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

Abstract

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.