<p>Association Between Autistic Symptoms and Self-Stigma in Patients with Schizophrenia Spectrum Disorders</p>

Abstract

Purpose Self-stigma negatively influences self-esteem, quality of life, self-efficacy, treatment adherence, and recovery in psychiatric patients. By revealing personality traits that influence self-stigma, we can gain useful knowledge for the management of self-stigma. A previous meta-analysis indicated that patients with schizophrenia have higher scores on the Autism-Spectrum Quotient (AQ) than healthy controls. However, the relationship between autistic symptoms and self-stigma in patients with schizophrenia spectrum disorders remains unclear. Therefore, the present study aimed to reveal the association between autistic symptoms and self-stigma in patients with schizophrenia spectrum disorders. Patients and Methods We recruited 127 patients with schizophrenia spectrum disorders (schizophrenia, schizoaffective disorder, and delusional disorder). We assessed participants’ self-stigma and autistic symptoms using the Internalized Stigma for Mental Illness (ISMI) scale and the Autism-Spectrum Quotient (AQ), respectively. The differences in the scores of ISMI and AQ according to patient characteristics were investigated. Multiple regression analysis controlling for age and gender was performed to determine the relationship between the total scores on the AQ and IMSI scale. Results Female patients showed a higher level of self-stigma than males. Unmarried patients showed a significantly higher score on the AQ than married patients. Multiple regression analysis adjusted for age and gender indicated that the total score on AQ might be a predictor of the overall rating on ISMI in patients with schizophrenia spectrum disorders. Conclusion This study is the first to reveal the association between autistic symptoms and self-stigma in patients with schizophrenia spectrum disorders. Our results highlight the importance of considering autistic symptoms in the assessment and management of self-stigma in patients with schizophrenia spectrum disorders.

Mediating effects of self-stigma and depression on the association between autistic symptoms and recovery in patients with schizophrenia-spectrum disorders: a cross-sectional study

“…One previous report showed that the age of onset was lower in patients with schizophrenia-spectrum disorders who had autism-spectrum disorders than in those without such disorders [31]. The results of this study indicated that a younger age of onset among patients with schizophrenia-spectrum disorders was associated with a higher AQ total score, which is consistent with the results of previous studies [21,31]. We identified a weak positive correlation between age at onset and the QIDS score in the bivariate correlation analysis.…”

“…One previous study revealed a significant association between autistic symptoms and self-stigma in with schizophrenia-spectrum disorders [21]. Considering that prior studies have shown that self-stigma is associated with depressive symptoms and recovery, we hypothesized that autistic symptoms would also directly or indirectly correlate with self-stigma, depressive symptoms, and recovery.…”

“…We recruited 110 patients at the Miyagi Psychiatric Center with schizophrenia-spectrum disorders from March 2019 to November 2019 to assess their symptoms of autism, self-stigma, and depression, as well as the extent of recovery. Psychological assessment data were collected from each patient according to a method described in a previous study [21]. All psychological data were successfully obtained from 105 patients (three patients withdrew consent and two did not complete the questionnaires).…”

“…"I do not think so" to 4. "I very much think so," and five subscales (alienation [1,5,8,16,17,21], stereotype endorsement [2,6,10,18,19,23,24], perceived discrimination [3,15,22,25,26], social withdrawal [4,9,[11][12][13]20], and stigma resistance [7,14,[27][28][29]). The average ISMI score is interpreted as follows: 1.00-2.00, no or very mild self-stigma; 2.01-2.50, a mild level of self-stigma; 2.51-3.00, a moderate level of self-stigma; and 3.01-4.00, a severe level of self-stigma.…”

“…Exploring the hypothesis that patients with schizophrenia-spectrum disorders exhibiting a higher level of autistic symptoms would have difficulty in coping with stigmatization due to reduced communication skills and cognitive flexibility and would be more likely to internalize stigma than those with fewer autistic symptoms, our recent investigation revealed a significant association between autistic symptoms and self-stigma in patients with schizophrenia-spectrum disorders [21]. Considering that self-stigma is associated with depressive symptoms and recovery, our previous findings suggested that autistic symptoms could also directly or indirectly correlate with the other three factors.…”