The Mediation Role of Self-Esteem for Self-Stigma on Quality of Life for People With Schizophrenia: A Retrospectively Longitudinal Study

Abstract

B ackground: Among patients with schizophrenia, there is evidence of a negative association between self-stigma and subjective quality of life (SQoL), and self-esteem was an important mediator in the association. We attempted to use a longitudinal study to investigate the aforementioned mediation on a sample with schizophrenia. Methods: We used longitudinal data retrieved from medical records of a psychiatric centre between June 2014 and December 2015. In the data, we retrieved information of self-stigma using the Self-Stigma Scale -Short; SQoL, using the WHO questionnaire on the Quality of Life -Short Form; and self-esteem, using the Rosenberg Self-Esteem Scale. All the measures were evaluated five times. Linear mixed-effect models accompanied by Sobel tests were used to tackle the mediating effects. Results: Data from 74 patients (57 males) with schizophrenia were eligible for analysis; their mean (SD) age was 39.53 (10.67); mean age of onset was 22.95 (8.38). Self-esteem was a mediator for patients in physical (p = .039), psychological (p = .003), and social SQoL (p = .004), but not in environment SQoL (p = .051). Conclusion: Based on our findings, mental health professionals could tailor different programs to patients with schizophrenia, such as self-stigma reduction and self-esteem improvement programs. However, treatment as a whole should be sensitive to both self-stigma and selfesteem. Also, we should consider individuals' health and wellbeing from social perspectives of disability rather than the medical model of disability emphasising symptoms and medications.

Factors related to preventive COVID-19 infection behaviors among people with mental illness

“…Moreover, the association between self-stigma and psychological distress found in the present study concurs with prior findings. 24 , 25 …”

“… 23 Individuals with mental illness and self-stigma are reluctant to adhere to treatment because they have high levels of psychological distress and lower levels of self-esteem. 24 , 25 Therefore, it is possible that individuals with mental illness may not want to perform preventive COVID-19 infection behaviors if they have self-stigma issues. However, to the best of the present authors’ knowledge, there is no empirical evidence for healthcare providers to understand the role of self-stigma for individuals with mental illness during COVID-19 pandemic.…”

Risk factors associated with experienced stigma among people diagnosed with mental ill-health: a cross-sectional study

“…Perhaps key to the relationship between stigma and quality of life is the process of selfstigma, the internalising of stigmatised beliefs towards oneself. Both Hsiao et al [42] and Huang et al [46] highlight the mediating role of self-stigma through it's impact on family coherence and individual quality of life, although both also emphasise the context of culture.…”

Worsen depression after viscosupplementation treatment for geriatric people with knee osteoarthritis?

“…The primary predictors of the aforementioned dependent variables were the follow-up measures at two, four, and six months and each follow-up measure was compared with baseline measure to determine the effects of hyaluronic acid. In all of the mixed effects models, gender, marital status, comorbidities (hypertension, diabetes mellitus, heart disease, depression, and cancer), and age were controlled because these factors may be confounders in patient-reported outcomes (Chang et al, 2017, Huang et al, 2018, Lee et al, 2017a, Lee et al, 2017b, Lee et al, 2018). Specifically, linear effect was estimated for age, and categorical effects were estimated for other independent variables.…”