Self-stigma in Patients with Schizophrenia in a Psychiatry Hospital in Lagos, Nigeria

Abstract

Aims: Schizophrenia is a devastating and disabling disorder associated with long term negative consequences and may require lifelong treatment. It is often complicated with self-stigma which makes treatment difficult and may be a source of complications. Ensuring good outcome will therefore, involve taking cognizance of self-stigma in the treatment plan. Studies examining self-stigma in patients with schizophrenia is scanty in Nigeria. The aim of the study was to determine the prevalence of self-stigma in patients with schizophrenia as well as identifying some of the correlates of self-stigma in the patients.
 Study Design: Cross-sectional survey
 Place and Duration of Study: Outpatient clinic of a Neuropsychiatry hospital in Lagos state, Nigeria.
 Methodology: 320 adult patients with schizophrenia were recruited using a consecutive sampling technique. MINI international Neuropsychiatric interview (Psychotic disorder module) was used to confirm the diagnosis, after which socio-demographic questionnaire and the Internalized Stigma of Mental illness Inventory (ISMI), were administered to the patients. The data was analyzed with SPSS version 16 and the result presented in frequency tables, percentages, mean and standard deviation where necessary.
 Results: Majority of the participants (83.4%) were less than 50 years old, they were mostly females (57.2%), of Yoruba ethnic group (59.7%), Christians (75.6%), and were low-income earners, earning either no income or less than ₦18,000 monthly (72.2%). Also, over four-fifth (86.2%) had good social support. Over a third (38.1%), were married, with about 80 percent of these living with their spouses while 46.5% were never married. The prevalence of self-stigma was 25.3%. Educational attainment below secondary school and multiple illness episodes were found to predict self-stigma in the study.
 Conclusion: Self-stigma is common in schizophrenia and its consideration in management is necessary for a good treatment outcome.

Internalised stigma among people with mental illness in Africa, pooled effect estimates and subgroup analysis on each domain: systematic review and meta-analysis

“…We examined the socio demographic and other factors that predicted internalised stigma. The individual papers found the following: female gender [ 32 ], rural residence [ 41 ], single relationship status [ 12 , 41 ], unemployed [ 43 , 59 , 61 ], unable to read and write [ 43 , 45 ], low income [ 59 ], psychotic symptoms [ 41 , 45 ], suicidal behaviour [ 12 , 41 ], greater than two years since diagnosis [ 12 ], drug nonadherent [ 12 , 32 ], presence of drug side effect/s [ 32 ]; previous hospital admission [ 43 ], longer duration of follow up [ 44 ], low self-esteem [ 43 ], no family support [ 32 ], poor social support [ 12 , 43 – 45 ], poor quality of life [ 12 ], and full insight into the condition [ 44 ] were significantly associated with internalised stigma.…”