Experiences of Stigma among Outpatients with Psychotic Illnesses in a Tertiary Hospital

Abstract

Background: Studies in most parts of the world, which have included persons with a mental illness in general and those with psychotic illnesses in particular conclusively show that they experience being stigmatized. These responses are seen as a major obstacle to recovery limiting opportunities and undermining self-esteem of people with mental illnesses. There is a conspicuous absence of this in the Indian context. This study assessed the nature and degree of stigma experienced by the persons with a psychotic disorder and examined its relationship with various clinical and demographic characteristics. Methods: The sample comprised of 100 consecutive remitted adults with a psychotic disorder as per DCR, ICD-10 attending outpatient services. Stigma was assessed using Wahl’s self-administered stigma questionnaire. After computing a composite score, groups experiencing ‘high’ stigma were differentiated from those having ‘low’ stigma scores on the basis of the median. Results: Results showed that participants tend to conceal their disorders, worry of being treated unfavorably, were treated as less competent and experienced offensive media portrayals of mental illness. Lower educational levels and history of psychiatric illness in the family significantly related with higher degrees of stigma. Conclusions: The findings of this study may be seen as a serious call for sustained attention to issues related to stigma as a central and powerful experience among those with a psychotic illness in the Indian context. Those who have another family member suffering from a psychiatric illness, and having lower levels of education should be particularly assessed and managed for stigma during routine outpatient evaluations. Keywords: Stigmatizing experiences, psychosis, outpatients, tertiary hospital