toward people with schizophrenia, desire for social distancing, gender (male and female), and major (medical and non-medical) differences.

Results: The people described in the vignette were deemed "dangerous" (28%) and "could snap out of the problem" (50.20%), according to the respondents. Female students were more likely than male students to agree that "schizophrenia is not really a medical disease" (4.40% vs. 8.9%, p ≤ 0.05). Compared with medical students, non-medical students were more likely to agree that "The problem is a reflection of personal weakness" (20% vs. 21.7%, p < 0.05). Many respondents said they would not "marry into the family of someone with schizophrenia" (95.6%) or "work closely with them" (77.6%). 

Conclusion: In this study, it was observed that a considerable percentage of Syrian college students exhibited stigma toward persons with schizophrenia and really wanted to avoid social interaction with them, with female and non-medical students having higher stigma toward people with schizophrenia in several subscale items. The findings imply that more anti-stigma interventions for Syrian college students should be implemented to help avoid or lessen the stigma toward people with schizophrenia.

University students' understanding and opinions of eating disorders: a qualitative study

BACKGROUND

Eating disorders (EDs) affect 1.25 million people in the UK. Evidence suggests the public display stigma and poor mental health literacy (MHL) towards EDs. There is a high prevalence of EDs in university populations, so it is important to determine the MHL of this at-risk group. Qualitative research exploring the MHL of this population is incomplete.

OBJECTIVE

Explore university students' beliefs and opinions of EDs, their knowledge of symptoms, treatment and help sources and how these are influenced by biological sex.

DESIGN

A qualitative study, using semistructured interviews analysed using inductive thematic analysis.

SETTING

The University of Birmingham.

PARTICIPANTS

Seven female and seven male University of Birmingham students.

RESULTS

Analysis revealed six themes, each with subthemes: ED characteristics, causes, body image, seeking help, stigma and awareness. Students displayed poor awareness towards ED signs and symptoms, causes and help sources. Students were not stigmatising towards EDs, but many perceived them as a female problem and believed society to be stigmatising. Many referenced informal sources of information such as social media and expressed a desire for ED teaching. Sex did not have a significant influence on knowledge or opinions of EDs in this study; however, there were some differences, for example, some males were more likely to see EDs as a weakness and to perceive themselves as having low levels of knowledge.

CONCLUSIONS

University students show broad awareness of EDs; however, knowledge of certain aspects of ED-MHL including help sources and symptom recognition was lacking. Although students were not stigmatising of EDs themselves, many perceived high levels of public stigma. This, alongside poor knowledge, may delay help-seeking. Campaigns educating students and the public about EDs would aid earlier diagnosis, improving long-term outcomes. Further research into awareness and knowledge in other populations would be beneficial.

Public perceptions of brain health: an international, online cross-sectional survey

OBJECTIVES

To investigate public perspectives on brain health.

DESIGN

Cross-sectional multilanguage online survey.

SETTING

Lifebrain posted the survey on its website and social media and shared it with stakeholders. The survey was open from 4 June 2019 to 31 August 2020.

PARTICIPANTS

n=27 590 aged ≥18 years from 81 countries in five continents completed the survey. The respondents were predominantly women (71%), middle aged (41-60 years; 37%) or above (>60 years; 46%), highly educated (69%) and resided in Europe (98%).

MAIN OUTCOME MEASURES

Respondents' views were assessed regarding factors that may influence brain health, life periods considered important to look after the brain and diseases and disorders associated with the brain. We run exploratory linear models at a 99% level of significance to assess correlates of the outcome variables, adjusting for likely confounders in a targeted fashion.

RESULTS

Of all significant effects, the respondents recognised the impact of lifestyle factors on brain health but had relatively less awareness of the role socioeconomic factors might play. Most respondents rated all life periods as important for the brain (95%-96%), although the prenatal period was ranked significantly lower (84%). Equally, women and highly educated respondents more often rated factors and life periods to be important for brain health. Ninety-nine per cent of respondents associated Alzheimer's disease and dementia with the brain. The respondents made a connection between mental health and the brain, and mental disorders such as schizophrenia and depression were significantly more often considered to be associated with the brain than neurological disorders such as stroke and Parkinson's disease. Few respondents (<32%) associated cancer, hypertension, diabetes and arthritis with the brain.

CONCLUSIONS

Differences in perceptions of brain health were noted among specific segments of the population. Policies providing information about brain-friendly health behaviours and targeting people less likely to have relevant experience may be needed.

Improving attitudes toward electroconvulsive therapy

AIMS AND METHOD

Electroconvulsive therapy (ECT) often causes fear in the general public because of media representation and negative reported side-effects. This study evaluates a new video focusing on experiences of ECT and how this can aid communicating medical information to the public. Knowledge and attitudes toward ECT after watching the video were compared with a group that received no information and a group that read the current NHS leaflet on ECT. The role of empathy was also considered as a covariate.

RESULTS

The video was the only condition found to positively affect knowledge and attitudes toward ECT. The video was especially beneficial to those that possessed low perspective-taking trait empathy.

CLINICAL IMPLICATIONS

These findings demonstrate the video improved knowledge and attitudes toward ECT compared with current material or no information. We suggest that the addition of personal experiences to public information adds perspective, improving overall attitudes toward health treatments.

Views of Schizophrenia Among Future Healthcare Professionals: Differences in Relation to Diagnostic Labelling, Causal Explanations, and Type of Academic Degree Program

OBJECTIVE

Stereotyped beliefs about schizophrenia are well-established in the society and relatively common among healthcare professionals and students. The aim of this study was to investigate the opinions about the causes, treatment, and outcome of schizophrenia among healthcare students.

METHOD

Undergraduate nursing and psychology students completed selected items of the Opinion on Mental Illness Questionnaire after reading a clinical vignette of undiagnosed schizophrenia.

RESULTS

Students who labelled the description as schizophrenia were more pessimistic regarding full recovery from the disorder. Those who acknowledged greater relevance to biogenetic risk factors were more convinced of the efficacy of medications. Respondents' opinions on the efficacy of psychological interventions were more positive among psychology students than among nursing students.

CONCLUSIONS

The study confirmed the associations of schizophrenia labelling with prognostic pessimism and beliefs about the efficacy of pharmacological treatment among future healthcare professionals. Students' opinions were less influenced by differences between academic degree programs. Information about current recovery rate and comprehensive care for schizophrenia may support future healthcare professionals in the relationship and the clinical management of PWS.

Perceived cause and determinants of help-seeking behavior of schizophrenia among Gondar Zuria district residents, Northwest Ethiopia

INTRODUCTION

The cause of schizophrenia could be a genetic predisposition, environment, viral infections, exposure to poison substances, living in a highly-populated area, and prenatal exposure to hunger mainly in the first three months. Evidence showed that the perceived cause of schizophrenia is supernatural, biological, spiritual, and social causes. Studies in Ethiopia showed that most of the general population perceived the causes of schizophrenia as traditional and the help they seek ranges to medical, religious, and social.

OBJECTIVE

This study aimed to assess perceived cause and determinants of help-seeking behavior of schizophrenia among Gondar Zuria district residents, 2020.

METHODS

A community-based cross-sectional study was conducted from December 3 to 25, 2020. A simple random sampling technique was employed to select 435 study participants. Data were collected through a face-to-face interview, entered into EPI DATA version 3, and analyzed using SPSS version 21. Bivariable and multivariable binary logistic regression analyses were employed to identify factors significantly associated with help-seeking behavior for schizophrenia. Statistical significance was declared at p-value < 0.05 with 95% confidence interval.

RESULTS

Nearly two-thirds (63.8%), the majority (90.8%), and more than half (52.5%) of the participants seek medical, religious, and social help for schizophrenia respectively. Being student (AOR = 3.43; 95% CI: 1.44, 8.15), unemployed (AOR = 4.87; 95% CI: 1.4, 16.40), perceived biological cause (AOR = 1.7; 95% CI: 1.01, 2.89), perceived religious cause (AOR = 0.48; 95% CI: 0.29, 0.80), and perceived social cause (AOR = 2.05; 95% CI: 1.29, 3.25) were significantly associated with medical help seeking. Attending primary school (AOR = 0.17; 95% CI: 0.04, 0.76), employed (AOR = 0.12; 95% CI: 0.02, 0.64), perceived religious cause (AOR = 2.34; 95% CI: 1.06, 5.11) were significantly associated with religious help. Being in the age group of 18-24 years (AOR = 3.5; 95% CI: 1.33, 9.18) and 25-44 years (AOR = 1.94; 95% CI: 1.03, 3.68) were significantly associated with social intervention.

CONCLUSION

Nearly two-thirds, the majority, and more than half of the respondents seek medical, religious, and social help for schizophrenia respectively. Being student, unemployed, perceived biological case, and perceived social cause increases the odds of seeking medical help while perceived religious cause decreases it. Being unemployed, attending primary school decreases the odds of seeking religious help whereas perceived religious cause increases it. Young adults have higher odds of social help-seeking behavior. It is better to create awareness for the community and consider integrating religious and social interventions into medical interventions.

Adapting to People With Schizophrenia: A Phenomenological Study on a Rural Society in Indonesia

BACKGROUND

The growing prevalence of schizophrenia in Indonesia requires the consideration of the families, caregivers, health care professionals, and the entire society, to serve as a support and coping resource for the patients. The process of recovery is rather difficult, especially in the absence of a decent place to live. Hence, there is the need to provide a supportive environment that facilitates recuperation from psychotic symptoms, enhances interaction with others, promotes self-expression of thoughts and feelings, and helps deal with daily stress and challenges. There are currently no studies on the framework of societal adaptation for people with schizophrenia (PWS). The aim of this research, therefore, was to explore the experiences of rural society inhabitants in adapting to PWS in Indonesia.

METHODS

The study uses a qualitative research design and implements an interpretive phenomenological approach. A total of ten society members were recruited from the community by purposive sampling, and the in-depth interviews conducted were audio-recorded and transcribed. In addition, thematic analysis was carried out using the interpretive phenomenological analysis method.

RESULTS

The majority of the participants assumed that PWS prompt the feeling of alertness over fear. In addition, the participants revealed a feeling of indecisiveness in related situations and emphasized the value of keeping up traditional beliefs and practices and the effectiveness of a demonstration of indifference. They explained the need to combine traditional and modern health practices as recommended by the spiritual leaders.

CONCLUSION

Societal adaptation to PWS entails the understanding of how to deal with the disease's uncertainty and complexity. It is important to create a supportive environment to promote mental health and wellbeing.