Early Intervention in Psychiatry
Volume 12, Issue 2, 2018, Pages 185-192

Psychosis: clinical insight and beliefs in immigrants in their first episode (Article)

Berg A.O.* , Barrett E.A. , Nerhus M. , Büchman C. , Simonsen C. , Færden A. , Andreassen O.A. , Melle I.
  • a NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway, Oslo University Hospital, Oslo, Norway
  • b NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway, Oslo University Hospital, Oslo, Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
  • c NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway, Oslo University Hospital, Oslo, Norway
  • d NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway, Oslo University Hospital, Oslo, Norway
  • e NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway, Oslo University Hospital, Oslo, Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
  • f Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
  • g NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway, Oslo University Hospital, Oslo, Norway
  • h NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway, Oslo University Hospital, Oslo, Norway

Abstract

Aim: Lack of insight into illness is frequent in psychotic disorders and seen as part of their primary pathology. The recognition of symptoms as psychotic, and beliefs about treatment alternatives, is also influenced by socio-cultural factors. Here we examined clinical insight into illness and beliefs about psychosis in immigrants in their first episode of psychosis compared with a reference group. Methods: A total of 277 first-episode psychosis participants were recruited to this cross-sectional study; 40 first- and 40 second-generation immigrants from Europe, Americas and Oceania (n = 37), Asia including Turkey (n = 28) or Africa (n = 15). The Birchwood Insight Scale was used to measure clinical insight and ‘The Attitudes and Beliefs about Mental Health Problems’ schizophrenia version to assess socio-cultural beliefs. Results: Immigrants did not differ from the reference sample in clinical insight. After controlling for education level, first-generation immigrants were less likely to recognize psychotic symptoms (odds ratio (OR) 2.9; Wald = 8.977, degrees of freedom (d.f.) 1, P = 0.003) and viewed hospitalization (OR 5.2; Wald = 20.388, d.f. 1, P = 0.001) and treatment by a psychiatrist (OR 4.9; Wald = 6.609, d.f. 1, P = 0.01)) as less beneficial than the reference group. Immigrants from Asia held more alternative explanations (OR 0.3; Wald = 6.567, d.f. 1, P = 0.010). There were significantly stronger associations between clinical insight and socio-cultural beliefs in the reference group. Conclusions: Socio-cultural beliefs about psychosis in immigrants in first-episode psychosis call for more tailored information to this group, and emphasize the importance of treatment interventions involving both a cultural and personal perspective of insight. © 2015 Wiley Publishing Asia Pty Ltd

Author Keywords

psychotic disorder schizophrenia bipolar disorder emigrant and immigrant

Index Keywords

educational status immigrant hospitalization Europe human psychiatrist middle aged Asia psychosis health belief controlled study priority journal Aged Central America ethnology Cross-Sectional Studies Young Adult Oceania cross-sectional study migrant psychology Humans Adolescent male Emigrants and Immigrants female South America Psychotic Disorders Pacific islands Africa introspection cultural factor Health Knowledge, Attitudes, Practice Article major clinical study adult Case-Control Studies case control study attitude to health
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84953432045&doi=10.1111%2feip.12297&partnerID=40&md5=29888f4ff6f38d692afeda5a477cb9ab
DOI: 10.1111/eip.12297
ISSN: 17517885
Cited by: 1
Original Language: English