Stigma and Discrimination Experiences in Patients with First-episode Schizophrenia

Abstract

Introduction Patients with schizophrenia, and first-episode patients in particular, suffer from stigma and discrimination due to their illness. Recently, interventions have been developed addressing stigma coping and empowerment strategies within psycho-educational or therapeutic group settings. Objectives To provide such interventions in a purposeful way, it is essential to identify those patients who would benefit most of such interventions. We propose that personal stigma experiences are a promising concept to identify such patients. Aims Since most existing assessments of stigma experiences are interview-based or do not consistently discriminate between experiences of and beliefs about stigma, a short self-rating instrument assessing experiences of stigma and discrimination has been developed and tested in a sample of patients with first-episode schizophrenia. Methods Patients with first-episode schizophrenia (N=48 participants of the multi-center 'first-episode (long-term) study” of the German Research Network on Schizophrenia) completed a 5-item self-rating assessing the burden due to experiences of stigma and discrimination. Psychopathology, global and social functioning, self-esteem, quality of life and anticipated stigma served as variables to determine construct validity of the scale. Results Average score of stigma experiences was 2.3 (out of 5 points). The stigma experiences score correlated significantly with lower quality of life, lower self-esteem and higher anticipated stigma. Conclusions The self-rating scale 'Burden of stigma experiences” is a promising instrument for identifying patients with a need for therapeutic or educational interventions addressing stigma coping. Validation studies in further patient samples would be desirable.