Gonzales Lauren, Saperstein Alice M, Qian Min, Gorecki Adam, Medalia Alice
Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, United States; New York State Office of Mental Health, New York, NY, United States.
Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, United States; New York State Office of Mental Health, New York, NY, United States.
Psychiatry Res. 2024 Dec;342:116233. doi: 10.1016/j.psychres.2024.116233. Epub 2024 Oct 19.
Schizophrenia is the most strongly stigmatized psychiatric diagnosis, with negative stereotypes including assumptions of incompetence and inability to recover. Individuals with cognitive impairment associated with schizophrenia (CIAS) have reported stigma experiences, suggesting that CIAS carries stigma in addition to the stigma associated with schizophrenia as a diagnostic label. While research has established that mental illness stigma more generally is linked with poor psychiatric and functional outcomes, no research has explored correlates of CIAS stigma. This study evaluated cognitive, psychiatric, and functional correlates of CIAS stigma among 54 individuals with schizophrenia spectrum disorders participating in a cognitive remediation trial. Participants with greater estimated cognitive decline reported higher levels of CIAS stigma experiences. Participants who reported higher levels of CIAS stigma also scored higher on a measure of depressive symptom severity. No significant associations were found between CIAS stigma and positive and negative psychosis symptoms or general psychopathology ratings. CIAS stigma was not associated with performance-based functional capacity or ratings of community functioning. Findings suggest that CIAS stigma is linked with the degree of cognitive decline and depressive symptom severity among individuals with schizophrenia spectrum disorders. Additional research is needed to elucidate directionality and the relationship between CIAS stigma and functioning outcomes.
精神分裂症是最受污名化的精神疾病诊断，负面刻板印象包括认为患者无能且无法康复。患有与精神分裂症相关的认知障碍（CIAS）的个体报告了污名经历，这表明CIAS除了作为诊断标签与精神分裂症相关的污名之外，还带有污名。虽然研究已经确定，一般而言精神疾病污名与不良的精神和功能结果有关，但尚无研究探讨CIAS污名的相关因素。本研究评估了54名参与认知康复试验的精神分裂症谱系障碍患者中CIAS污名的认知、精神和功能相关因素。估计认知衰退程度较高的参与者报告的CIAS污名经历水平较高。报告CIAS污名水平较高的参与者在抑郁症状严重程度测量中得分也较高。未发现CIAS污名与阳性和阴性精神病症状或一般精神病理学评分之间存在显著关联。CIAS污名与基于表现的功能能力或社区功能评分无关。研究结果表明，CIAS污名与精神分裂症谱系障碍患者的认知衰退程度和抑郁症状严重程度有关。需要进一步的研究来阐明方向性以及CIAS污名与功能结果之间的关系。
