Self-stigma common in schizophrenia, linked to empowerment
MedWire News: Around 40% of patients with schizophrenia or psychosis report moderate or high self-stigma, according to a European survey of mental-health service users.
Notably, the level of self-stigma was related to empowerment and social contact, which, the researchers say, could be targeted with interventions to alleviate stigmatizing beliefs.
Previous studies have shown that self-stigma compromises protective psychological mechanisms such as hope, self-esteem, and morale, and also reduces quality-of-life.
Moreover, in clinical terms, self-stigma is associated with an increase in positive, negative, and depressive symptoms, and overall symptom severity.
As a consequence there has been an emerging focus on self-stigma as a potential barrier to recovery from schizophrenia.
“Before considering the utility of self-stigma as a marker of burden of illness and an area for intervention, it is vital to ascertain the degree to which self-stigma is reported across Europe,” study co-author Elaine Brohan (Institute of Psychiatry, King's College London, United Kingdom) and colleagues comment in the journal Schizophrenia Research.
The researchers collected self-report data from 1229 individuals with a diagnosis of schizophrenia, psychosis, or schizoaffective disorder from 14 mental-health centers across Europe.
The primary measure was the Internalized Stigma of Mental Illness Scale (ISMI) – a 29-item scale that assesses self-stigma across five subscales: Alienation, stereotype endorsement, perceived discrimination, social withdrawal, and stigma resistance.
Categorizing total ISMI scores into minimal, low, moderate, and strong, the researchers found that 41.7% of patients reported moderate or higher levels of self-stigma.
Overall, alienation was the most frequently endorsed subscale, followed by social withdrawal and discrimination experience.
In a multivariate model, 42% of the variance in self-stigma scores was predicted by levels of empowerment, perceived discrimination, and social contact.
“The strong association between self-stigma and empowerment and social contact generates the future hypothesis that interventions to enhance these factors may have a role in reducing self-stigma,” Brohan and colleagues conclude.
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By Andrew Czyzewski