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06-04-2010 | Mental health | Article

Self-stigma common in schizophrenia, linked to empowerment


Free abstract

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.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Andrew Czyzewski

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