Causal attribution of psychosis: a comparison of patients and their caregivers in Hong Kong

Abstract

OBJECTIVES: Subjective understanding of the illness cause is one of the important aspects of illness appraisal for patients with schizophrenia and their caregivers. However, studies looking at the causal beliefs within the Chinese sample and comparing views of patients and caregivers were scarce. This study aims to explore the illness causal attributions of Chinese schizophrenic patients and their respective caregivers. METHODS: Eighty patient-caregiver dyads were recruited from the outpatient departments of the Early Assessment Service for Young people with psychosis (EASY) service in Hong Kong. They were asked about their beliefs of the illness cause using an open-ended question. Their reported times for each particular cause or class were respectively recorded. RESULTS: The most frequently perceived causal class by patients (Reported times [RT] = 40, 50.0%) and caregivers (RT = 59, 73.8%) was psychosocial cause, followed by personal factors (patients: RT = 19, 23.8%; caregivers: RT = 17, 21.3%) and biological or physical factors (same for patient and caregivers: RT = 13, 16.3%). About 20% of them did not know the illness cause. Some distinctive differences were that caregivers reported introvert personality of patients, their high expectation of themselves and excessive computer playing as the cause of their condition fifteen times more than that reported by patient. CONCLUSION: Through the identification of the causal attributions of patients and caregivers, this acts as the first step to achieve an agreement between their belief systems with that of mental health providers, which may improve treatment outcome. It also highlights the importance of the continuation of psychoeducation for patients and caregivers.