Fung Kelvin M T, Tsang Hector W H, Corrigan Patrick W
Department of Rehabilitation Sciences.
Institute of Psychology.
Psychiatr Rehabil J. 2008 Fall;32(2):95-104. doi: 10.2975/32.2.2008.95.104.
Treatment non-adherence has frequently been noticed among people with schizophrenia. Self-stigma towards one's mental illness is believed to be a contributing factor undermining adherence. This study aimed at obtaining empirical support regarding the relationship between psychosocial treatment adherence and self-stigma. Other significant predictors of adherence to psychosocial interventions were to be identified.
Eighty-six people with DSM IV diagnoses of schizophrenia were recruited from psychiatric hospitals and community settings in Hong Kong. Their level of stigma, self-esteem, self-efficacy, insight, psychosocial treatment adherence and demographic data were collected. Multiple regression was used to investigate the adjusted relationship between psychosocial treatment adherence and the selected independent variables.
Higher level of self-stigma, poorer current insight on the social consequences of having mental illness, and living with others were found to be significant predictors of poor psychosocial treatment attendance. Better self-esteem and current insight about the negative social consequences were significant predictors of better psychosocial treatment participation. Self-stigma and self-esteem exhibited the strongest contributions to psychosocial treatment adherence.
Self-stigmatization is associated with the level of treatment adherence among people with schizophrenia, and its negative effect was found to intensify along the self-stigmatization process. Further studies to enhance understanding of self-stigma and improve treatment adherence are suggested.
精神分裂症患者中治疗不依从现象屡见不鲜。对自身精神疾病的自我污名化被认为是破坏依从性的一个促成因素。本研究旨在获得关于心理社会治疗依从性与自我污名化之间关系的实证支持。还将确定依从心理社会干预的其他重要预测因素。
从香港的精神病医院和社区环境中招募了86名符合DSM-IV精神分裂症诊断标准的患者。收集了他们的污名化程度、自尊、自我效能感、洞察力、心理社会治疗依从性和人口统计学数据。采用多元回归分析来研究心理社会治疗依从性与所选自变量之间的校正关系。
较高的自我污名化水平、对患有精神疾病的社会后果当前洞察力较差以及与他人同住被发现是心理社会治疗出勤率低的重要预测因素。较好的自尊和对负面社会后果的当前洞察力是心理社会治疗参与度较高的重要预测因素。自我污名化和自尊对心理社会治疗依从性的影响最为显著。
自我污名化与精神分裂症患者的治疗依从性水平相关，并且发现其负面影响在自我污名化过程中会加剧。建议进一步开展研究，以加深对自我污名化的理解并提高治疗依从性。
