Causes of schizophrenia reported by patients' family members in China

Background Better methods of assessing patients' and family members' causal models of illness are needed to improve adherence with biomedical interven tions and to design services that meet the needs of consumers. Aims To develop a quantitative measure suitable for assessing the relations hip of causal beliefs to expressed emotion, stigma, care;seeking and adhere nce. Method The Causal Models Questionnaire for Schizophrenia, which includes 45 causes identified during in-depth interviews with family members, was admi nistered to 245 family members of 135 patients with DSM-III-R schizophrenia in Suzhou and Siping,China at the time of admission to hospital. Results Respondents, who identified a mean of 2.5 causes (range 1-10, mode 2), attributed 84% of the cause of schizophrenia to social, interpersonal a nd psychological problems. Hence, their beliefs do not concur with Chinese professionals' ideas about the biomedical causes of schizophrenia. Multivar iate analyses identified the socio-economic factors that influence family m embers' causal beliefs. Conclusions Despite the complexity of causal models, measures can be develo ped that will help improve clinicians' communication with patients and unde rstanding of help-seeking behaviours.