Negative maternal attitudes toward schizophrenia may be linked with delayed treatment of their children. We investigated the relation between negative attitudes toward schizophrenia and help-seeking among mothers of junior and senior high school students in Japan. The participants were 1309 Japanese mothers of junior and senior high school students. Social distance was evaluated by using the Social Distance Scale-Japanese version (SDS-J). In addition, mothers were asked about help-seeking for a child with sleeplessness, social withdrawal, and strange behavior. One-way analysis of variance and Student’s t-test were used to evaluate associations between social distance toward schizophrenia and help-seeking. Most (76.4%) participants were aged 40 - 49 years. Maternal demographic characteristics significantly associated with social distance were employment and participation in welfare activities for people with mental illness. In responding to a child with sleeplessness, social withdrawal, and strange behavior, the level of maternal social distance was not significantly associated with the likelyhood of seeking psychiatric help. However, mothers with greater social distance were less likely to seek help at a psychiatric clinic. Maternal social distance toward schizophrenia was not significantly associated with seeking psychiatric help; however, it did affect the type of facility selected among those would seek such help.
Delayed treatment of schizophrenia is associated with worse outcomes [
As compared with fathers, mothers tend to spend more time with their children. Therefore, negative maternal attitudes toward schizophrenia may lead to lack of treatment for mental illness in their children [
The participants were 1309 Japanese mothers of 696 junior high school students and 613 senior high school students and were extracted from 1,370,000 candidates included in a database administered by a Japanese private company specializing in questionnaire research. Stratified random sampling was used, as previously described [11-13]. The study was approved by the Ethics Committee of the Niigata University School of Medicine.
The participants completed a questionnaire that requested information on sociodemographic data. Social distance was evaluated by using the Social Distance Scale-Japanese version (SDS-J) [
Mothers were also asked about what help they would seek if they had a child with sleeplessness, social withdrawal, and strange behavior. Specifically, they were asked the type of medical facility at which they would seek a consultation. The details of this questionnaire have been previously published [
All analyses were performed using the Statistical Package for Social Sciences (SPSS), version 18.0. Oneway analysis of variance and Student’s t-test were used to examine the associations between social distance toward schizophrenia and maternal demographic characteristics and the associations between social distance and help-seeking.
Most (76.4%) participants were aged 40 - 49 years (
The mean score ± SD on the Social Distance Scale was 12.2 ± 3.9 (range, 0 - 24). Maternal demographic characteristics significantly associated with social distance were employment and participation in welfare activities for people with mental illness (
On the questionnaire that asked about hypothetical help-seeking for a child with sleeplessness, social withdrawal, and strange behavior, there was no significant association between maternal social distance and the likelihood of seeking psychiatric help (p = 0.060;
Parental attitudes toward schizophrenia are an important factor in early detection and intervention for a child with schizophrenia [
The limited number of previous studies of attitudes toward schizophrenia among parents of adolescents have mostly focused on factors that affect those attitudes [11,18]. Demographic characteristics significantly associated with parental attitudes were family income, occupation, presence of a neighbor with schizophrenia, and participation in welfare activities for people with mental illness [
not significantly associated to age, occupation, and family income. In the present study, 76.5% of mothers were part-time workers or full-time housewives; thus, family income depended primarily on fathers. Maternal occupation was not significantly associated with social distance, which differs from the results of Lysaker et al. [
We examined the association of maternal social distance toward schizophrenia with the likelihood of medical consultation, the type of consultation sought, and the timing of treatment for a child with symptoms of mental illness. The results showed that level of maternal social distance was not associated with likelihood of seeking psychiatric help or treatment timing. These findings are new and somewhat contradictory to our study hypothesis and earlier findings. Indeed, a number of studies have shown that a negative attitude toward schizophrenia is associated with a lower likelihood of seeking psychiatric help [4-6].
These differing results may be due to differences in the
medical systems of Japan and other countries. In Western countries most people have primary care physicians [
We also found that a negative attitude toward schizophrenia affected the type of hospital selected, namely, it significantly reduced maternal help-seeking at psychiatric clinics. This result differs from the findings of a study by Platz et al., which showed that a substantial number of contacts with mental health care professionals were made along help-seeking pathways. The label of schizophrenia is related to stigma [20,21]. In Japan, the disease name was changed from seishin bunretsu byou to tougou shicchou shou in 2002, after which the proportion of patients who were informed of their diagnosis increased from 36.7% to 69.7% in 3 years [22,23]. Therefore, the disease name likely affects the public image of the disease. Mothers that avoid psychiatric clinics may have an unfavorable image of such clinics. However, the number of psychiatric clinics is increasing in Japan. Future research should focus on understanding why these negative attitudes cause individuals to avoid only psychiatric clinics. In addition, if the case is to be made that negative attitudes have a substantial effect on illness evaluation, researchers should examine whether such attitudes are linked to other disease components, such as depression.
We would like to highlight three points from our results. First, when symptoms of mental illness occur in children, mothers should quickly seek expert evaluation and treatment because delayed treatment is linked to worse prognosis [
The authors thank the study participants. This work was supported by a 2010 Grant-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science (22592581), entitled “Investigations of the Consciousness of Parents of Junior and Senior High School Students Concerning Schizophrenia and the Development of Educational Enlightenment Media”. None of the authors has any conflicts of interest associated with this study.