Indirect self-destructiveness in women with schizophrenia

Abstract

Background: Many authors emphasise the influence of gender differences on mental health and the course and experience of mental illness, and/or postulate a gendered perspective in mental health research. Research holistically considering indirect selfdestructiveness in women with schizophrenia is hard to find in the international literature; studies have been performed on the sole basis of some discrete manifestations of indirect self-destructiveness. Aim: The aim of this study was to explore the indirect self-destructiveness syndrome and its categories in women with schizophrenia. Method: A group of 125 women with paranoid schizophrenia, aged 27–57, were examined by using the Polish version of the Chronic Self-Destructiveness Scale (CS-DS); for comparison, a group of 175 men with schizophrenia and a sociodemographically well-matched group of 125 healthy women were examined. Results: The intensity of indirect self-destructiveness and most of its categories were found to be greater in the group of women with schizophrenia compared to men with schizophrenia (transgression, poor health maintenance, personal and social neglects) and healthy women (transgression, personal and social neglects, lack of planfulness, helplessness). Nevertheless, women with schizophrenia displayed signs of better psychosocial adjustment than schizophrenic men. Conclusions: Comprehensive therapeutic, i.e. psychiatric, psychological and social, interventions should serve to enhance the “self ” defence and self-care functions, and improve the evaluation of adequacy and efficiency in women with schizophrenia. Working with such patients towards increasing their life satisfaction, although life did not spare them suffering, seems to be equally important in (psycho) therapy. The mobilisation and orientation of their actions towards those in favour of their development and health appear as crucial.