Stefano Barlati, Gabriele Nibbio, Lorenzo Bertoni, Irene Calzavara-Pinton, Donato Morena, Nicola Necchini, Stefano Paolini, Antonio Baglioni, Daniela Zardini, Laura Poddighe, Jacopo Lisoni, Giacomo Deste, Roger S McIntyre, Antonio Vita
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引用次数: 0
Abstract
Background: People living with schizophrenia often experience high levels of stigma and are consistently at risk of internalizing it. Internalized stigma has a negative impact on several clinical and recovery outcomes in people with schizophrenia, but the effect of internalized stigma on important patient reported outcomes that are gaining increasing scientific and clinical relevance, such as life engagement, has not yet been extensively investigated.
Aims: This study aims to investigate the relationship between several different socio-demographic, clinical, functional and medication-related variables and life engagement, with the hypothesis that internalized stigma, alongside other factors, could represent an individual predictor of reduced life engagement.
Methods: Ninety-four participants diagnosed with schizophrenia were included in this cross-sectional study and were investigated with validated instruments assessing life engagement, schizophrenia symptoms severity, global clinical severity, internalized stigma, psychosocial functioning, antipsychotic-related side effects, attitude toward medications, and subjective well-being. Predictors of life engagement were assessed using a stepwise multivariate linear regression analysis.
Results: Greater global clinical severity (β = .685, p < .001), fewer years of education (β = -.240, p < .001), and greater stigma endorsement (β = .180, p = .005) emerged as individual predictors of reduced patient life engagement, explaining a large proportion of the observed variance (Adjusted R2 = .649, p = .001).
Conclusions: Internalized stigma, among other well-recognized variables, appears to represent an individual predictor of worse patient life engagement in people living with schizophrenia. This finding should strengthen the notion that stigma, and internalized stigma in particular, represent important dimensions and treatment targets in the clinical management of schizophrenia, also in the perspective of improving patient-reported outcomes.
背景：精神分裂症患者经常经历高度的耻辱，并且始终存在将其内化的风险。内化耻辱感对精神分裂症患者的一些临床和康复结果有负面影响，但内化耻辱感对重要的患者报告结果的影响正在获得越来越多的科学和临床相关性，如生活参与度，尚未得到广泛的研究。目的：本研究旨在探讨几个不同的社会人口学、临床、功能和药物相关变量与生活投入之间的关系，并假设内化的耻辱感与其他因素一起可能代表生活投入降低的个体预测因子。方法：94名被诊断为精神分裂症的参与者被纳入这项横断面研究，并使用经过验证的工具进行调查，评估生活投入、精神分裂症症状严重程度、整体临床严重程度、内化耻辱、社会心理功能、抗精神病药物相关副作用、对药物的态度和主观幸福感。使用逐步多元线性回归分析评估生活投入的预测因子。结果：总体临床严重程度更高(β =。685、p p p =。005)成为患者生活参与度降低的个体预测因子，解释了观察到的大部分方差(调整后的R2 =。649, p = .001)。结论：在其他公认的变量中，内化的耻辱似乎代表了精神分裂症患者更糟糕的患者生活参与的个体预测因子。这一发现应该加强这样一种观念，即耻辱，特别是内化耻辱，在精神分裂症的临床管理中代表了重要的维度和治疗目标，也从改善患者报告结果的角度来看。
期刊介绍：
The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities.
Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas.
The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.
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