Self-stigma in schizophrenia: a systematic review and meta-analysis of 37 studies from 25 high- and low-to-middle income countries

Fond, Guillaume; Vidal, Martin; Joseph, Morgane; Etchecopar‐Etchart, Damien; Solmi, Marco; Yon, Dong Keon; Correll, Christoph U.; Boyer, Laurent

doi:10.1038/s41380-023-02003-4

Cited by 13 publications

(4 citation statements)

References 76 publications

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“…Mixed findings were also noted in the association between age and self-stigma in patients with psychotic disorders. Many past reports revealed no significant association between age and self-stigma ( 5 , 40 ). Nonetheless, our finding that younger patients had greater self-stigma than older patients concurs with some prior studies which demonstrated that self-stigma level increased with decreasing age of schizophrenia patients ( 44 – 46 ).…”

Section: Discussionmentioning

confidence: 91%

“…Many previous studies observed lack of sex difference in self-stigma among patients with severe mental illness including schizophrenia ( 5 , 40 ). Our finding that female patients had greater self-stigma than the male counterparts is, however, in line with some earlier studies on chronic schizophrenia ( 42 , 43 ), as well as young early psychosis sample in Hong Kong ( 13 ).…”

Section: Discussionmentioning

confidence: 94%

“…Cross-cultural differences may also contribute to discrepant findings on self-stigma. Recent meta-analyses showed higher frequency of high self-stigma and greater stereotype endorsement in schizophrenia patients from Asian countries compared to the others ( 5 , 40 ). Literature suggested that perceived stigma and self-stigma in people with mental illness may be greater in regions with relatively group-oriented cultures (e.g., Asian and Chinese populations) than those regions with more individual-oriented cultures (e.g., countries in Europe and North America) ( 41 ).…”

Section: Discussionmentioning

confidence: 99%

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Rate and correlates of self-stigma in adult patients with early psychosis

Chu

et al. 2023

Front. Psychiatry

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IntroductionSelf-stigma impedes recovery process and is associated with poorer clinical and functional outcomes in people with psychotic disorders. However, there is limited research specifically examining self-stigma in the early stage of illness, and mixed findings were observed regarding factors associated with increased self-stigma. We aimed to investigate the rate and correlates of self-stigma in a cohort of adult patients with early psychosis using a comprehensive array of clinical, treatment and other illness-related variables.MethodsA total of 101 Chinese adult early psychosis patients aged 26–55 years who had received three-year psychiatric treatment for first psychotic episode in Hong Kong and completed self-stigma assessment were included for the current investigation. A broad range of assessments encompassing socio-demographics, premorbid adjustment, onset and illness profiles, symptom severity, psychosocial functioning, treatment characteristics and medication side-effects were conducted.ResultsTwenty-eight (27.7%) patients had moderate-to-high levels of self-stigma. Univariate linear regression analyses showed that age at study entry, sex, educational level, age at psychosis onset, duration of untreated psychosis (DUP), insight level, global psychosocial functioning, and the use of second-generation antipsychotic were related to self-stigma levels. Final multivariable regression model revealed that female sex, younger age at entry, longer DUP and better insight were independently associated with higher levels of self-stigma.ConclusionMore than one-fourth of early psychosis patients experienced significant self-stigma, highlighting an unmet need for early detection and intervention of self-stigma in the initial years of illness. Further investigation is warranted to clarify trajectories and predictors of self-stigma in the early illness course.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Rate and correlates of self-stigma in adult patients with early psychosis

Chu

et al. 2023

Front. Psychiatry

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“…Previous studies have examined how clinical symptoms and side effects affect social functioning, but the relative contribution of factors and the role of medication type are unclear. Moreover, the impact of psychiatric symptoms, antipsychotic medications, and side effects on QoL is not static or uniform across patients and settings and may interact with each other and with other factors, such as social support, unmet needs, coping skills, and circumstances [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring the interplay of psychiatric symptoms, antipsychotic medications, side effects, employment status, and quality of life in Chronic Schizophrenia

Zhou,

Yang,

Wang

et al. 2024

BMC Psychiatry

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Background Many factors contribute to quality of life (QoL) in patients with schizophrenia, yet limited research examined these factors in patients in China. This cross-sectional study explores subjective QoL and its associated factors in patients. Methods The QoL was assessed using the Schizophrenia Quality of Life Scale (SQLS). Clinical symptoms were evaluated using the Brief Psychiatric Rating Scale (BPRS) and seven factors were extracted. Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety. Cognitive impairment was assessed using the Ascertain Dementia 8 (AD8). The Treatment Emergent Symptom Scale (TESS) and Rating Scale for Extrapyramidal Side Effects (RSESE) were used to evaluate the side effects of medications. Results We recruited 270 patients (male:142,52.6%, mean age:41.9 ± 9.4 years). Positive correlations were observed between SQLS and its subdomains with the total score of BPRS, PHQ-9, GAD-7, AD8, TESS, and RSESE (all P < 0.005). Patients who were taking activating second-generation antipsychotics (SGAs) had lower scores on total SQLS, Motivation/ Energy domain of SQLS (SQLS-ME) as well as Symptoms/ Side effects domain of SQLS (SQLS-SS) compared to those taking non-activating SGAs (all P < 0.005). Multiple regression analysis showed that depressive/ anxiety symptoms and cognitive impairment had significant negative effects on QoL (P ≤ 0.001), while activating SGAs had a positive effect (P < 0.005). Blunted affect and unemployment were inversely associated with the motivation/energy domain (P < 0.001). Conclusion Our findings emphasize the important role of depression/anxiety symptoms and cognitive impairment in the QoL of patients with chronic schizophrenia. Activating SGAs and employment may improve the QoL of these individuals. Trial registration This protocol was registered at chictr.org.cn (Identifier: ChiCTR2100043537).

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