title: The relationships between patients' and caregivers' beliefs about the causes of schizophrenia and clinical outcomes in Latin American countries.
abstract: Beliefs about the causes of schizophrenia are thought to impact treatment outcomes. We investigated 3 theoretically opposing belief systems (biological, psychosocial, magical-religious) in relation to the severity of positive and negative symptoms and to attitudes towards medications. We recruited 253 patients with schizophrenia and their primary caregivers from public mental health clinics in Bolivia, Chile, and Peru. We assessed patients' and caregivers' beliefs about the causes of schizophrenia, which were used as predictors of symptom severity and medication attitudes in linear regression analyses. Patients' scores on biological, psychosocial, and magical-religious beliefs were positively correlated with one another, indicating that these domains were not, as anticipated, "opposing". Patients with higher levels of biological and psychosocial beliefs had significantly lower levels of positive and negative symptoms; in contrast, higher levels of magical-religious beliefs were associated with increased positive symptoms and less favorable attitudes towards medications. Patients' belief systems are significant predictors of symptom severity and medication attitudes. Research is needed on the extent to which psychotherapeutic treatments for schizophrenia should bolster patients' beliefs in the biological and psychosocial domains and weaken beliefs in the magical-religious domain; this research should also attend to the ethical considerations involved in intervening on belief systems cross-culturally.
authors.affiliation: Universidad de Tarapacá, Avenida 18 de Septiembre 2222, Arica, Chile; Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. Electronic address: acaqueo@uta.cl.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Caqueo-Urízar
authors.affiliation: Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life-Research Unit, 13005 Marseille, France. Electronic address: Laurent.BOYER@ap-hm.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Boyer
authors.affiliation: Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life-Research Unit, 13005 Marseille, France. Electronic address: karine.baumstarck@univ-amu.fr.
authors.forename: Karine
authors.initials: K
authors.lastname: Baumstarck
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115-6018, USA; Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Blvd, Rockville, MD 20852, USA. Electronic address: stephen.gilman@nih.gov.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Gilman
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001838:Bolivia; D017028:Caregivers / Q000523:psychology*; D002677:Chile; D003431:Cross-Cultural Comparison; D003469:Culture; D005260:Female; D006801:Humans; D008273:Magic; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010568:Peru; D012069:Religion and Psychology; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: Attitudes towards medication; Caregivers; Causal beliefs; Health outcomes; Schizophrenia; Symptoms