Sowislo Julia F, Lange Claudia, Euler Sebastian, Hachtel Henning, Walter Marc, Borgwardt Stefan, Lang Undine E, Huber Christian G
Universitäre Psychiatrische Kliniken (UPK), Wilhelm Klein-Str. 27, 4012, Basel, Switzerland.
Eur Arch Psychiatry Clin Neurosci. 2017 Jun;267(4):351-357. doi: 10.1007/s00406-016-0729-y. Epub 2016 Oct 19.
Background There is evidence for two different types and/or sources of mental illness stigma, namely the display of psychiatric symptoms and the use of psychiatric service institutions. However, no current study has compared the two. Furthermore, gaps exist in our knowledge of both types of stigma. Little is known about the perceived stigma of specific psychiatric service treatment environments, for instance forensic settings. In addition, systematic research on stigma attached to symptoms of personality disorders in the general population is scarce, and for borderline personality disorder, nonexistent. Methods We conducted a representative survey of the general population (N = 2207) in the canton of Basel-Stadt, Switzerland. Participants were asked to read a vignette depicting either the psychiatric symptoms of a fictitious character or a psychiatric service institution to which the character had been admitted, and indicate desired social distance (an indicator for stigma). Type of symptoms, type of psychiatric service, dangerousness, and gender were systematically varied between vignettes. Findings Desired social distance was significantly lower in relation to psychiatric service use than to psychiatric symptoms. Overall, symptoms of alcohol dependency, behavior endangering others, and the fictitious character's being male tend to increase stigmatization. Interestingly, the character's being hospitalized in a psychiatric unit at a general hospital and also respondent familiarity with psychiatric services tend to decrease stigmatization. Interpretation Familiarity of the general population with psychiatric patients should be increased. Furthermore, treatment in psychiatric units located within general hospitals should be promoted, as such treatment is associated with decreased stigma.
背景 有证据表明存在两种不同类型和/或来源的精神疾病污名，即精神症状的表现和精神科服务机构的使用。然而，目前尚无研究对两者进行比较。此外，我们对这两种污名的了解都存在差距。对于特定精神科服务治疗环境（如法医环境）的感知污名知之甚少。此外，关于一般人群中人格障碍症状所附着污名的系统研究很少，而关于边缘型人格障碍的此类研究则不存在。方法 我们在瑞士巴塞尔市进行了一项具有代表性的普通人群调查（N = 2207）。参与者被要求阅读一个 vignette，其中描绘了一个虚构角色的精神症状或该角色所入住的精神科服务机构，并指出期望的社会距离（污名的一个指标）。vignettes 之间系统地改变了症状类型、精神科服务类型、危险性和性别。结果 与精神科服务使用相比，与精神症状相关的期望社会距离显著更低。总体而言，酒精依赖症状、危害他人的行为以及虚构角色为男性往往会增加污名化。有趣的是，角色在综合医院精神科住院以及受访者对精神科服务的熟悉程度往往会减少污名化。解读 应提高普通人群对精神科患者的熟悉程度。此外，应推广在综合医院精神科进行治疗，因为这种治疗与污名减少相关。
