Constructing illness: How the public in eight Western nations respond to a clinical description of "schizophrenia"

Sigrun Olafsdottir*, Bernice A. Pescosolido

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)


According to classic and contemporary social theory, the community is crucial to how individuals respond to the onset of health problems. Cultural response to symptoms provides the foundation for lay diagnosis; offers a gauge for marking individual and societal health literacy; and reflects the cultural embeddedness of modern medical knowledge. Using data collected between 2004 and 2007 from the Stigma in Global Context - Mental Health Study (SGC-MHS) on the recognition of schizophrenia from vignettes describing individuals meeting DSM-IV criteria, we examine the nature and correlates of lay diagnosis. Focusing on Western societies in the SGC-MHS, we ask three questions regarding problem recognition in Bulgaria (N = 255), Cyprus (N = 253), Germany (N = 382), Hungary (N = 352), Iceland (N = 291), Spain (N = 327), Great Britain (N = 289), and the United States (N = 449): (1) What is the cross-national variation in recognition of schizophrenia as a mental illness? (2) Is lay diagnosis associated with individuals' socio-demographic characteristics and/or their evaluation of underlying causes? (3) Are lay diagnoses likely to shape the nature and direction of the illness career? We find lay diagnosis of " mental illness" to be high across these Western nations with some, though modest, difference across countries. Variation for the more specific diagnosis of " schizophrenia" is greater, though fairly consistent in country ordering. Lay diagnoses are shaped most consistently by attributions, inconsistently by socio-demographics, and generally associated with respondents' treatment recommendations and expected outcomes. In light of assumptions about public beliefs and knowledge that often underlie research, community efforts, clinical programs, and health policy, these findings suggest that a greater understanding of the complexities of lay diagnosis is warranted.

Original languageEnglish
Pages (from-to)929-938
Number of pages10
JournalSocial Science and Medicine
Issue number6
Publication statusPublished - Sept 2011

Bibliographical note

Funding Information:
Support provided by the Fogarty International Center and the National Institute of Mental Health , Grant No. 5R01TW006374 ; the Icelandic Foundation , and the National Science Foundation support to the General Social Survey. We thank Jason Beckfield for comments on earlier drafts of this paper.

Other keywords

  • Cross-national research
  • Culture
  • Help-seeking
  • Mental illness
  • Public attitudes
  • Schizophrenia


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