Challenging the stigma of schizophrenia

Villares, Cecília Cruz; Sartorius, Norman

doi:10.1590/s1516-44462003000100001

Cited by 17 publications

(6 citation statements)

References 1 publication

(1 reference statement)

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“…These consequences contribute to the disability produced by the disorder and establish a vicious circle of disadvantage increasing the burden on patients and their families. 4 Several studies on public stigma, undertaken in different countries, point to people with schizophrenia facing a great amount of stigma in society and also to schizophrenia being one of the mental disorders most stigmatized by the general population. [5][6][7][8][9] Even though public stigma towards schizophrenia can be a problem that affects the majority of countries and cultures, it is important to understand how it is built and manifested in specific cultural contexts.…”

Section: Public Stigma and Schizophreniamentioning

confidence: 99%

Public stigma and schizophrenia in São Paulo city

Peluso¹,

Blay²

2011

Rev. Bras. Psiquiatr.

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Objective: To assess public stigma in relation to people with schizophrenia and possible factors associated with this phenomenon. Method: A cross-sectional study was conducted with a probabilistic sample of 500 individuals who live in the city of São Paulo, Brazil, and are aged between 18 and 65 years. A structured questionnaire was used, and it was applied in person. Questionnaire began with the presentation of a vignette describing an individual with schizophrenia (according to DSM-IV and ICD-10 criteria). This was followed by questions that assessed perceived negative reactions and discrimination, perceived dangerousness and emotional reactions in relation to the case presented in the vignette. Results: People with schizophrenia were perceived as potentially dangerous by 74.2% of interviewees. In addition, 59.0% of the sample perceived them as capable of arousing negative reactions, and 57.2% as capable of arousing discrimination in society. However, emotional reactions reported by the interviewees themselves were mainly pro-social in nature. The most important factors associated with these responses were: attribution of "biological" causes and perceived dangerousness. Conclusion: This study indicated that beliefs related to public stigma towards people with schizophrenia are commonly held in São Paulo city. An important focus for future studies is to investigate the scope and impact of public stigma on the everyday experiences of people with schizophrenia in the Brazilian context. Descriptors

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Section: Public Stigma and Schizophreniamentioning

confidence: 99%

Public stigma and schizophrenia in São Paulo city

Peluso¹,

Blay²

2011

Rev. Bras. Psiquiatr.

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“…28 In addition, prejudice and discrimination related to schizophrenia have been observed to result in poor treatment compliance. 29 In a study about internalized stigma, Ritsher and Phelan 12 found that alienation predicted depressive symptoms and reduced self-esteem, suggesting that it may be very difficult for individuals to escape, without assistance, a vicious circle of low self-esteem and alienation negatively impacting on each other. 12 Awareness of illness may result in better functional outcome, but if awareness is accompanied by acceptance of stigmatizing beliefs, greater social dysfunction, less hope, and lower self-esteem become more likely.…”

Section: Course and Outcomementioning

confidence: 99%

“…33,34 Finally, there is evidence that prejudice and discrimination related to schizophrenia result in an increased probability of misuse of alcohol and drugs. 29 Stigmatization can have detrimental consequences for both objective and subjective quality of life (QOL). Attributing one's problems to a mental illness is associated with reduced subjective QOL among persons with schizophrenia, much of which may be mediated by perceived stigma and lower self-esteem.…”

Section: Course and Outcomementioning

confidence: 99%

Stigmatization as an Environmental Risk in Schizophrenia: A User Perspective

Zelst

2009

Schizophrenia Bulletin

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Stigmatization represents a chronic negative interaction with the environment that most people with a diagnosis of schizophrenia face on a regular basis. Different types of stigma-public stigma, self--stigma, and label avoidance--may each have detrimental effects. In the present article, the possible consequences of stigma on onset, course, and outcome of schizophrenia are reviewed. Stigmatization may be conceptualized as a modifiable environmental risk factor that exerts its influence along a variety of different pathways, not only after the illness has been formally diagnosed but also before, on the basis of subtle behavioral expressions of schizophrenia liability. Integrating stigma-coping strategies in treatment may represent a cost-effective way to reduce the risk of relapse and poor outcome occasioned by chronic exposure to stigma. In addition, significant gains in quality of life may result if all patients with schizophrenia routinely receive information about stigma and are taught to use simple strategies to increase resilience vis-à-vis adverse, stigmatizing environments.

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“…There is substantial evidence in the literature that, worldwide, those with SMI are rejected and discriminated against (Angermeyer & Matschinger, 1997; Guimon, Fischer, & Sartorius, 1999; Link, Struening, Rahav, Phelan, & Nuttbrock, 1997; Ohaeri & Abdullahi, 2001; Thara & Srinivasan, 2000; Villares & Sartorius, 2003). Link and Phelan (Link & Phelan, 2001) theorize that stigma occurs as a process of discrimination and rejection at individual (e.g., experiences of rejection by others) and structural (e.g., poor access to services, denial of housing, residing in poor neighborhoods) levels, and also as a result of social-psychological responses of the stigmatized individual (e.g., lost of mastery, decreased self-esteem, negative self-view).…”

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confidence: 99%

Perceived Mental Illness Stigma and HIV Risk Behaviors Among Adult Psychiatric Outpatients in Rio de Janeiro, Brazil

Elkington

McKinnon

Mann

et al. 2009

Community Ment Health J

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We examined the associations between perceived mental illness stigma and HIV risk and protective behaviors among adults with severe mental illness (SMI) in Rio de Janeiro, Brazil. We measured mental illness stigma across three domains ("Personal Experiences," "Perceived Attractiveness," and "Relationship Discrimination"), and examined the relationship between experiences of stigma in each domain and HIV risk and protective behaviors over the past three months in 98 outpatients with SMI. Those who reported greater "Relationship Discrimination" stigma were significantly more likely to be sexually active and to have unprotected sex; they were significantly less likely to report deliberately having fewer partners as a way to protect themselves from HIV. The role of stigma in unprotected sexual behavior should be examined further and considered in any HIV prevention intervention for people with SMI. KeywordsSevere mental illness; HIV sexual risk behaviors; perceived mental illness stigma; psychiatric outpatients Worldwide, rates of HIV infection (1.9%-3.1%) are sharply elevated in most samples of people with severe mental illness (SMI) compared to the general population (Cournos & McKinnon, 1997;Rosenberg et al., 2001a), with rates as high as 23.8% among those with SMI who also are homeless and/or have a substance use disorder (Rosenberg, et al 2003a, b;Empfield et al., 1993;Silberstein et al., 1994). SMI refers to a heterogeneous group of psychiatric conditions, typically characterized by psychosis, acute or persistent in duration; functional disability; and a history of hospitalization and/or maintenance medication (McKinnon & Rosner, 2000). Studies show that 40%-70% of adults with SMI are sexually active in the past three to six months and that the majority of those who are active engage in high rates of HIV risk behaviors such as unprotected sex, sex with multiple and/or high risk partners, sex exchange, and substance use before sex (Collins, Holman, Freeman, & Patel, 2006;Meade & Sikkema, 2005;Wainberg et al., 2008;). In Brazil, rates of HIV infection (0.8%-1.6%) among adult (Almeida & Pedroso, 2004;Guimarães et al., 2008) are higher than the estimated general population rate (0.6%) (Ministry of Health of Brazil National Coordination for STD and AIDS, 2005), and people with SMI have been identified by the Ministry of Health as a population particularly vulnerable to HIV/AIDS. Studies examining sexual risk behaviors among SMI patients in Brazil found 42% to 63% were sexually active in the past three to 12 months, and of those, 72% to 83% reported unprotected sexual activity and 27% to 31% reported multiple partners (Guimarães et al., 2008;Oliveira, 1997;Wainberg et al., 2008).Diagnosis and symptoms of mental illness, the defining characteristic of this population, have been associated with HIV risk behaviors among psychiatric samples, though inconsistently (Brunette et al., 1999;Cournos, McKinnon, Meyer-Bahlburg, Guido, & Meyer, 1993;Hanson et al., 1992;Kelly et al., 1995;Levounis, Galanter, Dermatis, Ha...

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Challenging the stigma of schizophrenia

Cited by 17 publications

References 1 publication

Public stigma and schizophrenia in São Paulo city

Public stigma and schizophrenia in São Paulo city

Stigmatization as an Environmental Risk in Schizophrenia: A User Perspective

Perceived Mental Illness Stigma and HIV Risk Behaviors Among Adult Psychiatric Outpatients in Rio de Janeiro, Brazil

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