Stigma experiences and perceived stigma in patients with first-episode schizophrenia in the course of 1year after their first in-patient treatment

Abstract

Patients with schizophrenia suffer from stigma and discrimination due to their illness. Yet it is not well examined how experiences of stigma and discrimination express at the early illness stage and how they develop subsequently. Therefore, clinical and psycho-social correlates of stigma experiences and perceived stigma are analyzed in patients with first-episode schizophrenia over the course of 1year after their first in-patient treatment. Questionnaire data assessed within the multi-centre-RCT First-Episode Study of the German Research Network on Schizophrenia were analyzed. Patients with first-episode schizophrenia were assessed 8weeks after their first in-patient treatment (post-acute assessment) and 1year later. N=48 (post-acute) and N=24 (1-year follow-up) patients provided questionnaire data appropriate for analyses, with N=12dyads. These data included burden due to stigma experiences (B-STE), perceived stigma (PDDQ), clinical (PANSS, CDSS, CGI, GAF, SAS) and psycho-social factors (LQLP, FSNK-self-esteem, KK-Scale). Cross-lag-correlation models showed a causal relation between stigma experiences (post-acute) and reduced self-esteem after 1year. Multiple regression models revealed different models for experienced and perceived stigma. Factors associated with higher stigma experiences were older age, worse clinical global impression, better social adjustment, lower self-esteem, and the belief that illness is not driven by chance or fate. The different associations between psycho-social factors and stigma experiences and perceived stigma demonstrate the complexity of this inter-relationship. The results have practical implications for psycho-educational and other therapeutic interventions addressing stigma coping. Since the sample was small and selective, replication studies are needed.