SCHIZOPHRENIA AND PSYCHOSOCIAL FACTORS: A SYSTEMATIC REVIEW ACROSS ASIA AND PAKISTAN
Main Article Content
Keywords
Schizophrenia, Psychosocial Factors, Culture, Religion, Social Support, Gender Difference, Mental Health, Psychotic Illness
Abstract
Background: Schizophrenia is characterized as disturbances in thinking, emotional responsiveness, and behavior. This psychiatric condition involves a wide range of symptoms which can be characterized into two categories; positive and negative symptoms. Whereas, psychosocial factor is defined as the interaction among the social environment, behaviors, emotions, and thoughts of individuals. The aim of this review was to identify the psychosocial factors that play an important role in the manifestation of schizophrenia.
Methods: The following research utilized PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as a checklist and guideline.
Results: The review consisted of a total of 20 studies which were selected through the PRISMA screening process and extracted 4 different themes serving as psychosocial factors which were; Cultural practices/aspects, religion, social support and gender difference.
Conclusion: The findings indicated that, in Pakistan and Asia the most common psychosocial factors which were reported to contribute in the symptoms of schizophrenia were; culture as the nature of hallucinations and delusions as well as their thoughts and behaviors were influenced by cultural and social practices which in turn affect their compliance towards treatment. Moreover, religion not only affected the beliefs and attitudes of patients but it also disrupted their psychopathology. Additionally, patients with lack of social support were reported to have higher relapse rate, more complications, and non-adherence to treatment. Lastly, gender difference was a notable psychosocial factor that demonstrated the differences in the recovery and onset of schizophrenia in men and women and their subsequent treatment outcome. S
References
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5. Smith, J. (2023, February 8). What are the different types of schizophrenia? https://www.medicalnewstoday.com/articles/192770#outdated-types
6. Jones, H. (2023, November 27). What are the different types of schizophrenia? Verywell Health. https://www.verywellhealth.com/types-of-schizophrenia-5094170
7. Freudenreich, O., Francis, A., & Fricchione, G. L. (2019). Psychosis, mania, and catatonia. In J. L. Levenson (Ed.), The American Psychiatric Association Publishing Textbook of Psychosomatic Medicine and Consultation-Liaison Psychiatry (3rd ed.). American Psychiatric Association Publishing.
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9. Ahmad, I., Khalily, M. T., Hallahan, B., & Shah, I. (2017). Factors associated with psychotic relapse in patients with schizophrenia in a Pakistani cohort. International journal of mental health nursing, 26(4), 384–390. https://doi.org/10.1111/inm.12260
10. Zafar, S. N., Syed, R., Tehseen, S., Gowani, S. A., Waqar, S., Zubair, A., Yousaf, W., Zubairi, A. J., & Naqvi, H. (2008). Perceptions about the cause of schizophrenia and the subsequent help seeking behavior in a Pakistani population - results of a cross-sectional survey. BMC psychiatry, 8, 56. https://doi.org/10.1186/1471-244X-8-56
11. Grover, S., Davuluri, T., & Chakrabarti, S. (2014). Religion, spirituality, and schizophrenia: a review. Indian journal of psychological medicine, 36(2), 119–124. https://doi.org/10.4103/0253-7176.130962
12. Sofronov, A. G., Dobrovolskaya, A. E., Trusova, A. V., Getmanenko, I. A., & Gvozdetskiy, A. N. (2020). Svyaz' psikhosotsial'nogo blagopoluchiya bol'nykh shizofreniei s klinicheskimi, sotsial'no-demograficheskimi i neirokognitivnymi kharakteristikami [The relationship of psychosocial well-being of patients with schizophrenia with clinical, socio-demographic and neurocognitive characteristics]. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova, 120(6. Vyp. 2), 105–112. https://doi.org/10.17116/jnevro2020120062105
13. Kurzban, S., Davis, L., & Brekke, J. S. (2010). Vocational, social, and cognitive rehabilitation for individuals diagnosed with schizophrenia: a review of recent research and trends. Current psychiatry reports, 12(4), 345–355. https://doi.org/10.1007/s11920-010-0129-3
14. Saraceno, B., Levav, I., & Kohn, R. (2005). The public mental health significance of research on socio-economic factors in schizophrenia and major depression. World psychiatry : official journal of the World Psychiatric Association (WPA), 4(3), 181–185.
15. Brekke, J. S., Kohrt, B., & Green, M. F. (2001). Neuropsychological functioning as a moderator of the relationship between psychosocial functioning and the subjective experience of self and life in schizophrenia. Schizophrenia Bulletin, 27(4), 697–708.
16. Bighelli, I., Rodolico, A., García-Mieres, H., Pitschel-Walz, G., Hansen, W.-P., Schneider-Thoma, J., Siafis, S., Wu, H., Wang, D., Salanti, G., Furukawa, T. A., Barbui, C., & Leucht, S. (2021). Psychosocial and psychological interventions for relapse prevention in schizophrenia: A systematic review and network meta-analysis. *The Lancet Psychiatry, 8*(11), 969-980. https://doi.org/10.1016/S2215-0366(21)00243-1
17. ASSOCIATION BETWEEN SOCIAL SUPPORT AND SELF-ESTEEM IN PEOPLE WITH SCHIZOPHRENIA. (2017, June 30). Gale OneFile: Health and Medicine. https://go.gale.com/ps/i.do?id=GALE%7CA534010045&sid=sitemap&v=2.1&it=r&p=HRCA&sw=w&userGroupName=anon%7E911234c1&aty=open-web-entry
18. Nasr, T., & Kausar, R. (2009). Psychoeducation and the family burden in schizophrenia: a randomized controlled trial. Annals of General Psychiatry, 8(1). https://doi.org/10.1186/1744-859x-8-17
19. Wang, L., Zhou, J., Yu, X., Qiu, J., & Wang, B. (2013). Psychosocial rehabilitation training in the treatment of schizophrenia outpatients: A randomized, psychosocial rehabilitation training-and monomedication-controlled study. Pakistan Journal of Medical Sciences, 29(2), 597–600. https://doi.org/10.12669/pjms.292.2951
20. Degnan, A., Baker, S., Edge, D., Nottidge, W., Noke, M., Press, C. J., Husain, N., Rathod, S., & Drake, R. J. (2018). The nature and efficacy of culturally-adapted psychosocial interventions for schizophrenia: A systematic review and meta-analysis. Psychological Medicine, 48(5), 714–727. https://doi.org/10.1017/S0033291717002264
21. Suhail, K., & Ghauri, S. (2009). Phenomenology of delusions and hallucinations in schizophrenia by religious convictions. Mental Health Religion & Culture, 13(3), 245–259. https://doi.org/10.1080/13674670903313722
22. Zill-e-Huma, & Siddiqui, F. H. (2018). Gender differences in recovery and quality of life among schizophrenic patients in Karachi. Journal of Social Sciences and Humanities, 57(1), 87–100. https://doi.org/10.46568/jssh.v57i1.100
23. Bauer, S. M., Schanda, H., Karakula-Juchnowicz, H., & Olajossy-Hilkesberger, L. (2011). Culture and the prevalence of hallucinations in schizophrenia. Comprehensive Psychiatry, 52(3), 319–325. https://doi.org/10.1016/j.comppsych.2010.06.008
24. McFarlane, W. R. (2016b). Family Interventions for Schizophrenia and the Psychoses: a review. Family Process, 55(3), 460–482. https://doi.org/10.1111/famp.12235
25. Maura, J., & Weisman de Mamani, A. (2017). Culturally adapted psychosocial interventions for schizophrenia: A review. Cognitive and Behavioral Practice, 24(4), 445-458. https://doi.org/10.1016/j.cbpra.2017.01.004
26. World Health Organization: WHO. (2022b, January 10). Schizophrenia. https://www.who.int/news-room/fact-sheets/detail/schizophrenia#:~:text=Schizophrenia%20affects%20approximately%2024%20million,as%20many%20other%20mental%20disorders.
27. Sajid, W. B., Rashid, S., & Akhtar, F. (2011). Phenomenology of delusions and hallucinations in schizophrenia in Central Punjab, Pakistan. Pakistan Armed Forces Medical Journal, 61(1). Retrieved from https://www.pafmj.org/PAFMJ/article/view/1808
28. Jameel, H. T., Panatik, S. A., Nabeel, T., Sarwar, F., Yaseen, M., Jokerst, T., & Faiz, Z. (2020). Observed Social Support and Willingness for the Treatment of Patients with Schizophrenia Psychology Research and Behavior Management, Volume 13, 193–201. https://doi.org/10.2147/prbm.s243722
29. Asif, U., Saleem, Z., Yousaf, M., Saeed, H., Hashmi, F. K., Islam, M., Hassali, M. A., & Saleem, F. (2017). Genderwise clinical response of antipsychotics among schizophrenic patients: a prospective observational study from Lahore, Pakistan. International Journal of Psychiatry in Clinical Practice, 22(3), 177–183. https://doi.org/10.1080/13651501.2017.1395055
30. Stompe, T., Karakula, H., Rudalevičiene, P., Okribelashvili, N., Chaudhry, H. R., Idemudia, E. E., & Gscheider, S. (2006). The pathoplastic effect of culture on psychotic symptoms in schizophrenia. Retrieved from https://d1wqtxts1xzle7.cloudfront.net/68474066 /The_ pathoplastic_effect_of_culture_on_ps20210801-747-ytv0vt.pdf
31. Kulhara, P., & Chakrabarti, S. (2001). Culture and schizophrenia and other psychotic disorders. Psychiatric Clinics of North America, 24 (3), 449–464. https://doi.org/10.1016/S0193-953X(05)70240-9
32. Bhui, K., & Tsangarides, N. (2008). Culture and schizophrenia. Psychiatry, 7(11), 454-457. https://doi.org/10.1016/j.mppsy.2008.08.005
33. Maura, J., & Weisman de Mamani, A. (2017). Culturally adapted psychosocial interventions for schizophrenia: A review. Cognitive and Behavioral Practice, 24(4), 445-458. https://doi.org/10.1016/j.cbpra.2017.01.004
34. Chidarikire, S., Cross, M., Skinner, I., & Cleary, M. (2018). An ethnographic study of schizophrenia in Zimbabwe: The role of culture, faith, and religion. Journal of Spirituality in Mental Health, 22(2), 173–194. https://doi.org/10.1080/19349637.2018.1531366
35. L Borras, S Mohr, P-Y Brandt, C Gilliéron, A Eytan, P Huguelet, Religious Beliefs in Schizophrenia: Their Relevance for Adherence to Treatment, Schizophrenia Bulletin, Volume 33, Issue 5, September 2007, Pages 1238–1246, https://doi.org/10.1093/schbul/sbl070
36. Irmak, M. K. (2012). Schizophrenia or possession? Journal of Religion and Health, 53(3), 773–777. https://doi.org/10.1007/s10943-012-9673-y
37. Mohr, S., Brandt, P.-Y., Borras, L., Gilliéron, C., & Huguelet, P. (2006). Toward an Integration of Spirituality and Religiousness Into the Psychosocial Dimension of Schizophrenia. American Journal of Psychiatry, 163(11), 1952–1959. https://doi.org/10.1176/ajp.2006.163.11.1952
38. Morejón, A. J. V., Rubio, J. M. L., & Vázquez-Morejón, R. (2018). Social support and clinical and functional outcome in people with schizophrenia. International Journal of Social Psychiatry, 64(5), 488–496. https://doi.org/10.1177/0020764018778868
39. Munikanan, T., Midin, M., Mohd Daud, T. I., Abdul Rahim, R., Abu Bakar, A. K., Nik Jaafar, N. R., Sidi, H., & Baharuddin, N. (2017). Association of social support and quality of life among people with schizophrenia receiving community psychiatric service: A cross-sectional study. Comprehensive Psychiatry, 75, 94–102. https://doi.org/10.1016/j.comppsych.2017.02.009
40. Jameel, H. T., Panatik, S. A., Nabeel, T., Sarwar, F., Yaseen, M., Jokerst, T., & Faiz, Z. (2020).
Observed Social Support and Willingness for the Treatment of Patients with Schizophrenia
Psychology Research and Behavior Management, Volume 13, 193–201. https://doi.org/10.2147/prbm.s24372241. Andia, Ana Maria Ph.D., M.D; Zisook, Sidney M.D.; Heaton, Robert K. Ph.D.; Hesselink, John M.D.; Jernigan, Terry Ph.D.; Kuck, Julie Ph.D.; Moranville, John M.D.; Braff, David L. M.D.. Gender Differences in Schizophrenia. The Journal of Nervous and Mental Disease 183(8):p 522-528, August 1995.
42. Gender Differences in Schizophrenia : The Journal of Nervous and Mental Disease. (n.d.). LWW. https://journals.lww.com/jonmd/abstract/1995/08000/gender_differences_in_schizophrenia.5.aspx
43. APA PsycNet. (n.d.). https://psycnet.apa.org/record/2014-08272-007
44. Vol. 48 No. 1 (2017): Pakistan Journal of Psychology | Pakistan Journal of Psychology. (n.d.). https://www.pjpku.com/index.php/pjp/issue/view/7
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Mar 26, 2025
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Ayesha Shahid Sheikh, Rida Zehra, Tehreem Fatima, & Dr. Ruqyyia Hani. (2025). SCHIZOPHRENIA AND PSYCHOSOCIAL FACTORS: A SYSTEMATIC REVIEW ACROSS ASIA AND PAKISTAN. Journal of Population Therapeutics and Clinical Pharmacology, 32(2), 873-887. https://doi.org/10.53555/93xq4755
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Author Biographies
Ayesha Shahid Sheikh
Clinical Psychologist, Email: ayeshasheikh37@hotmail.com
Rida Zehra
BSc Clinical Psychology, University of Management and Technology Lahore, Pakistan.
Tehreem Fatima
BSc Clinical Psychology, University of Management and Technology Lahore, Pakistan.
Dr. Ruqyyia Hani
MBBS, Shenyang Medical College, China.
How to Cite
Ayesha Shahid Sheikh, Rida Zehra, Tehreem Fatima, & Dr. Ruqyyia Hani. (2025). SCHIZOPHRENIA AND PSYCHOSOCIAL FACTORS: A SYSTEMATIC REVIEW ACROSS ASIA AND PAKISTAN. Journal of Population Therapeutics and Clinical Pharmacology, 32(2), 873-887. https://doi.org/10.53555/93xq4755