Perceived Stigma and Associated Factors among People with Schizophrenia at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Institution Based Study

Abstract

Background. While effective treatments are available for people with schizophrenia, presence of perceived stigma prevents them from accessing and receiving the help they need to get. Objectives. To assess the prevalence and associated factors of perceived stigma among people with schizophrenia attending the Outpatient Department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Methods. Institution based cross-sectional study design was conducted among 411 subjects using an Amharic version of the perceived devaluation and discrimination scale. Single population proportion formula was used to calculate sample size. Subjects were selected by systematic sampling techniques. Binary logistic regression and odds ratio with 95% confidence interval were used to identify the association factors of outcome variables. Results. A total of 411 subjects participated in the study giving a response rate of 97.4%. The prevalence of perceived stigma was found to be 83.5%. Education status (not able to read and write) (AOR = 2.64, 95% CI: 1.118, 6.227), difficulties of adherence to antipsychotic drug (AOR = 4.49, 95% CI: 2.309, 8.732), and duration of illness less than one year (AOR = 3.48, 95% CI: 2.238, 5.422) were factors associated with perceived stigma. Conclusion. Overall, the prevalence of perceived stigma was found to be high. Education status (not able to read and write), difficulties of adherence to antipsychotic medication, and duration of illness were factors associated with perceived stigma. Adherence to antipsychotic medication particularly during the early stage of the illness and strengthening the educational status of the participants were suggested in the clinical care setting.

Prevalence and factors associated with higher levels of perceived stigma among people with schizophrenia Addis Ababa, Ethiopia

“…This result is consistent with the reported magnitude of high perceived stigma in studies carried out among schizophrenia and schizoaffective disorder patients in Austria 66.9% [44], a meta-analysis report of the magnitude perceived stigma among schizophrenia patients in the USA, which revealed a rate of 64.55% [22], and the magnitude of self-stigma among schizophrenia spectrum disorders in Czech-Republic was 63.32% [45]. However, this finding was lower than that in the study conducted in Ethiopia, where prevalence of higher perceived stigma was reported at 83.5% before 6 years back by using the perceived devaluation and discrimination scale and in this study, factors associated with perceived stigma completely different from the previous study [9]. Another study conducted in southern California showed that 80% of people with schizophrenia had experienced perceived stigma [46].…”

“…In another study conducted in 14 European countries, the prevalence of stigma was 41.7% among schizophrenia patients [8]. In Ethiopia, the prevalence of stigma among people with mental illness were reported to be within the range of 32.1% to 83.5% [9,10].…”

“…Then perceived stigma scores have dichotomized those participants scoring greater than or equal to the mean score of 2.5 on PDD scales as having "high perceived stigma" and those scoring below the mean value considered as having "low perceived stigma" [42]. It is widely used in different settings in different countries including Ethiopia [8,9,13].…”

“…A number of factors have been found to be significant predictors of perceived stigma among patients with schizophrenia from previous studies including educational status, residency, social withdrawal, non-adherence to medication, duration of illness, marital status, old age, and low self-esteem [9,13,18,[25][26][27].…”

“…Moreover, perceived stigma negatively impacts the quality of life, physical, and mental well-being of people with schizophrenia [21,[28][29][30][31]. It is also linked with a poor level of functioning, poor adherence to drugs, and an increased dropout rate [9,32]. However, research into perceived stigma and associated factors among people with schizophrenia in low-and middle-income countries are limited.…”