Bad things happen and can drive you crazy: The causal beliefs of 701 people taking antipsychotics

In almost all countries the public prefers psycho-social explanations of ‘schizophrenia’ to bio-genetic ones. The causal explanations of people who experience psychosis have been under researched, and, if they diverge from the dominant bio-genetic paradigm, can be dismissed as ‘lack of insight’. Of the 832 people completing a survey about their experiences on antipsychotic, 701, from 30 countries, answered an open question about what had caused the problems for which they had been prescribed the drugs. On a Bio-Social likert scale, from 1 = ‘Purely Biological’ to 5 = ‘Purely Social’, the mean score was 4.24. Thematic analysis produced seven themes: Social (75.6%), Psychological (18.4%), Bio-genetic (17.5%), Iatrogenic (17.1%), Drug and Alcohol (10.1%), Medical Condition (6.8%) and Insomnia (6.0%). Those with a psychosis diagnosis were even more likely than others to report a Social cause. The causal beliefs of this sample are consistent with previous studies of people diagnosed with ‘schizophrenia’ and the beliefs of the public. They are also aligned with recent research into the social causes of psychosis. It is argued that rather than dismiss the beliefs as ‘lack of insight’ it is more respectful and productive to listen carefully and adjust our understandings and services accordingly.