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精神分裂症患者的内化污名:与社会人口学、临床和药物相关特征的关系。

Internalized stigma among people with schizophrenia: Relationship with socio-demographic, clinical and medication-related features.

机构信息

Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Department of Mental Health, Salerno, Italy.

出版信息

Schizophr Res. 2022 May;243:364-371. doi: 10.1016/j.schres.2021.06.007. Epub 2021 Jun 25.

DOI:10.1016/j.schres.2021.06.007
PMID:34183209
Abstract

BACKGROUND

People with schizophrenia are at high risk of suffering from stigma and internalizing it. Recently, a better understanding of the stigma process has shifted the attention from public stigma to self-stigma, which is deeply debilitating. This study aimed to assess factors associated to self-stigma by evaluating socio-demographic, clinical and treatment-related variables in a group of subjects diagnosed with schizophrenia and to identify predictors of high internalized stigma.

METHODS

Ninety-four inpatients accessing rehabilitative centers with a diagnosis of schizophrenia were included in this cross-sectional study. Measures included both patient-rated scales, assessing internalized stigma, attitude toward medications, side effects experience and subjective well-being, and clinician-rated scales, assessing schizophrenia symptoms and global clinical severity and antipsychotic-related side effects.

RESULTS

Twenty-one patients (22.3%) showed high internalized stigma while 73 (77.7%) did not. Patients experiencing more medication adverse effects and worse subjective well-being were more likely to suffer from internalized stigma according to a logistic regression analysis. Extrapyramidal, psychic and some autonomic reactions also emerged as individual predictors of self-stigma in a separate regression analysis.

CONCLUSIONS

Self-stigma and subjective medication side effects perception represent a relevant issue in patients' life and should be carefully taken into account in clinical practice.

摘要

背景

精神分裂症患者面临较高的受污名化及内化污名的风险。最近,对污名化过程的深入理解,使人们的关注点从公众污名化转移到了自我污名化,后者具有严重的致残性。本研究旨在评估一组精神分裂症患者的社会人口学、临床和治疗相关变量与自我污名化的相关性,并确定高内化污名的预测因素。

方法

本横断面研究纳入了 94 名在康复中心接受治疗的精神分裂症住院患者。研究采用了患者自评量表,评估内化污名、对药物的态度、药物副作用体验和主观幸福感,以及临床医生评定量表,评估精神分裂症症状、总体临床严重程度和抗精神病药物相关的副作用。

结果

21 名患者(22.3%)表现出较高的内化污名,而 73 名患者(77.7%)则没有。根据逻辑回归分析,经历更多药物不良反应和较差主观幸福感的患者更有可能受到内化污名的困扰。在另一项回归分析中,锥体外系、精神和一些自主反应也成为自我污名的个体预测因素。

结论

自我污名化和主观药物副作用感知是患者生活中的一个重要问题,在临床实践中应予以重视。