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Psychosis: clinical insight and beliefs in immigrants in their first episode
Author(s) -
Berg Akiah Ottesen,
Barrett Elizabeth Ann,
Nerhus Mari,
Büchman Camilla,
Simonsen Carmen,
Færden Ann,
Andreassen Ole A.,
Melle Ingrid
Publication year - 2018
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12297
Subject(s) - psychosis , immigration , schizophrenia (object oriented programming) , psychiatry , odds ratio , odds , medicine , psychology , clinical psychology , early psychosis , clinical practice , family medicine , logistic regression , archaeology , history
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 E urope, A mericas and O ceania ( n = 37), A sia including T urkey ( n = 28) or A frica ( n = 15). The B irchwood I nsight S cale was used to measure clinical insight and ‘ T he A ttitudes and B eliefs about M ental H ealth P roblems’ 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; W ald = 8.977, degrees of freedom (d.f.) 1, P = 0.003) and viewed hospitalization ( OR 5.2; W ald = 20.388, d.f. 1, P = 0.001) and treatment by a psychiatrist ( OR 4.9; W ald = 6.609, d.f. 1, P = 0.01)) as less beneficial than the reference group. Immigrants from A sia held more alternative explanations ( OR 0.3; W ald = 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.