Szcześniak Dorota, Kobyłko Agnieszka, Wojciechowska Irena, Kłapciński Michał, Rymaszewska Joanna
Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry,
Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
Neuropsychiatr Dis Treat. 2018 Oct 8;14:2599-2608. doi: 10.2147/NDT.S169051. eCollection 2018.
The aim of this study was to investigate the perceived level of internalized stigma among patients with severe mental illnesses and its relationship with demographic and clinical variables in Poland.
A study sample (n=114, mean age=42.46±14.1 years; 55% of females) consisting of patients with nonorganic psychotic disorders as well as unipolar and bipolar affective disorders was evaluated (58% of outpatients and 39% of inpatients). All patients filled in the Internalized Stigma of Mental Illness (ISMI) scale (maximum severity=4). The demographic and clinical data were collected.
The study population demonstrated a mild level of internalized stigma (2.23±0.5). The highest score was observed in the alienation domain (2.63±0.8) and reflected moderate severity. The lowest score was noted in the stereotype endorsement domain (2.08±0.6). Moreover, the highest degree of internalized stigma was present in participants with unipolar affective disorder and was of moderate severity (2.46±0.6), while the level was moderate in the alienation domain (2.85±0.8). The level of vocational training education was the only variable associated with higher internalized stigma (=0.02). There were no associations between gender, employment, and marital status and internalized stigma. The duration of the disease was the only clinical factor showing a significant positive correlation with stigma internalization (=0.23; =0.01). The number of hospital admissions and suicide attempts was not significantly correlated with internalized stigma.
People with severe mental illnesses in Poland experience a mild level of self-reported internalized stigma. Internalized stigmatization was most strongly associated with alienation, which indicates the need for stigma assessment procedures followed by stigma intervention programs in daily clinical practice. This is in accordance with the trend of environmental "open door" psychiatry, which could be the first step to decrease the level of stigma and internalized stigma in psychiatric patients in Poland.
本研究旨在调查波兰严重精神疾病患者内化耻辱感的感知水平及其与人口统计学和临床变量的关系。
对一组研究样本（n = 114，平均年龄 = 42.46±14.1岁；55%为女性）进行评估，样本包括非器质性精神障碍患者以及单相和双相情感障碍患者（58%为门诊患者，39%为住院患者）。所有患者填写了精神疾病内化耻辱感（ISMI）量表（最高严重程度 = 4）。收集了人口统计学和临床数据。
研究人群表现出轻度的内化耻辱感（2.23±0.5）。在疏离领域观察到最高分（2.63±0.8），反映出中度严重程度。在刻板印象认同领域得分最低（2.08±0.6）。此外，单相情感障碍参与者的内化耻辱感程度最高，为中度严重（2.46±0.6），而在疏离领域该水平为中度（2.85±0.8）。职业培训教育水平是与较高内化耻辱感相关的唯一变量（P = 0.02）。性别、就业状况和婚姻状况与内化耻辱感之间无关联。疾病持续时间是唯一与耻辱感内化呈显著正相关的临床因素（r = 0.23；P = 0.01）。住院次数和自杀未遂次数与内化耻辱感无显著相关性。
波兰的严重精神疾病患者自我报告的内化耻辱感水平较轻。内化耻辱感与疏离感关联最为紧密，这表明在日常临床实践中需要进行耻辱感评估程序，随后开展耻辱感干预项目。这与环境友好型“开放门”精神病学的趋势相符，这可能是降低波兰精神病患者耻辱感和内化耻辱感水平的第一步。
