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Explanatory models of illness in schizophrenia: comparison of four ethnic groups

Unit for Social and Community Psychiatry, Barts and the London School of Medicine, London

Correspondence: Rosemarie McCabe, Unit for Social and Community Psychiatry, Barts and the London School of Medicine, Newham Centre for Mental Health, London E13 8SP, UK. Tel: +44 (0)20 7540 2296; Fax: +44 (0)20 7540 2976; e-mail: r.mccabe{at}qmul.ac.uk

Declaration of interest None. Funding detailed in Acknowledgements.

Background Explanatory models of illness may differ between ethnic groups and influence treatment satisfaction and compliance.

Aims To compare explanatory models among people with schizophrenia from four cultural backgrounds and explore their relationship with clinical and psychological characteristics.

Method Explanatory models, insight, treatment compliance, health locus of control, quality of life, treatment satisfaction, therapeutic relationships and symptomatology were assessed in UK Whites and Bangladeshis, African–Caribbeans and West Africans.

Results When biological and supernatural causes of illness were compared, Whites cited biological causes more frequently than the three non-White groups, who cited supernatural causes more frequently. When biological and social causes were compared, Whites cited biological causes more frequently than African–Caribbeans and Bangladeshis, who cited social causes more frequently. A biological explanatory model was related to enhanced treatment satisfaction and therapeutic relationships but not treatment compliance.

Conclusions Explanatory models of illness contribute to patient satisfaction with treatment and relationships with clinicians.

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