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我根本不想让任何人知道我有精神病:早期发病的精神病青少年如何应对污名化。

I Didn't Want the Psychotic Thing to Get Out to Anyone at All: Adolescents with Early Onset Psychosis Managing Stigma.

机构信息

Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark.

Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.

出版信息

Cult Med Psychiatry. 2024 Sep;48(3):569-590. doi: 10.1007/s11013-024-09859-3. Epub 2024 Jun 13.

DOI:10.1007/s11013-024-09859-3
PMID:38869653
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11362372/
Abstract

The impact of stigmatisation on adults with mental illnesses has been thoroughly demonstrated. However, little is known about experiences of stigmatisation among adolescents with mental illness. Through semi-structured interviews with 34 Danish adolescents (14-19 years) diagnosed with psychosis, this study explores adolescents' experiences of psychosis stigma. On the basis of phenomenological analysis, we find that stigmatisation is widely experienced, and psychosis is generally regarded as more stigmatising than co-morbid mental illnesses. The participants engage in different strategies to manage possible stigma, especially strategies of (non-)disclosure. Disclosure is experienced as both therapeutic and normative, but also bears the risk of stigmatisation, and is therefore associated with numerous considerations. Being understood when disclosing is central to the participants, and lack of understanding from others is a continuous challenge. Nevertheless, participants experience benefits when feeling understood by people they confide in and can to a degree create the grounds for this through centralising aspects of their experiences of psychosis and mental illness. We argue that disclosure is both a stigma management strategy and a normative imperative, and that being understood or not is a challenge transcending stigma definitions.Clinical trial registration: Danish Health and Medicines Authority: 2612-4168. The Ethics Committee of Capital Region: H-3-2009-123. ClinicalTrials.gov: NCT01119014. Danish Data Protection Agency: 2009-41-3991.

摘要

污名化对成年精神疾病患者的影响已得到充分证实。然而,对于青少年精神疾病患者的污名化体验,我们知之甚少。通过对 34 名丹麦青少年(14-19 岁)的半结构化访谈,这些青少年被诊断为精神病,本研究探讨了青少年对精神病污名的体验。基于现象学分析,我们发现污名化现象普遍存在,精神疾病普遍被认为比共病精神疾病更具污名化。参与者采用不同的策略来管理可能的污名,特别是披露策略。披露既具有治疗性又具有规范性,但也存在污名化的风险,因此需要考虑很多因素。在披露时被理解对参与者来说至关重要,而得不到他人的理解则是一个持续的挑战。然而,当参与者感到被他们信任的人理解时,他们会从中受益,并且可以在一定程度上通过将他们的精神病和精神疾病经历的某些方面中心化来创造这种理解的基础。我们认为,披露既是一种污名管理策略,也是一种规范性要求,而被理解或不被理解是一个超越污名定义的挑战。临床试验注册:丹麦卫生和药品管理局:2612-4168。首都地区伦理委员会:H-3-2009-123。ClinicalTrials.gov:NCT01119014。丹麦数据保护局:2009-41-3991。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b6b/11362372/6e9134077d2c/11013_2024_9859_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b6b/11362372/3eefe6dbb8a5/11013_2024_9859_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b6b/11362372/6e9134077d2c/11013_2024_9859_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b6b/11362372/3eefe6dbb8a5/11013_2024_9859_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b6b/11362372/6e9134077d2c/11013_2024_9859_Fig2_HTML.jpg

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Eur Psychiatry. 2022 Nov 4;65(1):e78. doi: 10.1192/j.eurpsy.2022.2337.
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Stigma towards people with mental illness in the Nordic countries - a scoping review.北欧国家对精神疾病患者的污名化——一项范围综述
Nord J Psychiatry. 2023 May;77(4):319-328. doi: 10.1080/08039488.2022.2105946. Epub 2022 Aug 5.
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On the definition of stigma.污名的定义。
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Intracranial and subcortical volumes in adolescents with early-onset psychosis: A multisite mega-analysis from the ENIGMA consortium.青少年首发精神病患者的颅内和皮质下容积:来自 ENIGMA 联盟的多中心大型分析。
Hum Brain Mapp. 2022 Jan;43(1):373-384. doi: 10.1002/hbm.25212. Epub 2020 Oct 5.
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Should we be concerned about stigma and discrimination in people at risk for psychosis? A systematic review.我们是否应该关注有精神病风险的人群中的污名化和歧视问题?一项系统性综述。
Psychol Med. 2020 Apr;50(5):705-726. doi: 10.1017/S0033291720000148. Epub 2020 Feb 17.
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