Dual jeopardy for Indian service users: Qualitative study of managing comorbid schizophrenia and diabetes mellitus.

Abstract

Objective: Diabetes mellitus is a sequelae of antipsychotic medication in people of Indian descent with schizophrenia. The Indian socio-cultural context amplifies challenges of managing chronic illness. The aim of this study was to explore Indian mental health service users' perspectives of managing comorbid psychosis and diabetes mellitus, specifically culture-related difficulties.

Methods: In this exploratory study, people with an Indian cultural background recruited from community mental health clinics were interviewed by an Indian psychiatrist using a semi-structured questionnaire. Interviews were professionally transcribed. Reflexive thematic analysis was used to develop central organising concepts and identify themes.

Results: Four themes were identified: culture-specific views on comorbidity, preferences for tailoring education to Indian language and culture, changes in interpersonal relationships within extended family and relationships with healthcare professionals. Advice from hospital services was not specific to Indian culture and there were wider impacts of illness for wider family.

Conclusion: Indian New Zealanders have challenges in managing dual mental and physical illnesses. Further research is needed to develop approaches to care that emphasise service users' culture as core to understanding illness and treatment. This includes consideration of gender roles, families, communities, food, language, lifestyle and barriers to treatment.