title: Insight and attitudes towards medication among inpatients with chronic schizophrenia in the US and China.
abstract: BACKGROUND
  The impact of culture on insight on illness and attitudes towards medication among patients with schizophrenia has not been well studied. We compared inpatients in the US and in China (a culture that numerous studies have shown heavily stigmatizes mental illness and psychosis), on measures of insight and acceptance of medication, controlling for overall severity of schizophrenia symptoms.
  
  
  METHODS
  Clinical antipsychotic treatment for intervention effectiveness (CATIE) was a large study of pharmacotherapy of people with schizophrenia across the US. Insight was measured using the insight and treatment attitudes questionnaire (ITAQ) and attitudes towards medication by the drug attitude inventory (DAI) and symptoms of schizophrenia by the Positive and Negative Syndrome Scale (PANSS). These measures were applied to a sample of hospitalized patients diagnosed with schizophrenia at the Guangzhou Psychiatric hospital, the largest psychiatric hospital in Southern China. Mean ITAQ and DAI scores, net of total schizophrenia symptoms and other differences were compared at the time of admission using analysis of covariance.
  
  
  RESULTS
  Both insight and favourable attitudes towards medication were significantly and substantially lower in the sample from Guangzhou on bivariate analysis even after adjusting for severity of overall schizophrenia symptoms on the PANSS.
  
  
  CONCLUSIONS
  Inpatients in China had far lower scores on measures of insight and acceptance of their need for and benefits of medication, controlling for overall severity of schizophrenia symptoms, suggesting a significant impact of Chinese culture which is presumed to more heavily stigmatize mental illness and especially psychosis, although other explanations can not be ruled out.
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA, Somaia.Mohamed@yale.edu.
authors.forename: Somaia
authors.initials: S
authors.lastname: Mohamed
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenheck
authors.forename: Hongbo
authors.initials: H
authors.lastname: He
authors.forename: Ning
authors.initials: N
authors.lastname: Yuping
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002681:China / Q000208:ethnology; D002908:Chronic Disease / Q000208:ethnology / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D012559:Schizophrenia / Q000188:drug therapy* / Q000208:ethnology*; D012565:Schizophrenic Psychology; D057545:Social Stigma; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000208:ethnology
chemical_list: D014150:Antipsychotic Agents