Catthoor K C E E R, Sabbe B G C, Dreesen T, Janssen F, Vandendriessche F, Steegen G, Matthys F, Matton C, Mertens C, Detraux J
Tijdschr Psychiatr. 2020;62(1):37-46.
Stigma is one of the greatest challenges facing people with severe mental illness (smi) and can have profound psychological, social and professional consequences.
AIM: To systematically review the evidence of effectiveness of anti-stigma interventions (anti-stigma campaigns and specific interventions to reduce public stigma and self-stigma) for people with smi and to make recommendations for clinical practice.
METHOD: A systematic literature search for individual studies and reviews concerning the efficacy of interventions that reduce stigma for people with smi.
RESULTS: Anti-stigma interventions have small-to-medium effects. Although head-to-head comparisons do not show a clear advantage for educational or contact interventions, results suggest that the elements of contact, recovery and continuity (for public stigma) and psycho-education (for self-stigma) may yield the greatest effects. Due to the short follow-up period of most studies, there is limited evidence on the long-term effectiveness of these interventions. More specifically, it remains unknown whether these interventions lead to changes in actual behavior.
CONCLUSION: Anti-stigma interventions have limited effects on knowledge, attitudes and behavior. Several methodological shortcomings, as well as short follow-up periods in most studies, preclude making firm conclusions.
污名化是重度精神疾病患者所面临的最大挑战之一,可能会产生深远的心理、社会和职业影响。
系统回顾针对重度精神疾病患者的反污名化干预措施(反污名化运动以及减少公众污名和自我污名的具体干预措施)有效性的证据,并为临床实践提出建议。
对关于减少重度精神疾病患者污名化干预措施疗效的个体研究和综述进行系统的文献检索。
反污名化干预措施具有中小程度的效果。尽管直接比较并未显示出教育或接触干预措施具有明显优势,但结果表明,接触、康复和持续性(针对公众污名)以及心理教育(针对自我污名)等要素可能产生最大效果。由于大多数研究的随访期较短,这些干预措施长期有效性的证据有限。更具体地说,这些干预措施是否会导致实际行为的改变仍不清楚。
反污名化干预措施对知识、态度和行为的影响有限。一些方法学上的缺陷以及大多数研究较短的随访期,使得难以得出确凿结论。