Attitude towards Mental Help-Seeking, Motivation, and Economic Resources in Connection with Positive, Negative, and General Psychopathological Symptoms of Schizophrenia: A Pilot Study of a Psychoeducation Program
Authors: Abbas Qasir , Baig Khawar Bilal , Sadiq Urooj , Khan Muhammad Umar , Shahzadi Mafia , Ramzan Zoobia 
Published: July 2022

Background

Pharmacological treatment is usually the first line of treatment for schizophrenia, but more strategies are needed to augment this treatment to promote better outcomes. It is known that adherence to pharmacological treatment in schizophrenia patients can be increased by working with their insight into their disorder. In literature, many programs have been found to increase mental help-seeking and reducing symptom severity but most are from the Western cultures and/or are conducted with people attending any institution (i.e., a university or an in-patient care unit) and with specific age ranges (i.e., young adults or older adults). However, in the noninstitutionalized population of different age groups of Pakistan, there is a need to find ways (alongside medication) that promote attitude toward mental help-seeking and reduce symptom severity. Therefore, the current pilot study was designed to investigate the impact of a psychoeducation program on increasing patients’ motivations and help-seeking attitudes toward treatment, reducing the severity of the symptoms, and the role of financial sources in the course of their illness.

Methodology

In this pilot study, we targeted diagnosed patients with schizophrenia disorder from different hospitals and primary care clinics. After eligibility screening, 255 participants were included, and 220 completed the psychoeducation program. Both men, 143(56.08%) and women, 112(43.82%) with marital statuses of being single 123(48.24%), married 98(38.43%) and divorced/widower/widowed 34(13.33%) were included. Respondents’ age range was 18-52 years (M=35.45, SD=10.27).

Results

Findings revealed that significant change in symptoms severity was observed after 16-weeks psycho-education program on positive symptoms (Md=21.05, n=220) compared to before (Md=25.00, n=220, z=-12.47, p=.000, ηp2= .59, negative symptoms (Md=15.74, n=220) compared to before (Md=17.44, n=220, z=-9.52, p=.000, ηp2= .45, and general psychopathological symptoms (Md=38.32, n=220) compared to before (Md=43.40, n=220, z=-12.72, p=.000, ηp2= .61. Similarly, on HSAT (Md=39.03, n=220) compared to before (Md=28.27, n=220, z=-10.43, p=.000, ηp2= .50, and PMFT (Md=5.69, n=220) compared to before (Md=4.85, n=220, z=-12.43, p=.000, ηp2= .59 respectively. Change in patients’ motivation after 16-weeks at low motivation level was -55(25%) (this category got reduced as people moved to better motivation levels), at moderate motivation level it was 10(4.55%) and at high motivation level it was 45(20.45%). Symptoms severity reduced in across all income groups but patients in low-income group tended to gain more from the psychoeducation programas compared to middle- and high-income group in both pre and post treatment.

Conclusion

It is concluded that our psychoeducation program helps promote patients’ motivation and help-seeking attitude toward treatment, and helps reduces positive, negative, and general symptoms severity across all age groups and income groups. However, one of the limitations of this psychoeducation program is that it appears to be more advantageous for patients from low-income group as compared to middle- and high-income groups. However, this limitation can be considered a strength in a country like Pakistan where around 40% of the population lives in poverty. Usually, lower income groups tend to be worse off when it comes to treatment outcomes of any kind, but psychoeducation seems to be the avenue that appears different. Psychoeducation for schizophrenia should be explored further especially in poverty struck countries. Furthermore, the present research has opened way for an indigenous psychoeducation program for Pakistani schizophrenia patients that could potentially be used with all Urdu/Hindi speaking patients.

Trial Registration

Thai Clinical Trial Registry (TCTR20210208003).