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Rosenthal Oren R, Roe D, Hasson-Ohayon I, Roth S, Thomas EC, Zisman-Ilani Y. Beliefs About the Causes of Psychosis Among Persons With Psychosis and Mental Health Professionals: A Scoping Review. Psychiatr Serv 2021; 72:1178-1192. [PMID: 34126775 DOI: 10.1176/appi.ps.202000460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The beliefs that people with psychosis hold about causes of their illness (causal beliefs) can affect their choice to adhere to treatment and engage in mental health services. However, less is known about causal beliefs of mental health professionals (MHPs) and their impact on treatment adherence and service engagement. This review explored literature focusing on MHPs' causal beliefs and mapped the degree of concordance between their causal beliefs and those of people with psychosis. METHODS A systematic literature search of PubMed, Embase, Scopus, PsycINFO, and Applied Social Sciences Index Abstracts and a gray-literature search of PsyArXiv and MedNar yielded 11,821 eligible references. The first author reviewed all titles and abstracts, and the coauthors reviewed 10% (N=1,200). RESULTS Forty-two articles were included. Most articles indicated that MHPs tend to endorse biogenetic beliefs (9 of 15 articles assessing MHPs' beliefs, 60%), whereas people with psychosis tend to endorse psychosocial beliefs (16 of 31 articles, 52%) and other nonbiogenetic beliefs (in 8 of 31 articles, 26%). Most studies did not compare causal beliefs of people with psychosis and their treating MHP. Studies varied in design, setting, and measures. CONCLUSIONS MHPs and people with psychosis often hold complex views composed of different types of causal beliefs. However, a gap in causal beliefs between these groups appears to exist, which may affect the therapeutic relationship and pose barriers to treatment adherence. Future studies should address this gap by developing interventions that facilitate open communication about causal beliefs to promote treatment alliance and shared decision making.
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Affiliation(s)
- Rotem Rosenthal Oren
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
| | - David Roe
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
| | - Ilanit Hasson-Ohayon
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
| | - Stephanie Roth
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
| | - Elizabeth C Thomas
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
| | - Yaara Zisman-Ilani
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (Rosenthal Oren, Roe); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon); Ginsburg Health Sciences Library, Temple University, Philadelphia (Roth); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Thomas, Zisman-Ilani)
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Tolmeijer E, Hardy A, Jongeneel A, Staring ABP, van der Gaag M, Berg DVD. Voice-hearers' beliefs about the causes of their voices. Psychiatry Res 2021; 302:113997. [PMID: 34038805 DOI: 10.1016/j.psychres.2021.113997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/07/2021] [Indexed: 10/21/2022]
Abstract
Despite empirical evidence for multifactorial causes of voice-hearing, people's own beliefs about what caused their voices are understudied. People with distressing voices (n=125) completed measures of trauma, post-traumatic stress disorder (PTSD) symptoms, and beliefs about causality. Most participants reported trauma in the past (97%) and PTSD symptoms were prevalent. Traumatic experiences were the most commonly endorsed causal factor of voice-hearing (64%), followed by distress (62%). Beliefs about biological causes, including drug use (22%), were least endorsed. Those who experienced more traumatic events and more PTSD symptoms were more likely to endorse trauma as a causal factor of voice-hearing (R2=0.38).
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Affiliation(s)
- Eva Tolmeijer
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN The Hague, the Netherlands.
| | - Amy Hardy
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, UK; South London & Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Alyssa Jongeneel
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN The Hague, the Netherlands
| | - Anton B P Staring
- Altrecht Psychiatric Institute, ABC department for first episode psychosis, ABC straat 8, 3512 PX Utrecht, the Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN The Hague, the Netherlands
| | - David van den Berg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN The Hague, the Netherlands
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RE B, S R, JC B, W J, D S, AP M, M P, S P. Clinicians' views of treatment types for first episode psychosis delivered in a randomised controlled trial (MAPS). EClinicalMedicine 2020; 24:100421. [PMID: 32775968 PMCID: PMC7393656 DOI: 10.1016/j.eclinm.2020.100421] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Clinicians' treatment beliefs could affect the feasibility of delivering different treatments in a randomised controlled trial (RCT). In MAPS (Managing Adolescent first Episode Psychosis: a feasibility Study), adolescents with first episode psychosis (FEP) were randomly allocated to receive either antipsychotic medication (AP), psychological intervention (cognitive behavioural therapy [CBT] and family intervention [FI]), or both. We conducted a nested qualitative study to investigate clinicians' views of these treatments. METHODS Purposive sampling identified seventeen clinicians from CAMHS and Early Intervention services with prescribing responsibilities for 14-18 year olds at three participating MAPS sites. Individual participants were interviewed to examine their views of treatments in the MAPS trial. Interview transcripts were analysed using inductive Thematic Analysis. FINDINGS Clinicians viewed the decision to refer adolescents to the MAPS trial as requiring careful clinical judgement. Assessment complexity and diagnostic uncertainty had to be balanced against the urgency for treatment to reduce risk and distress. Underlying influences including duty of care and treatment beliefs underpinned decisions. Clinicians consistently valued AP as the primary treatment for FEP, with CBT and/or FI seen as helpful secondary treatment options. Nevertheless, the potential harms of prescribing AP, or not, to such a young population were highlighted as being of concern in treatment decision-making, and fostered reluctance to refer into a RCT. INTERPRETATION The design and delivery of RCTs involving young people experiencing FEP should consider the views of responsible clinicians, recognising that perceived treatment urgency, limitations in diagnostic precision, and existing treatment beliefs may influence trial processes. FUNDING NIHR HTA programme (project number 15/31/04).
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Affiliation(s)
- Byrne RE
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, Manchester, M25 3BL, UK
- Division of Psychology and Mental Health, University of Manchester, Manchester, M13 9PL, UK
| | - Reeve S
- Department of Clinical, Educational, and Health Psychology, University College London, WC1E 6BT
| | - Bird JC
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Jones W
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, Manchester, M25 3BL, UK
| | - Shiers D
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, Manchester, M25 3BL, UK
| | - Morrison AP
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, Manchester, M25 3BL, UK
- Division of Psychology and Mental Health, University of Manchester, Manchester, M13 9PL, UK
| | - Pyle M
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, Manchester, M25 3BL, UK
- Division of Psychology and Mental Health, University of Manchester, Manchester, M13 9PL, UK
| | - Peters S
- Division of Psychology and Mental Health, University of Manchester, Manchester, M13 9PL, UK
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Lien YJ, Kao YC. Public beliefs and attitudes toward schizophrenia and depression in Taiwan: A nationwide survey. Psychiatry Res 2019; 273:435-442. [PMID: 30684789 DOI: 10.1016/j.psychres.2019.01.062] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/15/2019] [Accepted: 01/15/2019] [Indexed: 01/05/2023]
Abstract
Beliefs about and attitudes toward mental illness may be influenced by cultural- or country-specific contexts. Through a national survey, the current study investigated beliefs and attitudes toward people with schizophrenia and depression among the general public in Taiwan. A random-digit-dialing telephone-based cross-sectional survey was administered to Taiwanese adults aged 20-64 years (n = 1600). The data were analyzed through binary logistic regressions to test for differences between these disorders in causal beliefs, stereotypes, emotional reactions, desire for social distance, and help-seeking behavior. The results revealed that respondents were more concerned with biogenetic causal explanations for people with schizophrenia than for those with depression. Significantly more respondents perceived people with schizophrenia as more likely to be unpredictable and violent toward others. A similar trend was observed for the desire for social distance. For both disorders, respondents were significantly more likely to express compassion than to express anger toward the person described in the vignette. Respondents also expressed more desire for social distance from someone like the vignette who have received psychiatric treatment. These findings provide useful directions for the implementation of optimal psychoeducation among such communities. .
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Affiliation(s)
- Yin-Ju Lien
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan; Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan.
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