Gaebel Wolfgang, Zäske Harald, Baumann Anja E, Klosterkötter Joachim, Maier Wolfgang, Decker Petra, Möller Hans-Jürgen
Department of Psychiatry and Psychotherapy, Heinrich-Heine-University Düsseldorf, Rhineland State Clinics Düsseldorf, Bergische Landstrasse 2, D-40629 Düsseldorf, Germany.
Schizophr Res. 2008 Jan;98(1-3):184-93. doi: 10.1016/j.schres.2007.09.013. Epub 2007 Oct 24.
In 2001, the World Psychiatric Association's global antistigma-program "Fighting stigma and discrimination because of schizophrenia--Open the Doors" was initiated in Germany. Several measures to tackle the stigma in certain target populations have been proven successful, but the effectiveness of the program on the general population level has not yet been examined.
Before the start of a number of antistigma interventions in 2001, a professional survey institute was commissioned to conduct a representative telephone survey in 6 German cities (N=7225). The cities were chosen with respect to the implementation of antistigma programs (Düsseldorf, Munich), awareness programs (Bonn, Cologne; with the aim to enhance early recognition of schizophrenia), and none of the programs (Berlin, Essen). A panel design follow-up survey (N=4622) was conducted in 2004. Stereotypes, beliefs and attitudes about schizophrenia and social distance--i.e. the distance between different groups of society--towards people with schizophrenia, and the knowledge of antistigma projects were assessed.
Overall, social distance decreased significantly between 2001 and 2004 (p=0.001). At the city level, this effect was only significant in those cities where antistigma projects were implemented (p<0.001), although the observed attitude changes were small. In cities with antistigma projects, social distance primarily decreased in the social distance subscale "transient social relations" (p<0.001), but not in the subscale "closer social relations". Both subcales did not change significantly in cities without antistigma projects.
The present study provides limited evidence for the efficacy of antistigma interventions on the population level in Germany. Further research is needed to separate direct effects of antistigma interventions from more general, indirect influences on social distance.
2001年，世界精神病学协会的全球反耻辱项目“消除因精神分裂症产生的耻辱和歧视——打开大门”在德国启动。已证实一些针对特定目标人群消除耻辱的措施是成功的，但该项目在普通人群层面的有效性尚未得到检验。
在2001年开展多项反耻辱干预措施之前，委托一家专业调查机构在德国6个城市进行了一项代表性电话调查（N = 7225）。这些城市是根据反耻辱项目的实施情况（杜塞尔多夫、慕尼黑）、宣传项目（波恩、科隆；旨在提高对精神分裂症的早期识别）以及未实施任何项目（柏林、埃森）来选择的。2004年进行了一项面板设计随访调查（N = 4622）。评估了对精神分裂症的刻板印象、信念和态度，以及社会对精神分裂症患者的社会距离，即社会不同群体之间的距离，还有对反耻辱项目的了解情况。
总体而言，2001年至2004年间社会距离显著降低（p = 0.001）。在城市层面，这种影响仅在实施了反耻辱项目的城市中显著（p < 0.001），尽管观察到态度变化很小。在实施了反耻辱项目的城市中，社会距离主要在社会距离子量表“短暂社会关系”中降低（p < 0.001），但在“亲密社会关系”子量表中没有降低。在未实施反耻辱项目的城市中，两个子量表均无显著变化。
本研究为德国反耻辱干预措施在人群层面的有效性提供了有限证据。需要进一步研究以区分反耻辱干预措施的直接效果与对社会距离更普遍、间接的影响。
