Correlates of internalized stigma levels in people with psychosis in the Czech Republic

Abstract

Background: Internalized stigma negatively affects lives and prognosis of individuals with psychosis. Aim: This study aimed to identify correlates of internalized stigma among individuals with psychosis in a sample of community care users in the Czech Republic. Methods: A cross-sectional study was conducted among 133 community service users with psychosis. A shortened version of the Internalized Stigma of Mental Illness (ISMI-10) scale was used alongside the 5-level EQ-5D version (EQ-5D-5L), assessing health-related quality of life. Descriptive and linear regression analyses were performed in order to determine levels of internalized stigma and its correlates. Results: High levels of internalized stigma were reported in 25% of participants. Lower internalized stigma levels were associated with better self-reported health status and being married, and higher internalized stigma with a longer period of time since initial contact with psychiatric care. Conclusion: Lower internalized stigma levels are associated with better self-reported health-related quality of life. In addition, clients having used psychiatric care for longer periods of time reported significantly higher internalized stigma levels. Therefore, authors suggest self-stigma reduction interventions based in a community setting with an emphasis on targeting clients with chronic psychosis.

Internalized stigma in patients with schizophrenia: A hospital-based cross-sectional study from Nepal

“…This finding is in line with a study from China conducted among severe mental disorders in rural communities using the same tool for measuring stigma [25]. However, this estimate is higher compared to most other studies within Nepal [15,17] and other parts [8,28] of the world. Studies comparing stigma scores within diagnostic categories have persistently reported higher self-stigma scores for schizophrenia and psychosis compared to affective disorders and this could be the main reason behind the discrepancy reported [25,29].…”

“…On the other hand, too long duration as more than 10 years could mean patients have adjusted somehow to their diagnosis leading to less stigma as reported in this study. Results reporting positive correlations of duration of illness with ISMI scores have been reported in a number of studies [8,[12][13][14]. These differences could be because the first study was conducted among all outpatients with mental illness and not only schizophrenia, the second study among severe mental illnesses, including schizophrenia, schizoaffective disorder, and bipolar disorder while the third study was conducted among psychosis in community setting, rather than in hospital setting.…”

“…Sample size was calculated using the Cochran's formula: n = (z1α /2 ) 2 (p)(q)/(d) 2 , where p = 44% [8] and considering 10% drop out from the study, n = 95+10 = 105 was the minimum required sample size.…”

“…Self-stigma and eventually internalized stigma lead to low self-esteem, depression, delayed treatment-seeking, long duration of untreated illness and poor quality of life [3,7]. Additionally, compared to neurosis, psychotic illnesses like schizophrenia have high heritability, and are considered equivalent with insanity, and aggression [7] leading to more pervasive stigma [7][8][9][10][11].…”

Development of public stigma toward people with mental health problems in Czechia 2013–2019

“…Mental health care remained institutionalized [15], economically ineffective [16,17], and problematic from a human rights perspective [18]. Attitudes towards those with mental illness have been unfavourable among the general population as well as among medical doctors or students [5,6,19], and people with mental health problems and their relatives often feel that they are targets of stigma and discrimination [20,21].…”