Public beliefs about the treatment of schizophrenia and depression in Brazil.

BACKGROUND: Little is known about public beliefs concerning the treatment of mental disorders in developing countries. AIMS: To assess preferences on sources of help and treatment and the perception of prognosis for schizophrenia and depression. METHOD: A household survey was carried out in 2002 with a probabilistic sample of 1000 individuals, residents of São Paulo city, Brazil, with ages ranging from 18-65. Vignettes in colloquial language describing individuals with schizophrenia and depression (according to DSM-IV and ICD-10) were presented, together with a structured questionnaire with questions about the vignette. RESULTS: Results indicated the same general tendencies for schizophrenia and depression. The public considered the help of lay people and psychologists the most useful. Medical professionals are viewed less favorably. The treatments and activities most recommended are psychotherapy and general activities, such as physical activities and attending church services. Medical treatments are seen as more harmful than helpful. The more important determinants were: identification as mental illness, religion, sex and years of school completed. Prognosis with treatment for both disorders is viewed as favorable. CONCLUSIONS: These results may indicate that the public need to receive more information on the full range of treatments options, especially those related to medical treatment.

How should alcohol dependence be treated? The public view.

AIMS: The aim of this study was to assess public preferences on sources of help and treatment, and perception of prognosis for alcohol dependence. METHOD: A household survey was administered in 2002 to a probabilistic sample of 500 individuals, all residents of the city of São Paulo, Brazil, with ages ranging from 18 to 65. A vignette in colloquial language describing an individual with alcohol dependence (according to DSM-IV and ICD-10 criteria) was presented together with a structured questionnaire with questions about the vignette. RESULTS: The public considered the help of lay people, self-help groups and psychologists the most useful. Medical professionals were viewed less favourably. The treatments and activities most recommended were psychotherapy and general activities, such as physical activities, keeping the mind busy and attending church services. Medical treatments were seen as more harmful than helpful. The more important determinants were identification of alcohol dependence as mental illness, religion and number of years of school completed. Prognosis with treatment was viewed as favourable. CONCLUSION: These results may indicate that the public needs to receive more information on the full range of treatments options, especially those related to professional or formal treatment.

Public conceptions of schizophrenia in urban Brazil : symptom identification and causal attributions.

OBJECTIVE: Little is known about public conceptions of mental disorders in Latin America and the Caribbean. The aim of this article is to assess how the population identifies symptoms of schizophrenia and the causes attributed to this disorder in the city of São Paulo, Brazil. METHOD: A household survey was carried out in 2002 with a probabilistic sample of 500 individuals, residents of São Paulo with ages ranging from 18 to 65. Vignette describing in colloquial language an individual with schizophrenia (according to DSM-IV and ICD-10) was presented together with a structured questionnaire with questions about the vignette. RESULTS: The symptoms of schizophrenia were identified by 23.4% as depression. The term schizophrenia was used in only 2.2% of the responses. A bit more than half of the respondents believed it was a mental illness. The main causes attributed were "drug use" and "isolation". Factors most influencing responses about causes were years of schooling and identification as a mental illness. CONCLUSIONS: Medical-scientific concepts are used less in São Paulo than in other countries. The main causes attributed by the public relate to psychosocial stress. Causes of biological or moral nature are considered less relevant.

Community perception of mental disorders - a systematic review of Latin American and Caribbean studies.

BACKGROUND: Little is known about the perception of mental disorders and stigma in developing countries. The aim of this study was to review the literature on popular perception of mental disorders in Latin America and the Caribbean. METHODS: Electronic search was made on Medline and Lilacs for original articles published from January 1980 to December 2001, using "public attitudes" and "mental disorders" as key words on Medline and "attitudes about health" as well as "stigma" as key words on Lilacs. In addition, a manual search was conducted in the references of the articles obtained in the electronic search and in area periodicals. RESULTS: The search produced 871 articles, ten of which fulfilled the inclusion criteria. Attitudes in relation to the mentally ill are predominantly positive, especially among individuals with a higher educational or socioeconomic level. Schizophrenia is the condition most often identified as mental illness and considered the most serious affliction. Depression and alcoholism are identified as mental illnesses by a smaller portion of the population. The community mostly recommends treatment with health professionals. CONCLUSION: In Latin America and the Caribbean, there is a tendency to share the beliefs of the western medical model and few signs of the presence of elements from traditional medicine or religion. However, the studies exhibited various methodological gaps and problems. New studies, using more appropriate methodology, should be carried out in this region.