Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
Zigong Affiliated Hospital of Southwest Medical University, Zigong Psychiatric Research Center, Zigong, China.
Int J Soc Psychiatry. 2024 Aug;70(5):957-966. doi: 10.1177/00207640241245932. Epub 2024 Apr 14.
Few studies have examined whether social support contributes to better consequences among chronic patients with severe mental illnesses (SMI) in their community recovery stage and whether self-stigma would be a mechanism through which social support impacts psychiatric symptoms and personal and social functioning.
This study aimed to examine prospective associations of social support with long-term self-stigma, psychiatric symptoms, and personal and social functioning, and to investigate whether self-stigma would mediate the associations of social support with psychiatric symptoms and personal and social functioning among patients with SMI.
A total of 312 persons with SMI (schizophrenia and bipolar disorder) in their community recovery stage participated in the study. Social support, self-stigma, psychiatric symptoms, and personal and social functioning were evaluated at baseline. The follow-up assessment was conducted at 6 months with the baseline measures except for social support. Hierarchical linear regression and mediation analysis were performed.
The results showed that baseline social support predicted decreases in stigma (β = -.115, = .029) and psychiatric symptoms (β = -.193, < .001), and increases in personal and social functioning (β = .134, = .008) over 6 months, after adjusting for relevant covariates. Stigma at 6 months partially mediated the association between baseline social support and 6-month psychiatric symptoms (indirect effect: β = -.043, CI [-0.074, -0.018]). Stigma and psychiatric symptoms at 6 months together mediated the association between baseline social support and 6-month personal and social functioning (indirect effect: β = .084, 95% CI [0.029, 0.143]).
It is necessary to provide comprehensive social support services and stigma reduction interventions at the community level to improve the prognosis of SMI.
很少有研究考察社会支持是否会对处于社区康复阶段的慢性严重精神疾病（SMI）患者产生更好的结果，以及自我污名是否是社会支持影响精神症状和个人及社会功能的一种机制。
本研究旨在检验社会支持与长期自我污名、精神症状、个人及社会功能之间的前瞻性关联，并探讨自我污名是否在 SMI 患者的社会支持与精神症状及个人和社会功能之间的关联中起中介作用。
共有 312 名处于社区康复阶段的 SMI（精神分裂症和双相情感障碍）患者参与了本研究。在基线时评估了社会支持、自我污名、精神症状和个人及社会功能。除社会支持外，在 6 个月时进行了随访评估。采用分层线性回归和中介分析。
结果显示，在调整了相关协变量后，基线社会支持预测了 6 个月时的污名（β=-.115， =.029）和精神症状（β=-.193， <.001）减少，以及个人和社会功能（β=.134， =.008）增加。6 个月时的污名部分中介了基线社会支持与 6 个月时精神症状之间的关联（间接效应：β=-.043，CI [-0.074，-0.018]）。6 个月时的污名和精神症状共同中介了基线社会支持与 6 个月时个人和社会功能之间的关联（间接效应：β=.084，95%CI [0.029，0.143]）。
有必要在社区层面提供全面的社会支持服务和减少污名化干预，以改善 SMI 的预后。
