The opinion of caregivers on aspects of schizophrenia and major affective disorders in a Nigerian setting.

Background: In Nigeria the burden of caring for persons with severe mental disorders rests largely on families whose attitudes to these conditions have not been explored.

Objectives: To assess the opinion of relatives of 75 schizophrenics and 20 major affective disorder cases on aspects of the disease and compare with the responses of relatives of cancer, infertility and sickle cell disease (SCD) cases.

Method: Caregivers were assessed using a burden questionnaire that contained items on etiological beliefs and attitudes to illness.

Results: The responses of relatives of the two psychiatric illness groups were similar. The single most important etiological factors were that "it is Satan's work" (35.8%) and "it is a natural illness" (23.2%). Other factors were "genetic" (9.5%), "witchcraft" (10.5%) and "curse by enemies" (10.5%). This was similar to the opinion of cancer and infertility caregivers; but different from SCD where the most important causative factors were "genetic" (41.5%) and "natural" (21.5%). Psychiatric caregivers had higher frequency of anger and stigma. Over two-thirds of psychiatric caregivers felt glad caring for the patient and would not like the patient institutionalized. Most families were thought to be supportive and there was an impression that caring had made family emotional ties closer.

Conclusions: These families were tolerant and would cooperate with health authorities. Causative models are influenced by available knowledge and practices in the culture. To actualize the potential of families to play useful community psychosocial roles, there is a need for public mental health literacy and welfare support.