Abstract
BackgroundSeveral studies have indicated that self-stigma is associated with depressive symptoms and could be a barrier to recovery in patients with schizophrenia-spectrum disorders. More recently, an association between autistic symptoms and self-stigma was found in schizophrenia-spectrum patients. This study aimed to investigate the association between self-stigma, autistic and depressive symptoms, and recovery in patients with schizophrenia.MethodsIn total, 105 participants were evaluated using the Autism Spectrum Quotient, the Internalized Stigma of Mental Illness Scale, the Quick Inventory of Depressive Symptomatology, and the Recovery Assessment Scale to investigate autistic symptoms, self-stigma, depressive symptoms, and recovery, respectively. The relationship between self-stigma, autistic symptoms, depressive symptoms, and recovery was assessed using structural equation modeling analysis.ResultsImpaired attention switching, one symptom of autism, was found to positively affect stereotype endorsement, which negatively influenced recovery through depressive symptoms. Moreover, problems with communication skills negatively affected recovery through depressive symptoms. Concerning self-stigma, stereotype endorsement and perceived discrimination had a negative effect on recovery through depressive symptoms, whereas stigma resistance had a direct negative effect on recovery.ConclusionsThis study may provide meaningful insight into the psychological structure of recovery and could inform effective interventions for patients with schizophrenia-spectrum disorders. This was a cross-sectionally designed study; therefore, further longitudinal studies are needed to identify the causal relationships between self-stigma, autistic and depressive symptoms, and recovery.
Highlights
Several studies have indicated that self-stigma is associated with depressive symptoms and could be a barrier to recovery in patients with schizophrenia-spectrum disorders
No significant differences were observed in terms of sex, age, diagnosis, Bivariate correlations between self-stigma, autistic and depressive symptoms, recovery, and patient characteristics There was a significant negative correlation between the Autism Spectrum Quotient (AQ) total score and the Quick Inventory of Depressive Symptomatology (QIDS) score and the onset of age in patients with schizophrenia-spectrum disorders (r = − 0.34, p < 0.05 and r = − 0.349, p < 0.05, respectively; Table 3)
The Recovery Assessment Scale (RAS) score was negatively associated with the Internalized Stigma of Mental Illness Scale (ISMI) total score (r = − 0.574, p < 0.001), all the ISMI subscales (r = − 0.516 [“stereotype endorsement” subscale] to − 0.385 [“stigma resistance” subscale], all p < 0.01), the AQ total score (r = − 0.462, p < 0.001), the AQ “social skills” subscale (r = − 0.458, p < 0.001), and the QIDS score (r = − 0.560, p < 0.001; Table 4)
Summary
Several studies have indicated that self-stigma is associated with depressive symptoms and could be a barrier to recovery in patients with schizophrenia-spectrum disorders. An association between autistic symptoms and self-stigma was found in schizophrenia-spectrum patients. This study aimed to investigate the association between self-stigma, autistic and depressive symptoms, and recovery in patients with schizophrenia. Self-stigma arises when people with psychiatric disorders who live in a society that endorses stigmatizing ideas internalize such ideas and believe that they are less valuable because they have a mental illness [5]. Self-stigma has a negative effect on patients with mental illness (e.g., low self-esteem and selfefficacy, reduced quality of life (QOL), and depressive symptoms) [6,7,8,9,10,11,12]. Self-stigma can be a barrier to recovery and negatively influence treatment adherence [13,14,15,16,17]
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