Self-stigma and schizophrenia: a cross-sectional study

Abstract

ObjectiveThe aim of this study was to investigate the degree of self-stigma in schizophrenia and its association with clinical and demographic factors.Patients and methodsA total of 197 outpatients (54.3% females) diagnosed with schizophrenia spectrum disorders (schizophrenia, schizoaffective disorder, delusional disorder) according to International Classification of Diseases – tenth edition participated in the study. The mean age of the patients was 40.10±11.49 years. All individuals completed the Internalized Stigma of Mental Illness (ISMI) scale and a demographic questionnaire. The disorder severity was assessed by both a psychiatrist (the objective version of Clinical Global Impression – severity scale [objCGI-S]) and the patients (the subjective version of Clinical Global Impression – severity scale [subjCGI-S]). Treatment with antipsychotics stabilized the patients.ResultsThe overall level of self-stigma measured by the total score of the ISMI was 63.32±13.59. The total score of the ISMI positively correlated with the severity of the disorder measured by the objCGI-S and subjCGI-S. In addition, self-stigma positively correlated with the treatment duration and the number of psychiatric hospitalizations. The backward stepwise regression was applied to identify the most significant factors connected to self-stigma. The regression analysis identified the following regressors as the most relevant to self-stigma: the number of previous psychiatric hospitalizations, the severity of the disorder rated by a psychiatrist, and the difference between the objective rating and the subjective rating of the severity of the disorder.ConclusionOutpatients with schizophrenia spectrum disorders, who have undergone a higher number of psychiatric hospitalizations, who dispose of a higher severity of the disorder and show a higher discrepancy between their rating of the severity and the psychiatric rating, showed a greater degree of self-stigma. The management of self-stigma in patients with schizophrenia should be implemented in the routine care.

Prevalence and factors associated with higher levels of perceived stigma among people with schizophrenia Addis Ababa, Ethiopia

“…A history of being hospitalized once or twice increased higher perceived stigma by 1.94 times among schizophrenia patients when compared to patients who did not have a history of admission. This is in line with the findings of other studies done in two areas of the Czech Republic [45,51]. The number of previous admissions presented high vulnerability to higher perceived stigma among schizophrenia patients.…”

“…The prevalence of high perceived stigma among people with schizophrenia was found to be 62.6%. This result is consistent with the reported magnitude of high perceived stigma in studies carried out among schizophrenia and schizoaffective disorder patients in Austria 66.9% [44], a meta-analysis report of the magnitude perceived stigma among schizophrenia patients in the USA, which revealed a rate of 64.55% [22], and the magnitude of self-stigma among schizophrenia spectrum disorders in Czech-Republic was 63.32% [45]. However, this finding was lower than that in the study conducted in Ethiopia, where prevalence of higher perceived stigma was reported at 83.5% before 6 years back by using the perceived devaluation and discrimination scale and in this study, factors associated with perceived stigma completely different from the previous study [9].…”

“…This is in line with the findings of the other two studies that were done in Ethiopia and the Czech Republic. Self-stigma was highly associated with an extended duration of illness among schizophrenia patients [45]. In a similar study done in India among hospitalized schizophrenia patients, the mean duration of illness of 12.6 years was significantly correlated with high perceived stigma [52].…”

Development of self-stigma inventory for patients with schizophrenia (SSI-P): reliability and validity study

“…These studies found that selfstigma is positively correlated with depression, hopelessness, and negatively correlated with self-esteem. Some studies also found a relationship between the severity of the illness (CGI-S) and self-stigma [51]. However, we did not find a significant correlation between SSI-P and CGI-S in this study.…”

Psychopathological profile and antipsychotic treatment may be linked to internalised stigma in schizophrenia – a cross-sectional study

“…This difference may be directly proportional to lack of insight. Thus, the patients lacking insight into their disease may not consider the stigmatising stereotypes and attitudes as referring to them, and so may not internalise stigma [38]. These results were confirmed in the present study.…”