Symptom recognition and illness labelling: comparison between Chinese patients with psychosis and their caregivers

Abstract

OBJECTIVES: Recognition of symptoms and attribution of the condition form some essential parts of illness representation and appraisal for patients with schizophrenia and their caregivers. However, there has been no study exploring their symptoms recognition with illness labelling and thus, fail to provide an overall view of illness appraisal. This study aimed to explore the perception of symptoms and illness labelling by Chinese schizophrenic patients and their respective caregivers. METHODS: A total of 80 patient-caregiver dyads were recruited from the Early Assessment Service for Young people with psychosis (EASY) service in Hong Kong. The symptoms experienced by patients during illness and how participants labelled the condition of patients were explored using open-ended questions. The association between the illness labelling with the symptoms reported by participants was also assessed. RESULTS: The most frequently reported symptom class by patients was positive symptoms (Reported times [RT] = 76, 42.8%), followed by behavioural problems (RT = 33, 18.6%) whereas caregivers reported behavioural problems (RT = 70, 36.8%) more than positive symptoms (RT = 40, 21.1%). Negative and cognitive symptoms were reported less by both groups. A significant relationship was found between the psychosis label and the positive symptoms of the illness for caregivers (X2 = 5.367, df = 1, p = 0.021). CONCLUSIONS: By exploring symptoms recognition, illness labelling by patients and their caregivers and its relationship, these give us a more comprehensive understanding of their illness appraisal. Our results suggested that communication with patients and their caregivers should go beyond illness label and focus also on the actual understanding of other aspects of the illness such as symptoms. Our findings also guide us in the refinement of psychoeducation programme for caregivers and patients, that is, to put more emphasis on the recognition of negative symptoms as part of the condition, and alignment of their understanding.