Singh Aakanksha, Mattoo Surendra K, Grover Sandeep
Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Psychiatry. 2016 Jul-Sep;58(3):291-300. doi: 10.4103/0019-5545.192024.
Very few studies from India have studied stigma experienced by patients with schizophrenia.
To study stigma in patients with schizophrenia (in the form of internalized stigma, perceived stigma and social-participation-restriction stigma) and its relationship with specified demographic and clinical variables (demographic variables, clinical profile, level of psychopathology, knowledge about illness, and insight).
Selected by purposive random sampling, 100 patients with schizophrenia in remission were evaluated on internalized stigma of mental illness scale (ISMIS), explanatory model interview catalog stigma scale, participation scale (P-scale), positive and negative syndrome scale for schizophrenia, global assessment of functioning scale, scale to assess unawareness of mental disorder, and knowledge of mental illness scale.
On ISMIS scale, 81% patients experienced alienation and 45% exhibited stigma resistance. Stereotype endorsement was seen in 26% patients, discrimination experience was faced by 21% patients, and only 16% patients had social withdrawal. Overall, 29% participants had internalized stigma when total ISMIS score was taken into consideration. On P-scale, 67% patients experienced significant restriction, with a majority reporting moderate to mild restriction. In terms of associations between stigma and sociodemographic variables, no consistent correlations emerged, except for those who were not on paid job, had higher participation restriction. Of the clinical variables, level of functioning was the only consistent predictor of stigma. While better knowledge about the disorder was associated with lower level of stigma, there was no association between stigma and insight.
Significant proportion of patients with schizophrenia experience stigma and stigma is associated with lower level of functioning and better knowledge about illness is associated with lower level of stigma.
来自印度的研究中，很少有对精神分裂症患者所经历的污名化现象进行研究的。
研究精神分裂症患者的污名化现象（以内化污名、感知污名和社会参与限制污名的形式）及其与特定人口统计学和临床变量（人口统计学变量、临床特征、精神病理学水平、疾病知识和自知力）之间的关系。
采用目的抽样法选取100例缓解期精神分裂症患者，使用精神疾病内化污名量表（ISMIS）、解释模型访谈目录污名量表、参与量表（P量表）、精神分裂症阳性和阴性症状量表、总体功能评估量表、精神障碍自知力评估量表以及精神疾病知识量表进行评估。
在ISMIS量表上，81%的患者经历了疏离感，45%的患者表现出污名抵抗。26%的患者认可刻板印象，21%的患者面临歧视经历，只有16%的患者有社交退缩。总体而言，考虑ISMIS总分时，29%的参与者有内化污名。在P量表上，67%的患者经历了显著限制，大多数报告为中度至轻度限制。在污名与社会人口统计学变量之间的关联方面，除了没有带薪工作的人有更高的参与限制外，没有出现一致的相关性。在临床变量中，功能水平是污名的唯一一致预测因素。虽然对疾病有更好的了解与较低水平的污名相关，但污名与自知力之间没有关联。
相当比例的精神分裂症患者经历污名化，污名与较低的功能水平相关，而对疾病有更好的了解与较低的污名水平相关。
