Uchino Toshiro, Maeda Masaharu, Uchimura Naohisa
Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.
Kurume Med J. 2012;59(1-2):25-31. doi: 10.2739/kurumemedj.59.25.
Previous studies suggest that self-stigma is related to social isolation and discrimination. Although it is known that stigma has cultural and social impacts, only a few studies in Japan have explored self-stigma in people with schizophrenia. The present study was conducted to investigate self-stigma in people with schizophrenia and schizoaffective disorder in Japan under a typical clinical setting, and to examine the effect of psychoeducation on self-stigma. Fifty-six participants (44 men and 12 women) who met the DSM-IV criteria for schizophrenia and schizoaffective disorder were recruited. All participants completed several questionnaires including social distance scale. Collected data were classified into an experiential or non-experiential group according to hospital records. The experiential group received psychoeducation which focused on reducing self-stigma by correcting inaccurate ideas about schizophrenia, and the relation between schizophrenia and criminal activity or violence, by watching videotapes and analyzing data from a report published by the National Police Agency. After the intervention, participants completed the Japanese version of the Social Distance Scale (SDS-J), the Knowledge of Illness and Drugs Inventory (KIDI) questionnaire, the Drug Attitude Inventory 10 (DAI-10), and the Birchwood's Psychosis Insight Scale (BPIS). In addition Global Assessment of Functioning Scale (GAF) scores were calculated for each participant. Significant differences between the 2 groups were observed for the SDS-J, KIDI, and BPIS (P<0.01 for each). However, no significant differences were observed for the DAI-10, GAF, age, and duration of treatment. The results of a path analysis showed that increasing knowledge about schizophrenia and its treatment might play an important role in reducing the self-stigma associated with this disease. When performing psychoeducation for people with schizophrenia and schizoaffective disorder, we need to discuss the pervasive effects of stigma and discrimination.
以往的研究表明,自我污名与社会隔离和歧视有关。虽然已知污名具有文化和社会影响,但在日本只有少数研究探讨了精神分裂症患者的自我污名。本研究旨在调查日本典型临床环境下精神分裂症和分裂情感性障碍患者的自我污名,并检验心理教育对自我污名的影响。招募了56名符合《精神疾病诊断与统计手册》第四版(DSM-IV)精神分裂症和分裂情感性障碍标准的参与者(44名男性和12名女性)。所有参与者都完成了包括社会距离量表在内的几份问卷。收集的数据根据医院记录分为体验组或非体验组。体验组接受了心理教育,通过观看录像带和分析国家警察厅发布的一份报告中的数据,重点纠正对精神分裂症的错误观念以及精神分裂症与犯罪活动或暴力之间的关系,以减少自我污名。干预后,参与者完成了日语版的社会距离量表(SDS-J)、疾病与药物知识量表(KIDI)问卷、药物态度量表10(DAI-10)和伯奇伍德精神病洞察力量表(BPIS)。此外,还计算了每位参与者的功能总体评定量表(GAF)得分。两组在SDS-J、KIDI和BPIS上观察到显著差异(每项P<0.01)。然而,在DAI-10、GAF、年龄和治疗持续时间方面未观察到显著差异。路径分析结果表明,增加对精神分裂症及其治疗的了解可能在减少与该疾病相关的自我污名方面发挥重要作用。在对精神分裂症和分裂情感性障碍患者进行心理教育时,我们需要讨论污名和歧视的普遍影响。