This study aimed to investigate lay theories of the cause and treatment of bipolar disorder, and the recognition of its symptoms. This questionnaire-based study included vignette descriptions of mental disorders and 70 items relating to bipolar disorder. It was completed by 173 participants. Bipolar disorder was recognized less than depression but at the same rate as schizophrenia. Contrary to previous research, analysis showed that lay beliefs of the causes of bipolar disorder generally concur with scientific academic theories. Drug treatment was favoured as a cure rather than psychotherapy. Theories of cause and treatment were logically correlated. Overall, the results suggest that lay people have reasonably informed beliefs about the causes and treatments of bipolar disorder, however recognition of the symptoms is poor.
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References
1.
Agid, O., Shapira, B., Zislin, J., Ritsner, M., Hanin, B., Murad, H., Troudart, T., Bloch, M., Heresco-Levy, V. & Lerer, B. ( 1999) Environment and vulnerability to major psychiatric illness: A case control study of early parental loss in major depression, bipolar disorder and schizophrenia. Molecular Psychiatry, 4, 163-172.
2.
Andrews, G., Hall, W., Teesson, M. & Henderson, S. ( 1999) The Mental Health of Australians. Canberra: Commonwealth Department of Health and Aged Care.
3.
Angermeyer, M.C. & Dietrich, S. ( 2006) Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatrica Scandinavica, 113(3), 163-179.
4.
Angermeyer, M.C., Daumer, R. & Matschinger, H. ( 1993) Benefits and risks of psychotropic medication in the eyes of the general public: Results of a survey in the Federal Republic of Germany . Pharmacopsychiatry, 26, 114-120.
5.
Angermeyer, M.C. & Matschinger, H. ( 1994) Lay beliefs about schizophrenic disorder: The results of a population survey in Germany. Acta Psychiatrica Scandinavica , 89, 39-45.
6.
Angermeyer, M.C. & Matschinger, H. ( 1996) Public attitude towards psychiatric treatment. Acta Psychiatrica Scandinavica, 94, 326-336.
7.
Angermeyer, M.C. & Matschinger, H. ( 1999) Social representations of mental illness among the public . In The Image of Madness: The Public Facing Mental Illness and Psychiatric Treatment (eds J. Guimon, W. Fischer & N. Sartorius ). Basel: Karger.
8.
Bentall, R.P., Kinderman, P. & Manson, K. ( 2005) Self-discrepancies in bipolar disorder: Comparison of manic, depressed, remitted and normal participants. British Journal of Clinical Psychology, 44(4), 457-473.
9.
Bowden, C.L., Brugger, A.M., Swann, A.C., Calabrese, J.R., Janicak, P.G. & Petty, F. ( 1994) Efficacy of divalproex versus lithium and placebo in the treatment of mania. Journal of the American Medical Association , 271, 918-924.
10.
Bunney Jr, W.E. & Davis, J.M. ( 1965) Norepinephrine in depressive reactions: A review. Archives of General Psychiatry, 13, 483-494.
Carlson, G.A. & Strober, M. ( 1979) Affective disorders in adolescents. Psychiatric Clinics of North America, 2, 511-526.
13.
Daly, J.J., Prudic, J., Devanand, D.P., Nobler, M.S., Lisanby, S.H., Peyser, S., Roose, S.P. & Sacteim, H.D. ( 2001) ECT in bipolar and unipolar depression: Differences in speed of response. Bipolar Disorder, 3, 95-104.
14.
Fink, M. ( 2006) ECT in therapy-resistant mania: Does it have a place? Bipolar Disorder, 8, 307-309.
15.
Fischer, W., Goerg, D., Zbinden, E. & Guimon, J. ( 1999) Determining factors and the effects of attitudes towards psychotropic medication. In The Image of Madness: The Public Facing Mental Illness and Psychiatric Treatment (eds J. Guimon, W. Fischer & N. Sartorius), pp. 162-186. Basel: Karger.
16.
Fischer, L.J. & Goldney, R.D. ( 2003) Differences in community mental health literacy in older and younger Australians. International Journal of Geriatric Psychiatry, 18, 33-40.
17.
Furnham, A. ( 1984). Lay conceptions of neuroticism. Personality and Individual Differences, 5, 95-103.
18.
Furnham, A. ( 1986) Response bias, social desirability and dissimulation. Personality and Individual Differences, 7, 385-400.
19.
Furnham, A. ( 1988) Lay Theories. Oxford: Pergamon.
20.
Furnham, A. ( 1995) Lay beliefs about phobia. Journal of Clinical Psychology, 51, 518-525.
21.
Furnham, A. & Bower, P. ( 1992) A comparison of academic and lay theories of schizophrenia . British Journal of Psychiatry, 161, 201-210.
22.
Furnham, A. & Buck, C. ( 2003) A comparison of lay beliefs about autism and obsessive-compulsive disorder. International Journal of Social Psychiatry, 49, 287-307.
23.
Furnham, A. & Chan, E. ( 2004) Lay theories of schizophrenia. A cross-cultural comparison of British and Hong Kong Chinese attitudes, attributions and beliefs. Social Psychiatry and Psychiatric Epidemiology, 39, 543-552.
24.
Furnham, A. & Haraldson, E. ( 1998) Lay theories of etiology and ‘cure’ for four types of paraphilia: Fetishism, paedophilia, sexual sadism and voyeurism. Journal of Clinical Psychology, 54, 689-700.
25.
Furnham, A. & Henley, S. ( 1988) Lay beliefs about overcoming psychological problems. Journal of Social and Clinical Psychology, 26, 423-438.
26.
Furnham, A. & Hume-Wright, A. ( 1992) Lay theories of anorexia nervosa. Journal of Clinical Psychology, 48, 20-37.
27.
Furnham, A. & Kuyken, W. ( 1991) Lay theories of depression. Journal of Social Behaviour and Personality, 6, 329-342.
28.
Furnham, A. & Lowick, V. ( 1984) Lay theories of the causes of alcoholism. British Journal of Medical Psychology, 57, 319-322.
29.
Furnham, A. & Manning, R. ( 1997) Young people’s theories of anorexia nervosa and obesity. Counseling Psychology Quarterly, 10, 389-415.
30.
Furnham, A., Raja, N. & Khan, U. ( 2008) A cross-cultural comparison of British and Pakistani medical students’ understanding of schizophrenia. Psychiatry Research, 159, 308-319.
31.
Furnham, A. & Rees, J. ( 1988) Lay theories of schizophrenia. International Journal of Social Psychiatry, 34, 212-220.
32.
Furnham, A. & Thomson, L. ( 1996) Lay theories of heroin addiction. Social Science and Medicine, 43, 29-40.
33.
Furnham, A. & Wong, L. ( 2007) A cross-cultural comparison of British and Chinese beliefs about the causes, behaviour manifestations and treatment of schizophrenia . Psychiatry, 151, 123-138.
34.
Geller, B., Fox, L.W. & Clark, K.A. ( 1994) Rates and predictors of prepubertal bipolarity during follow-up of 6- to 12-year-old depressed children. Journal of the American Academy of Child & Adolescent Psychiatry, 33, 461-468.
35.
Goodwin, F.K. & Jamison, K.R. ( 2007) Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression (2nd edition). New York: Oxford University Press.
36.
Hammen, C. & Gitlin, M. ( 1997) Stress reactivity in bipolar patients and its relation to prior history of depression. American Journal of Psychiatry , 154, 856-857.
37.
Hasin, D. & Link, B. ( 1988) Age and recognition of depression: implication for a cohort effect in major depression. Psychological Medicine, 18, 683-688.
38.
Henquet, C., Krabbenham, L., De Graaf, R., ten Have, M. & Van Os, J. ( 2006) Cannabis use and expression of mania in the general population . Journal of Affective Disorders, 95, 103-110.
39.
Hillert, A., Sandmann, J., Ehmig, S.C., Weisbecker, H., Kepplinger, H.M. & Benkert, O. ( 1999) The general public’s cognitive and emotional perception of mental illnesses: an alternative to attitude-research. In The Image of Madness: The Public Facing Mental Illness and Psychiatric Treatment (eds J. Guimon, W. Fischer & N. Sartorius). Basel: Karger.
40.
Jorm, A.F. ( 2000) Mental health literacy. Public knowledge and beliefs about mental disorders. British Journal of Psychiatry, 177, 396-401.
41.
Jorm, A.F., Christensen, H. & Griffiths, K.M. ( 2005) The public’s ability to recognize mental disorders and their beliefs about treatment: changes in Australia over eight years. Australia & New Zealand Journal Psychiatry, 39, 248-254.
42.
Jorm, A., Korten, A., Jacomb, P., Christensen, H., Rodgers, B. & Pollitt, P. ( 1997a) Public beliefs about causes and risk factors for depression and schizophrenia. Social Psychiatry and Psychiatric Epidemiology , 32, 1143-1145.
43.
Jorm, A., Korten, A., Jacomb, P., Christensen, H., Rodgers, B. & Pollitt, P. ( 1997b) ‘Mental health literacy’: a survey of the public’s ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia , 166, 182-186.
44.
Jorm, A., Korten, A., Rodgers, B., Pollitt, P., Jacomb, P., Christensen, H. & Jiao, T. ( 1997c) Belief systems of the general public concerning the appropriate treatments for mental disorders. Social Psychiatry and Psychiatric Epidemiology, 32, 116-121.
45.
Jorm, A., Korten, A., Rodgers, B., Pollitt, H., Christensen, H. & Henderson, A. ( 1997d) Helpfulness of interventions for mental disorders: Beliefs of health professionals compared to the general public. British Journal of Psychiatry, 171, 233-237.
46.
Kendler, K., Neale, M., Kessler, R., Heath, A. & Eaves, L. ( 1992) A population-based twin study of major depression in women: The impact of varying definitions of illness. Archives of General Psychiatry, 49, 257-266.
47.
Kessler, R.C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H.U. & Kendler, K.S. ( 1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Co-morbidity Survey . Archives of General Psychiatry, 51, 8-19.
48.
Klimidis, S., Hsiao, F.-H. & Minas, H. ( 2007) Chinese-Australians’ knowledge of depression and schizophrenia in the context of their under-utilization of mental health care: An analysis of labelling. International Journal of Social Psychiatry, 53, 464-479.
49.
Knapp, J. & Delprato, D. ( 1980) Willpower, behaviour therapy, and the public. Psychological Record, 30, 477-482.
50.
Knight, M., Furnham, A. & Lester, D. ( 2000) Lay theories of suicide. Personality and Individual Differences, 29, 453-457.
51.
Kraepelin, E. ( 1921) Manic-Depressive Insanity and Paranoia. Edinburgh, Scotland: E. & S. Livingstone.
52.
Lam, D.H., Bright, J., Jones, S., Hayward, P., Schuck, N., Chisholm, D. & Shan, P. ( 2000) Cognitive therapy for bipolar illness: A pilot study of relapse prevention. Cognitive Therapy Research, 24, 503-520.
53.
Lam, D.H., Jones, S., Bright, J. & Hayward, P. ( 1999) Cognitive Therapy for Bipolar Disorder: A Therapist’s Guide to Concepts, Methods and Practice. Chichester: John Wiley & Sons Inc.
54.
Lauber, C., Falcato, L., Nordt, C. & Rossler, W. ( 2003) Lay beliefs about causes of depression. Acta Psychiatrica Scandinavica, 108 (Suppl 418), 96-99.
55.
Leverich, G., McElroy, S.L., Suppes, T., Keck JR, P.E., Denicoff, K.D. , Nolen, W.A., Altshuler, L.L., Rush, A.J., Kupka, R., Frye, M.A., Autio, K.A. & Post, R.M. (2002) Early physical and sexual abuse associated with an adverse course of bipolar illness. Biological Psychiatry, 51, 288-297.
56.
Lin, E., Goering, P., Offord, D.R., Campbell, D. & Boyle, M.H. ( 1996) The use of mental health services in Ontario: Epidemiologic findings. Canadian Journal of Psychiatry, 41, 572-577.
57.
Link, B.G., Phelan, J.C., Bresnahan, M., Stueve, A. & Pescosolido, B.A. ( 1999) Public conceptions of mental illness: labels, causes, dangerousness, and social distance. American Journal of Public Health, 89, 1328-1333.
58.
Neale, J.M. ( 1988) Defensive function of manic episodes. In Delusional Beliefs (eds T.F. Oltmanns & B.A. Maher). New York: Wiley.
59.
Neves-Pereira, M., Mundo, E., Muglia, P., King, N., Macciardi, F. & Kennedy, J.L. ( 2002) The brain-derived neurotrophic factor gene confers susceptibility to bipolar disorders: Evidence from a family-based association study. American Journal of Human Genetics, 71, 651-655.
60.
Nuechterlein, K.H. & Dawson, M.E. ( 1984) A heuristic vulnerability-stress model of schizophrenic episodes. Schizophrenia Bulletin, 10, 300-312.
61.
Nunnally, J. ( 1961) Popular Conceptions of Mental Health. New York: Holt, Rinehart & Winston.
62.
Peet, M. & Harvey, N.S. ( 1991) Lithium maintenance I: A standard education programme for patients. British Journal of Psychiatry, 158, 197-200.
63.
Priest, R.G., Vize, C., Roberts, A., Roberts, M. & Tylee, A. ( 1996) Lay people’s attitudes to treatment of depression: Results of opinion poll for Defeat Depression Campaign just before its launch . British Medical Journal, 313, 858-859.
64.
Rabkin, J.G. ( 1974) Public attitudes toward mental illness: A review of the literature. Psychological Bulletin, 10, 9-33.
65.
Rippere, V. ( 1977) Commonsense beliefs about depression and antidepressive behaviour. A study of social consensus. Behaviour Research and Therapy, 17, 465-473.
66.
Rippere, V. ( 1979) Scaling the helpfulness of antidepressive activities. Behaviour Research and Therapy, 17, 439-449.
67.
Rippere, V. ( 1980) Some historical dimensions of commonsense knowledge about depression and antidepressive behaviour. Behaviour Research and Therapy, 18, 373-385.
68.
Rippere, V. ( 1981) How depressing: Another cognitive dimension of commonsense knowledge. Behaviour Research and Therapy, 19, 169-181.
69.
Sarbin, T.R. & Mancuso, J.C. ( 1970) Failure of a moral enterprise: Attitudes of the public toward mental illness. Journal of Consulting and Clinical Psychology, 35, 66-74.
70.
Sarbin, T.R. & Mancuso, J.C. ( 1972) Paradigms and moral judgements: Improper conduct is not disease. Journal of Consulting and Clinical Psychology, 13, 6-8.
71.
Serretti, A. & Olgiati, P. ( 2005) Profiles of ‘manic’ symptoms in bipolar I, bipolar II and major depressive disorders. Journal of Affective Disorders, 84, 159-166.
72.
Shurka, E. ( 1983) Attitudes of Israeli Arabs towards the mentally ill. International Journal of Social Psychiatry, 29, 101-110.
73.
Siegler, M. & Osmond, H. ( 1966) Models of madness. British Journal of Psychiatry, 112, 1193-1203.
74.
Suppes, T., Swann, A.C., Dennehy, E.B., Habermacher, E.D., Mason, M., Crismon, M.L. et al. (2001) Texas medication algorithm project: Development and feasibility testing of a treatment algorithm for patients with bipolar disorder. Journal of Clinical Psychiatry, 62, 439-447.
75.
Wehr, T.A., Sack, D.A. & Rosenthal, N.E. ( 1987) Sleep reduction as a final common pathway in the genesis of mania. American Journal of Psychiatry, 144, 201-204.
76.
Wolff, G., Pathare, S., Craig, T. & Leff, J. ( 1996) Community attitudes to mental illness. British Journal of Psychiatry, 168, 183-190.
77.
Yoder, C.Y., Shute, G.E. & Tryban, G.M. ( 1990) Community recognition of objective and subjective characteristics of depression. American Journal of Community Psychology, 18, 547-566.
78.
Young, L.T., Warsh, J.J., Kish, S.J., Shannak, K. & Hornykeiwicz, O. ( 1994) Reduced brain 5-HT and elevated NE turnover and metabolites in bipolar affective disorder. Biological Psychiatry, 35, 121-127.
