Department of Psychiatry and Psychotherapy, University Hospital of Muenster, Muenster, Germany.
Klinik am Schlossgarten, Duelmen, Germany.
Psychiatry Res. 2018 Mar;261:391-399. doi: 10.1016/j.psychres.2018.01.012. Epub 2018 Jan 9.
Negative attitudes towards medication in schizophrenia patients are one major factor contributing to non-adherence behavior. Besides, self-stigmatization represents another frequent and important obstacle in patients suffering from psychotic disorders. Here, we investigated possible associations between medication adherence attitude and the extent of self-stigmatization, while also exploring factors related to self-stigmatization. Sociodemographic characteristics, clinical variables, medication attitude and self-stigmatization were assessed among 81 subjects with schizophrenia or schizoaffective disorder. The cross-sectional data was then analyzed by multivariate analyses. A more positive attitude towards medication was predicted by better insight into illness, lower degree of self-stigmatization and good subjective knowledge about medication (adjusted R = 0.23). Furthermore, a higher level of self-stigmatization was associated with lower subjective wellbeing, more severe depressive symptoms and male gender (adjusted R = 0.58). Other clinical variables had no additional predictive value for medication adherence attitude or the extent of self-stigmatization. Our findings support the notion that self-stigmatization is an influential factor on medication attitude that should therefore be appreciated in clinical practice. Besides this, special emphasis should be taken on depressive symptoms and reduced wellbeing, especially in male patients, to lower the extent of self-stigmatization.
精神分裂症患者对药物治疗的负面态度是导致不依从行为的一个主要因素。此外，自我污名化是精神病患者经常面临的另一个重要障碍。在这里，我们研究了药物治疗依从态度与自我污名化程度之间的可能关联，同时还探讨了与自我污名化相关的因素。我们评估了 81 名精神分裂症或分裂情感障碍患者的人口统计学特征、临床变量、药物治疗态度和自我污名化程度。然后通过多元分析对横断面数据进行了分析。对疾病有更好的洞察力、自我污名化程度较低以及对药物治疗有良好的主观认识，这预示着对药物治疗的态度会更加积极（调整后的 R = 0.23）。此外，较高的自我污名化程度与较低的主观幸福感、更严重的抑郁症状和男性性别有关（调整后的 R = 0.58）。其他临床变量对药物治疗态度或自我污名化程度没有额外的预测价值。我们的研究结果支持这样一种观点，即自我污名化是影响药物治疗态度的一个因素，因此在临床实践中应该重视这一点。除此之外，还应特别关注抑郁症状和幸福感降低的问题，尤其是在男性患者中，以降低自我污名化的程度。
