The Causes Of Schizophrenia

The DSM-V classifies schizophrenia as a psychotic disorder characterized by delusions, hallucinations, disorganized speech and behavior, and other symptoms that cause social or occupational dysfunction. For a diagnosis to be made, symptoms must have been present for six months and include at least one month of active symptoms. Schizophrenia is a disorder that can be found in nearly every culture. With a wide range of cultural subgroups and a multiplicity of individual cultural variations, perceptions and attitudes toward schizophrenia are extremely diverse. The beliefs about the causation of schizophrenia can influence the attitudes patients adopt about their illness and toward seeking help. For example, the cultural background of an individual

with schizophrenia impacts the beliefs about the causation of the disorder, the type of social support they have, and how much stigma is attached to their illness. All of these factors impact whether those affected seek help for their illness. They can explain when and how people communicate their symptoms and which ones they report. This understanding of the relationship between culture, ethnicity, and schizophrenia is crucial to cultivating a health care system that is effective in not only treating but curing people with schizophrenia within various cultures and ethnic groups.
Although genetic and biological factors are prevalent causal theories of schizophrenia held by a variety of different cultures, research has found that socio-environmental aspects have bearings on the causation of the disorder in multiple ethnic groups (Mallet, Leff, Bhugra, Pang, and Zhao, 2002). Mallet, Leff, Bhugra, Pang, and Zhao focused their research on the socio-environmental influences among African Caribbean people living in Britain with schizophrenia in hopes of discovering factors other than genetic predisposition and neurodevelopmental elements (abnormal brain structure). Researchers used a case-control study by means of the Present State Examination (PSE) to chronicle the symptoms of patients who had their first psychosis between the ages of 15 and 54. “Residents of London for at least 6 months, who had made contact with the hospital (in-patients, out patients, emergency clinics) or community services for the first time were petitioned to participate in the study, and a total of 100 participants were included in the study: “thirty-eight African Caribbean, thirty-eight White and twenty-four Asian people” (Mallet, et al., 2002). Research revealed that the key socio-environmental factors that distinguished African Caribbean people with schizophrenia from their peers were, unemployment, living alone, and extended periods of separation from their parents during childhood. Low levels of social and family support played a major role in the excess incidence of schizophrenia within this culture.
India demonstrates that within cultural subgroups conceptions of schizophrenia can vastly differ and can evolve with time.

In India, like in many countries, family members generally do not institutionalize other family members in need of significant medical care. They take on the demanding responsibility of caring for their mentally ill relatives. In some cases due to very little knowledge about schizophrenia, misconceptions about the causes of schizophrenia as well as stereotypes about the disease have emerged in the Indian culture. “[Certain] Indian families have been typically described as often believing in causes like supernatural forces and therefore seek help from magico-religious healers” (Srinivasan and Thara, 2001). However, in other cases, “much of the information on relatives’ belief about the cause of schizophrenia has come from developed countries, where the families are most likely better exposed to information about the disease than families in developing [regions] with low literacy” (Srinivasan and Thara, 2001). Two subsequent studies show forth the truth of these general

statements.
A study was done in 2001 that consisted of family members of two hundred and fifty four patients in southern India.

They were asked to name triggers they believed were involved in the development of the disorder. Twelve percent of the participants believed that the cause stemmed from supernatural forces and the rest specified other factors such as heredity, brain dysfunction, psychosocial stressors (stress in family), personality defect in adjustment and fate or God’s will. This study shows how attitudes and perceptions toward schizophrenia within a cultural subgroup can change from the normative beliefs of a culture. In more recent years, researchers evaluated the personal beliefs of seventy-three patients with schizophrenia in southern India between the ages of 20 to 60 by using a self-rated questionnaire. “A seventeen item Hindi questionnaire was designed specifically to study individual's beliefs in various types of magico-religious beliefs, the role of magico-religious beliefs in causation of mental illness/behavioral abnormalities and the role of treatment based on such beliefs” (Kate, Grover, Kulhara, & Nehra, 2012). Researchers found that despite increased urban population and Westernization of India over the years, two thirds of the patients still attributed their symptoms to metaphysical (karma, celestial beings) and supernatural forces but conversely forty percent talked of autonomy and participation in treatment decisions as opposed to relying solely on ancient

Hindu literature. Apparently, ancient Hindu literature holds the views that mental disorders are a reflection of abstract metaphysical entities, supernatural agents, sorcery or witchcraft. Consequentially, treatments were suggested in the form of herbs and ointments, charms and prayers, moral or emotional persuasion. All these beliefs influenced the perceptions pertaining to schizophrenia and the type of treatment administered. Although this study reveals that super-natural beliefs are still relevant in the Indian culture, many of the patients attribute their symptoms to biological causes as well and are open to receiving help from sources not germane to their indigenous culture.
On the contrary, some cultures like the Chinese, try to hide their family members with schizophrenia out of fear of being socially ostracized. Traditional Chinese beliefs about the cause