Self-esteem in persons with schizophrenia. A Nordic multicentre study

Abstract

Background: Deinstitutionalisation has led to many people with serious mental illness spending most of their time outside psychiatric institutions. Not much is known about their subjective life. The paper presents the results of analysis of self-esteem in a group of non-institutionalised people with schizophrenia. Methods: Interviews were conducted with random samples of people with schizophrenia receiving out-patient services in ten psychiatric centres in the five Nordic countries. The following instruments were used: The Interview Schedule for Social Interaction (ISSI), Camberwell Assessment of Needs, Lancashire Quality of Life Profile and the Rosenberg self-esteem scale, GAF and BPRS. The Rosenberg scale provided the main data for this paper and three different measures of self-esteem were used (positive self-esteem, negative self-esteem and overall self-esteem). Results: A total of 418 people took part in the study. Total participation rate was 55%. Multiple regression analysis showed the three self-esteem measurements to be mainly related to mental health and other subjective variables, and to lesser extent to social network. Demography played a negligible role, only (female) sex being associated with positive and gross self-esteem. Anxiety/depression and affect balance were the strongest predictors of positive, negative and gross self-esteem, and having at least one close friend was associated with positive and gross self-esteem. Conclusion: variations in self-esteem were mainly explained by differences in anxiety/depression and affect balance, and to extent also with satisfaction with the relations to one's family. Having at least one friend was the strongest social network predictor and sex the only significant demographic variable.