Early Detection of Psychosis - Helpful or Stigmatizing Experience for Those Concerned?

Abstract

This chapter provides an overview of the literature on early detection of psychosis concerning stigma and discrimination in individuals with an at-risk mental state (ARMS) for psychosis. Extended surveys about stigma and psychosis/schizophrenia show that these patients belong to the most stigmatized patient groups. Therefore, ARMS individuals are conceivably affected by stigma and its consequences. In response to the recent scientific debate concerning potential stigma associated with an ARMS for psychosis, a small but growing number of studies on the topic have been carried out. The following two questions are addressed in this chapter: (1) do ARMS individuals experience stigma - and if so, what kind of stigma, and (2) are early detection centers contributing to stigma in any form or is the support offered rather experienced as helpful? Special emphasis is placed on the subjective perspective of ARMS individuals. Research reviewed in this chapter suggests that ARMS individuals fear stigma rather than having experienced it. They suffer from fear of negative reactions from peers, leading to concealment of mental issues, social withdrawal and delayed help-seeking. According to the literature reviewed, early detection services help individuals coping with symptoms, social isolation and potential stigma instead of enhancing or causing the latter. More emphasis should be placed on the subjective experiences and perspectives of those concerned in future research. Potential stigma including self-stigmatization should be assessed and included into treatment recommendations for individuals with an ARMS.