Department of Behavioral Sciences and Health Education, Rollins School of Public Health of Emory University, Atlanta, Georgia, USA.
Early Interv Psychiatry. 2010 Feb;4(1):47-56. doi: 10.1111/j.1751-7893.2009.00155.x.
A longer duration of untreated psychosis (DUP) is associated with greater morbidity in the early course of schizophrenia. This formative, hypothesis-generating study explored the effects of stigma, as perceived by family members, on DUP.
Qualitative interviews were conducted with 12 African American family members directly involved in treatment initiation for a relative with first-episode psychosis. Data analysis relied on a grounded theory approach. A testable model informed by constructs of Link's modified labelling theory was developed.
Four main themes were identified, including: (i) society's beliefs about mental illnesses; (ii) families' beliefs about mental illnesses; (iii) fear of the label of a mental illness; and (iv) a raised threshold for the initiation of treatment. A grounded theory model was developed as a schematic representation of the themes and subthemes uncovered in the family members' narratives.
The findings suggest that due to fear of the official label of a mental illness, certain coping mechanisms may be adopted by families, which may result in a raised threshold for treatment initiation, and ultimately treatment delay. If the relationships within the grounded theory model are confirmed by further qualitative and quantitative research, public educational programs could be developed with the aim of reducing this threshold, ultimately decreasing DUP.
未治疗精神病期（DUP）较长与精神分裂症早期发病的更高发病率相关。这项形成性的、假说产生的研究探讨了家庭成员所感知的污名对 DUP 的影响。
对直接参与首发精神病患者治疗启动的 12 名非裔美国家庭成员进行了定性访谈。数据分析依赖于扎根理论方法。根据 Link 的改良标签理论的结构，开发了一个可测试的模型。
确定了四个主要主题，包括：（i）社会对精神疾病的信念；（ii）家庭对精神疾病的信念；（iii）对精神疾病标签的恐惧；以及（iv）治疗开始的门槛提高。作为家庭成员叙述中发现的主题和子主题的示意性表示，开发了一个扎根理论模型。
研究结果表明，由于对精神疾病官方标签的恐惧，家庭可能会采用某些应对机制，这可能导致治疗启动的门槛提高，最终导致治疗延误。如果进一步的定性和定量研究证实了扎根理论模型中的关系，那么可以开发公众教育计划，以降低这一门槛，最终减少 DUP。
