Psychosis: clinical insight and beliefs in immigrants in their first episode

Poster A13, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron

Akiah Ottesen Berg1, Elizabeth Ann Barrett, Mari Nerhus, Camilla Büchman, Carmen Simonsen, Ann Faerden, Ole A. Andreassen, Ingrid Melle; 1Oslo University Hospital, Oslo, Norway

Introduction: 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 and viewed hospitalization and treatment by a psychiatrist as less beneficial than the reference group. Immigrants from Asia held more alternative explanations. The association between clinical insight and socio-cultural beliefs was weaker among immigrants than in the reference group. Discussion: This study shows more variation between clinical insight and socio-cultural beliefs about psychosis in immigrants when compared to a Norwegian reference group. These findings call for more tailored information about psychosis to immigrant groups, and emphasizes the importance of treatment interventions involving both a cultural and personal perspective of insight.

Topic Area: Diagnosis and Phenomenology

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