Insight, self-stigma and depressive symptoms among patients with schizophrenia

Abstract

Depressive symptoms are rather prevalent among patients with schizophrenia and various factors can influence them. Insight and self-stigma shows complex and contradictory relationship, both are among most important features of schizophrenia with strong impact on depressive symptoms. We wanted to test hypothesis that preserved insight is related to depressive symptoms only when self-stigma is also high. Our cross-sectional research comprised 149 patients with diagnosis of schizophrenia, both gender, age span 25-45 years. Rating scales used were Calgary Depression Scale (CDS), Scale to assess Unawareness of Mental Disorder (SUMD) and Internalized Stigma in Mental Illness (ISMI) which are specifically designed for patients with schizophrenia. Majority of patients were male (72%), single or separated (85%). Relation between selfstigma and depressive symptoms was statistically significant ( b =0.12, 95% CI=[0.06, 0.19], β=0.32, t (135)=3.89, P b =–0.01, 95% CI=[–0.02,–0.001], β=–0.17, t (135)=–2.20, P =0.029). Post-hoc analysis showed that among patients with extremely high selfstigma (more than 90 centile), higher insight was related to more depressive symptoms (b=–0.22, 95% CI=[–0.42,–0.02], β=–0.34, t =–2.23, P =0.028). These results are important for tailoring specific antistigma programs for patients with high level of insight in order to prevent deleterious impact of depressive symptoms on course of schizophrenia.