Department of Health Education and Behavioral Sciences, Jimma University, Jimma, Ethiopia.
CIHLMU Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany.
Int J Ment Health Syst. 2013 Sep 3;7(1):21. doi: 10.1186/1752-4458-7-21.
Self stigma among people with mental illness results from multiple cognitive and environmental factors and processes. It can negatively affect adherence to psychiatric services, self esteem, hope, social integration and quality of life of people with mental illness. The purpose of this study was to measure the level of self stigma and its correlates among people with mental illness at Jimma University Specialized Hospital, Psychiatry clinic in southwest Ethiopia.
Facility based cross-sectional study was conducted on 422 consecutive samples of people with mental illness using interviewer administered and pretested internalized stigma of mental illness (ISMI) scale. Data was entered using EPI-DATA and analysis was done using STATA software. Bivariate and multivariate linear regressions were done to identify correlates of self stigma.
On a scale ranging from 1 to 4, the mean self stigma score was 2.32 (SD = 0.30). Females had higher self stigma (std. β = 0.11, P < 0.05) than males. Patients with a history of traditional treatment had higher self stigma (std. β = 0.11, P < 0.05). There was an inverse relationship between level of education and self-stigma (std. β = -0.17, P < 0.01). Perceived signs (std. β = 0.13, P < 0.05) and supernatural causes of mental illness (std. β = 0.16, P < 0.01) were positively correlated with self stigma. Higher number of drug side effects were positively correlated (std. β = 0.15, P < 0.05) while higher self esteem was negatively correlated (std. β = -0.14, P < 0.01) with self stigma.
High feeling of inferiority (alienation) but less agreement with common stereotypes (stereotype endorsement) was found. Female showed higher self stigma than male. History of traditional treatment and higher perceived supernatural explanation of mental illness were associated with higher self stigma. Drug side effects and perceived signs of mental illness were correlated with increased self stigma while education and self esteem decreased self stigma among people with mental illness. Patient empowerment psychosocial interventions and strategies to reduce drug side effects can be helpful in reducing self stigma among people with mental illnesses.
精神疾病患者的自我污名是由多种认知和环境因素及过程共同作用的结果。它会对患者对精神科服务的依从性、自尊心、希望、社会融合和生活质量产生负面影响。本研究的目的是测量埃塞俄比亚西南部吉姆马大学专科医院精神病学诊所精神疾病患者的自我污名程度及其相关因素。
采用访谈者管理和预测试的内化精神疾病污名量表（ISMI）对 422 例连续精神疾病患者进行基于机构的横断面研究。数据使用 EPI-DATA 录入，使用 STATA 软件进行分析。采用双变量和多变量线性回归来确定自我污名的相关因素。
在 1 到 4 的范围内，自我污名的平均得分为 2.32（标准差=0.30）。女性的自我污名程度高于男性（标准β=0.11，P<0.05）。有传统治疗史的患者自我污名程度更高（标准β=0.11，P<0.05）。教育程度与自我污名呈负相关（标准β=-0.17，P<0.01）。感知症状（标准β=0.13，P<0.05）和精神疾病的超自然原因（标准β=0.16，P<0.01）与自我污名呈正相关。更多的药物副作用与自我污名呈正相关（标准β=0.15，P<0.05），而更高的自尊心与自我污名呈负相关（标准β=-0.14，P<0.01）。
发现患者存在高度的自卑感（异化感），但对常见的刻板印象认同度较低（刻板印象认可）。女性的自我污名程度高于男性。传统治疗史和更高的精神疾病超自然解释与更高的自我污名相关。药物副作用和感知到的精神疾病症状与自我污名增加相关，而教育程度和自尊心降低了精神疾病患者的自我污名。赋予患者权力的心理社会干预和减少药物副作用的策略可能有助于减少精神疾病患者的自我污名。
