Faces In Schizophrenia Research Articles

Women with Schizophrenia: Beyond Psychosis.

Although women with schizophrenia face significant lifelong challenges due to their diagnosis and sex-related issues, those challenges are seldom taken into consideration in their medical treatment and general care. In order to report the needs and desires of a group of women with schizophrenia, we conducted a series of semistructured interviews with nine women diagnosed with schizophrenia and attending outpatient clinics at the Hospital Del Salvador in Valparaíso. Our qualitative study followed a phenomenological design. Using ATLAS.ti software, we performed a content analysis of the interview transcripts, developed a coding frame for each major topic addressed in the interviews, and triangulated the results. Despite presenting with psychotic symptoms, some women received different diagnoses. Although acknowledging the benefits of medication, women also reported concerns about weight gain and body image. All women reported experiences with stigma and self-stigma related to the diagnosis of schizophrenia, and most had experienced childhood trauma, including sexual abuse, parental violence, and/or bullying. Young women with schizophrenia also feared that if they become mothers, then their children might also have schizophrenia and/or that they would be unable to adequately care for them. Women with schizophrenia have different experiences and play different roles in society beyond their psychoses, an understanding that should integrated into more personalized treatments for schizophrenia that consider individual characteristics and needs.

The travails of women with severe mental illness and pregnancy.

Women with severe mental illness and pregnancy suffer substantial travails in accessing care for mental and perinatal health. Women with psychotic illnesses such as schizophrenia face higher risks of pregnancy and postnatal complications. Similarly, lack of access to holistic psychiatric care presents particular perils for these women and their children. Tailored care for these mothers-to-be and their babies is needed to prevent and ameliorate health complications, mental and physical. This will require targeted funding of services that connect women with and provide continuity of care.

Cervical Cancer Screening Among Female Medicaid Beneficiaries With and Without Schizophrenia.

In the United States, women with schizophrenia face challenges in receiving gynecologic care, but little is known about how cervical cancer screening rates vary across time or states in a publicly insured population. We hypothesized that women Medicaid beneficiaries with schizophrenia would be less likely to receive cervical cancer screening across the United States compared with a control population, and that women with schizophrenia and other markers of vulnerability would be least likely to receive screening. This retrospective cohort study used US Medicaid administrative data from across 44 states between 2002 and 2012 and examined differences in cervical cancer screening test rates among 283950 female Medicaid beneficiaries with schizophrenia and a frequency-matched control group without serious mental illness, matched on age and race/ethnicity. Among women with schizophrenia, multivariable logistic regression estimated the odds of receiving cervical cancer screening using individual sociodemographics, comorbid conditions, and health care service utilization. Compared to the control group, women with schizophrenia were less likely to receive cervical cancer screening (OR = 0.76; 95% CI 0.75-0.77). Among women with schizophrenia, nonwhite populations, younger women, urban dwellers, those with substance use disorders, anxiety, and depression and those connected to primary care were more likely to complete screening. Cervical cancer screening rates among US women Medicaid beneficiaries with schizophrenia were suboptimal. To address cervical cancer care disparities for this population, interventions are needed to prioritize women with schizophrenia who are less engaged with the health care system or who reside in rural areas.

Advancing the Measurement of Social Functioning in Schizophrenia: Applications of Egocentric Social Network Analysis.

People with schizophrenia face challenges with forming and maintaining social relationships, often resulting in poor social functioning. Commonly used measures of social functioning provide broad information relating to social relationships, but they do not adequately capture information regarding network structure and characteristics of network members. One method that can assess these more detailed aspects of social networks and provide a more comprehensive understanding of social functioning deficits is egocentric social network analysis (SNA). SNA is a scientific discipline that uses principles of network science and graph theory to analyze social relations quantitatively. Even though some types of SNA have been applied in prior schizophrenia studies, its application as a framework to measure social functioning has been extremely limited. Therefore, this article aims to formally introduce SNA and select quantitative SNA metrics, including measures of network composition, structure, homophily, and centrality, to schizophrenia researchers as novel ways of measuring components of social functioning. To demonstrate the application of SNA, we provide illustrative examples of the SNA metrics and graphical diagrams of social networks for two individuals with schizophrenia.

Lipid-modifying agents and risk of all-cause, natural and suicide mortality in schizophrenia: nationwide cohort study.

Individuals with schizophrenia face high mortality risks. The effects of lipid-modifying agents on this risk remain understudied. This study was conducted to investigate the effects of lipid-modifying agents on mortality risk in people with schizophrenia. This nationwide cohort study collected the data of people with schizophrenia from Taiwan's National Health Insurance Research Database for the period between 1 January 2001 and 31 December 2019. Multivariable Cox proportional hazards regression with a time-dependent model was used to estimate the hazard ratio for mortality associated with each lipid-modifying agent. This study included 110 300 people with schizophrenia. Of them, 22 528 died (19 754 from natural causes and 1606 from suicide) during the study period, as confirmed using data from Taiwan's national mortality database. The use of lipid-modifying agents was associated with reduced risks of all-cause (adjusted hazard ratio [aHR]:0.37; P < 0.001) and natural (aHR:0.37; P < 0.001) mortality during a 5-year period. Among the lipid-modifying agents, statins and fibrates were associated with reduced risks of all-cause mortality (aHRs:0.37 and 0.39, respectively; P < 0.001 for both) and natural mortality (aHRs: 0.37 and 0.42, respectively; P < 0.001 for both). Notably, although our univariate analysis indicated an association between the use of lipid-modifying agents and a reduced risk of suicide mortality, the multivariate analysis revealed no significant association. Lipid-modifying agents, particularly statins and fibrates, reduce the risk of mortality in people with schizophrenia. Appropriate use of lipid-modifying agents may bridge the mortality gap between these individuals and the general population.

Abnormalities in motor adaptation to different types of perturbations in schizophreniaperturbations in schizophrenia

Schizophrenia is a mental health disorder that often includes psychomotor disturbances, impacting how individuals adjust their motor output based on the cause of motor errors. While previous motor adaptation studies on individuals with schizophrenia have largely focused on large and consistent perturbations induced by abrupt experimental manipulations, such as donning prism goggles, the adaptation process to random perturbations, either caused by intrinsic motor noise or external disturbances, has not been examined – despite its ecological relevance. Here, we used a unified behavioral task paradigm to examine motor adaptation to perturbations of three causal structures among individuals in the remission stage of schizophrenia, youth with ultra-high risk of psychosis, adults with active symptoms, and age-matched controls. Results showed that individuals with schizophrenia had reduced trial-by-trial adaptation and large error variance when adapting to their own motor noise. When adapting to random but salient perturbations, they showed intact adaptation and normal causal inference of errors. This contrasted with reduced adaptation to large yet consistent perturbations, which could reflect difficulties in forming cognitive strategies rather than the often-assumed impairments in procedural learning or sense of agency. Furthermore, the observed adaptation effects were correlated with the severity of positive symptoms across the diagnosis groups. Our findings suggest that individuals with schizophrenia face challenges in accommodating intrinsic perturbations when motor errors are ambiguous but adapt with intact causal attribution when errors are salient.

Rethinking Schizophrenia: Beyond the Voices of Schizophrenia

Introduction Despite improvements and innovation in recent years, people living with schizophrenia face variations in access to optimal treatment and care. There is a lot about schizophrenia that is not fully understood, and the high-quality care and support needed by people living with this condition is often unavailable.Objectives Develop an evidence-based, compelling policy narrative on schizophrenia Engage a pan-European, multidisciplinary group of experts Offer concrete tools to patient and professional advocacy groups Disseminate findings Draw from our findings practical solutions on how to implement recommendationsMethods Based on carefully selected existing literature and available resources, literature review includes but is not limited to: Value of Treatment Recommendations, Global Burden of Disease Study, Comprehensive Mental Health Action Plan, Mental Health Atlas. The aim is to establish state of play, identify problems and solutions and take stock of current recommendations.We established a multi-disciplinary working group to lead the project, and ensured that representation on this group is cross-disciplinary and cross-sector. The expert group includes country-level patient advocates and clinical leads including key opinion leaders (KOLs) to keep the project focused on what is happening at a national level, and to help create ownership at the national level to take recommendations forward within each country.We conducted qualitative semi-structured interviews with people living with schizophrenia where they provided their insights into how to rethink the way we deal with schizophrenia.ResultsProvide clear, concrete and adaptable solutions Joint ownership by key stakeholder groups of a common policy narrative on schizophrenia Sustained policy engagement on schizophrenia at the EU and national levelConclusionsThere is a clear need to rethink the management of schizophrenia and redesign the care pathways to ensure optimal treatment and care for all people living with schizophrenia in Europe. Based around patient testimonies, the aim of the session is to highlight the need to optimise the way we manage schizophrenia by building a strong, coherent, evidence-based policy narrative which speaks to the current priorities in schizophrenia and draws from the current policy landscape in Europe.Experts involved in the Rethinking Schizophrenia project, coordinated by the European Brain Council, have explored the ways in which we can and need to change the way we deal with schizophrenia. The Rethinking Schizophrenia project falls under the Rethinking the management of brain disorders series, research-driven projects offering policy recommendations to make tangible changes with the aim to improve the lives of people living with brain disorders, neurological and mental alike, across Europe.Disclosure of InterestNone Declared

(079) Perception of Signals of Sexual Interest in Patients with Schizophrenia

Abstract Introduction Patients with schizophrenia (SCH) face many difficulties in forming and maintaining sexual relationships and often have unmet needs around intimacy. Low satisfaction with sexual relationships has been linked to a decrease in overall quality of life. Single relationship status also correlates with a poorer prognosis. However, the exploration of sources of sexual and relationship deficits in patients is an area that is habitually neglected, and there is little research addressing this phenomenon. Objective Our study aims to identify whether difficulties in forming sexual relationships reported by patients with SCH could be connected to: a) a compromised ability to interpret, recognize and respond to signals of sexual interest b) decreased salience of sexual intimacy. Methods Sample: Twenty male and female patients with schizophrenia and a control group of the same size, matched for demographic parameters, will be recruited from the Study of first episodes of schizophrenia (ESO). ESO is a large prospective database dedicated to the longitudinal follow-up of first-episode patients with SCH which contains a wealth of information on bio-psycho-social markers. Procedure: The variables of interest will be tested by two experiments developed in our laboratory. The first experiment depicts male and female actors showing behavioral displays conveying signals of a) sexual interest, b) neutral but friendly attitude and c) rejection, towards the observer. The second experiment is a simple viewing task designed to assess the salience of erotic stimuli compared to neutral ones. In addition, eye movements and pupil dilation will be measured using the eye-tracking device Eyelink 1000plus. Statistical analysis: A repeated-measures t-test will be used to assess the change in a continuous outcome. Results Preliminary results show that the patients (N=10) spent more time on erotic images (mean time= 884.69 ms) than the control group (N=9) (mean time= 772.14 ms). This difference is not statistically significant (p = 0.21). Currently, more data are being collected. Conclusions The preliminary results demonstrate that there is no difference in the interest in explicit sexual stimuli between patients with SCH and healthy controls. Explicit erotic signals seem to be sexually salient to them, which indicates their interest in sexual intimacy. Our research will further determine whether individuals with SCH have impaired ability to perceive, interpret, and react to signals of sexual interest. The implications of our findings could lead to a formulation of sexual remediation strategies. The study was supported by the Czech Health Research Council, no. NU21J-04-00024 and the Charles University, Fac Med1, GAUK no. 56123. Disclosure No.

Navigating the Discussion of Mental Illness With Vietnamese Americans.

Approaching mental health issues in the Vietnamese community is challenging due to the distinct cultural practices, the stigma of mental illness, and the language barrier. These complexities are compounded by additional stressors experienced by many Vietnamese Americans stemming from war trauma and the demands of immigration. In this article, the authors discuss the implications that Vietnamese cultural practices have on the perception of mental health in Vietnamese American communities. Specifically, the discussion encompasses mood disorders, particularly depression, and schizophrenia, 2 prevalent mental health conditions that often intersect with cultural nuances. Shedding light on this often-overlooked aspect, the authors provide insight into understanding the specific challenges Vietnamese Americans with depression and schizophrenia face. At the end of this article, a helpful table of commonly used mental health terms, their Vietnamese translations, and explanations in Vietnamese are presented. Beyond linguistics, the article extends its guidance to mental health providers seeking to engage in productive discussion about mental health with their patients. By offering practical tips tailored to cultural context, the article aims to foster a more inclusive approach to mental health in Vietnamese American communities.

Analysis of the effect of dance therapy intervention in inpatient schizophreni

The high predominance of non-drug consistency among those with schizophrenia and the many symptoms of solution antipsychotics support the utilization of dance/development treatment in the treatment of individuals with schizophrenia. This assessment of the writing centers on the utilization of dance/practice treatment to decrease the symptoms of antipsychotics and increment prescription adherence. We took a gander at the shame, the scope of side effects that might show, diminished knowledge, and developmental irregularities, among the different difficulties people with schizophrenia face. Moreover examined were the inconvenient consequences for close to home, conduct, and mental working. The writing on body mindfulness, the connection between the psyche and body, active work, self-articulation, and an assortment of other dance/development treatment methods were likewise inspected after a survey of the exploration on the utilization of dance/development treatment with individuals who have been determined to have schizophrenia. By showing the patient the conceivable results of their meds and decreasing their incapacitating impacts on mental, social, and close-to-home working, dance/development treatment has the ability to work on substantial mindfulness.

Grappling with Issues of Motherhood for Women with Schizophrenia.

Despite the fact that most persons with schizophrenia find steady employment difficult to sustain, many women with this diagnosis embrace and fulfill the most difficult task of all-motherhood. The aim of this paper is to specify the challenges of motherhood in this population and review the treatment strategies needed to keep mothers and children safe, protecting health and fostering growth. The review addresses concerns that had been brought to the author's earlier attention during her clinical involvement with an outpatient clinic for women with psychosis. It is, thus, a non-systematic, narrative review of topic areas subjectively assessed as essential to "good enough" mothering in the context of schizophrenia. Questions explored are the stigma against motherhood in this population, mothers' painful choices, issues of contraception, abortion, child custody, foster care and kin placement of children, the effects of antipsychotics, specific perinatal delusional syndromes, and, finally, the availability of parental support. This review is intended for clinicians. Recommendations are that care providers work collaboratively with mothers, take note of their strengths as well as their failings, offer a wide array of family services, monitor households closely for safety and for treatment adherence, appreciating the many challenges women with schizophrenia face daily.

Dance/movement therapy as a holistic approach to diminish health discrepancies and promote wellness for people with schizophrenia: a review of the literature.

Individuals with a diagnosis of schizophrenia face a myriad of obstacles to wellness, beginning with diagnostic discrepancies including over- and misdiagnoses on the schizophrenia spectrum. People with schizophrenia experience profound amounts of stigmatization from the general population, their healthcare providers, and even themselves. Such stigmatization creates a barrier for wellness, poorer prognoses, and often limits adherence to physical and mental healthcare. Moreover, it can exacerbate the already stifling symptomatology of their diagnoses, including specific bodily-related symptomatology. Oftentimes, a diagnosis of schizophrenia disrupts one's relationship with their body including a diminished mind-body connection, decreased interoceptive awareness, and thus unsuccessful intra- and interpersonal relationships. Some recent research suggests the use of mind-body therapies, however, if these practices are internalizing, they may not be appropriate for people with schizophrenia experiencing more acute symptomatology excluding them from treatment. Dance/movement therapy (DMT) is an embodied psychotherapeutic treatment option that can support participants in improving mind-body connection, social relationships, and self-regulatory skill development. Research on DMT has shown promising results for people with schizophrenia, however such research is limited and would benefit from increased studies that particularly measure the effects of DMT on mind-body connection and increased interoception for people with schizophrenia. Moreover, integrative and collaborative treatment models that couple DMT and biofeedback may further our understanding of the physiological and neurological effects of DMT interventions for people with schizophrenia and beyond. This review will examine the recent literature on health inequities for people with schizophrenia, their specific body-based disruptions and needs, and DMT as a promising treatment model, particularly when coupled with biofeedback.

A qualitative of stable symptomatology for patients with schizophrenia: do they have adequate post-discharge rehabilitative resources?

Many patients diagnosed with schizophrenia face obstacles to rehabilitation and discharge into the community, particularly with regard to the way resources are structured. Clarifying the difficulties will help health care providers address rehabilitation shortcomings. Semistructured in-depth interviews and participatory observations were conducted in various locations (family home, hospital ward, outpatient clinic, and on the street) with families, social workers, doctors, nursing staff, and patients with schizophrenia. These patients met the medical facility’s hospital discharge standards and either had not been discharged or had been discharged within two weeks of meeting the discharge criteria. This study explores the complex and interdependent role of social differences in the rehabilitation of patients with schizophrenia after acute treatment. The study identified five topics related to structural difficulties in resources for the rehabilitation of patients diagnosed with schizophrenia: (1) the role of policy; (2) inadequate facilities and responsibilities; (3) rejecting communities; (4) difficult families; and (5) the threat of stigma. The rehabilitation of patients diagnosed with schizophrenia is a systemic problem. Systemic rehabilitation policies and integrated social support would be more conducive to the rehabilitation of patients. Perhaps cognitive remediation therapy or the Assertive Community Treatment (ACT) Model could benefit individuals with complex disorders.

Dance/movement therapy as a holistic approach to diminish health discrepancies and promote wellness for people with schizophrenia: a review of the literature

Individuals with a diagnosis of schizophrenia face a myriad of obstacles to wellness, beginning with diagnostic discrepancies including over- and misdiagnoses on the schizophrenia spectrum. People with schizophrenia experience profound amounts of stigmatization from the general population, their healthcare providers, and even themselves. Such stigmatization creates a barrier for wellness, poorer prognoses, and often limits adherence to physical and mental healthcare. Moreover, it can exacerbate the already stifling symptomatology of their diagnoses, including specific bodily-related symptomatology. Oftentimes, a diagnosis of schizophrenia disrupts one’s relationship with their body including a diminished mind-body connection, decreased interoceptive awareness, and thus unsuccessful intra- and interpersonal relationships. Some recent research suggests the use of mind-body therapies, however, if these practices are internalizing, they may not be appropriate for people with schizophrenia experiencing more acute symptomatology excluding them from treatment. Dance/movement therapy (DMT) is an embodied psychotherapeutic treatment option that can support participants in improving mind-body connection, social relationships, and self-regulatory skill development. Research on DMT has shown promising results for people with schizophrenia, however such research is limited and would benefit from increased studies that particularly measure the effects of DMT on mind-body connection and increased interoception for people with schizophrenia. Moreover, integrative and collaborative treatment models that couple DMT and biofeedback may further our understanding of the physiological and neurological effects of DMT interventions for people with schizophrenia and beyond. This review will examine the recent literature on health inequities for people with schizophrenia, their specific body-based disruptions and needs, and DMT as a promising treatment model, particularly when coupled with biofeedback.

Coping Strategies among Caregivers of Schizophrenia - A Pilot Analysis

Caregivers of patients with schizophrenia face stress and emotional hardship and are frequently forced to assume lifelong caregivers role. For many families having a relative with mental illness can be a stressor. (2) To test the feasibility and practicability of the study, a pilot study was conducted among 28 caregivers of schizophrenia. True Experimental Research design was adopted in this study. Conclusion: This pilot study concludes by proving the effectiveness of psychosocial interventions on coping strategies among caregivers of schizophrenia.

Association Between Bipolar Disorder or Schizophrenia and Oral Anticoagulation Use in Danish Adults With Incident or Prevalent Atrial Fibrillation

Individuals with bipolar disorder or schizophrenia have a higher risk of adverse outcomes from cardiovascular diseases. Oral anticoagulation therapy (OAT) for patients with atrial fibrillation (AF) is needed for stroke prevention, but whether patients with bipolar disorder or schizophrenia face disparities in receiving this therapy is unknown. To assess whether bipolar disorder or schizophrenia is associated with a lower rate of OAT initiation in patients with incident AF and lower prevalence of OAT in those with prevalent AF. A nationwide cohort study of Danish patients with AF was conducted from January 1, 2005, to December 31, 2016, and data were analyzed from January 1 to June 15, 2020. Data from national registries included information on all redeemed prescriptions and all hospital contacts of all patients with incident or prevalent AF (age, 18-100 years) and increased risk status, defined by a CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, stroke or transient ischemic attack, vascular disease, age 65-74 years, sex category) risk score greater than or equal to 2. Hospital diagnosis of bipolar disorder or schizophrenia. Adjusted proportion differences for OAT initiation and OAT prevalence, comparing individuals with and without bipolar disorder or schizophrenia. Patients included with incident AF (n = 147 810) had a mean (SD) age of 76.9 (10.1) years, 78 577 (53.2%) were women, 1208 (0.8%) had bipolar disorder, and 572 (0.4%) had schizophrenia. Accounting for age, sex, and calendar time, bipolar disorder and schizophrenia were associated with significantly lower frequency of OAT initiation within 90 days after incident AF (bipolar disorder: -12.7%; 95% CI, -15.3% to -10.0%; schizophrenia: -24.5%; 95% CI, -28.3% to -20.7%) and lower OAT prevalence in patients with prevalent AF (bipolar disorder: -11.6%; 95% CI, -13.9% to -9.3% schizophrenia: -21.6%; 95% CI, -24.8% to -18.4%). Adjusting for socioeconomic factors and other comorbid conditions attenuated these associations, particularly for patients with bipolar disorder. However, schizophrenia continued to be associated with a with a lower rate of OAT initiation (-15.5%, 95% CI, -19.3% to -11.7%) and a -12.8% (95% CI, -15.9% to -9.7%) lower OAT prevalence. These associations were also present after the introduction of non-vitamin K antagonists (adjusted proportion difference in 2013-2016: -12.4%; 95% CI, -18.7% to -6.1% for initiation and -10.1%; 95% CI, -13.8% to -6.4% for prevalence). In this study, patients with bipolar disorder or schizophrenia were less likely to receive OAT in the setting of AF. For patients with bipolar disorder, this deficit was largely associated with socioeconomic factors and comorbidities, especially toward the end of the study period. For patients with schizophrenia, disparities in this stroke prevention therapy persistently exceeded what could be explained by other patient characteristics.

Šizofrenija sergančių artimųjų santykių pokyčiai ir stigmatizacijos patirtis pirminiame socialiniame tinkle

The goal of this article is to analyze the challenges that arise from stigma and that relatives of people with Schizophrenia face in their relationships in primary social network. Schizophrenia does not only change everyday life and relationships of the ill but also of their relatives. This topic is not researched in Lithuania. Meanwhile in the international context, the biggest attention is paid to the subjective and objective burden that relatives of the people with Schizophrenia face, leaving aside the changes and dynamics in their relationships. Therefore, in this article the influence of the stigmatization on the relationships in the closest environment of patient is discussed. In order to achieve this goal, qualitative research has been completed and 15 half-structured interviews with the people who have relatives, who suffer from Schizophrenia, were carried out. The relation to the person with Schizophrenia varied according to the individual cases – some of them were spouses, some where children, parents, siblings or further relatives. The results of the research reveal that Schizophrenia causes complex emotional experiences of patient’s family members, and gives an effect on relationships within the family, as well as on relationships of the ill and his family members with further relatives, friends, neighbors and colleagues.

TREATMENT ADHERENCE AND SOCIAL SUPPORT AMONG WOMEN WITH SCHIZOPHRENIA

Introduction:Women with schizophrenia face several challenges in terms of treatment adherence and social support. Most people with schizophrenia in low- and middle-income countries like India receive minimal formal care and poor social support,which further influence high non-adherence to medication. Methodology: The descriptive research design has been adopted, and 60-women with schizophrenia were recruited for the study from out-patient services of NIMHANS Hospital,Bengaluru.Subjects were selected by using a consecutive sampling method. The researcher used a self-prepared checklist to assess Treatment Adherence among Women with Schizophrenia (TAWS) and the Multidimensional Scale of Perceived Social Support (MSPSS) to collect the data. Results:Adherence to treatment among women with schizophrenia has been influenced by many factors such as other family activities are getting clash with the therapy,affordability,longer duration of treatment,accessibility,side effects of medicine, social stigma, misconceptions about medicine, resistance to taking medication, negative attitude towards treatment,repeated blood investigations and complex follow-ups,etc. Social Support from Family and significant others are negatively correlated with Treatment adherence among women with Schizophrenia. Conclusion: Poor adherence to treatment in patients with schizophrenia is a significant risk factor for poor outcomes, including relapse, re-hospitalization, and suicide. A thorough understanding of the multiple factors that influence adherence among women with schizophrenia would better deal with this problem.

M231. INTERNALIZED STIGMA AS A PREDICTOR OF EMPLOYMENT STATUS IN PATIENTS WITH SCHIZOPHRENIA

BackgroundEmployment is an important social determinant of health, especially for individuals with mental illnesses where it was found that gainful employment is crucial for both functional and clinical recovery. However, individuals with mental illnesses face significantly higher levels of unemployment compared to their counterparts without. Within different diagnoses of mental illnesses, it was found that patients with schizophrenia face higher levels of unemployment compared to patients with other diagnoses. Numerous qualitative studies have identified an association between internalized stigma and unemployment in individuals with schizophrenia, however, fewer quantitative studies have examined the specific relationship between the two factors. Therefore, we aim to elucidate the relationship between employment status and internalized stigma, and more specifically, its domains in patients with schizophrenia.MethodsOne hundred and seventy-nine patients with schizophrenia were included in this study. Illness severity was assessed using the Clinical Global Impression scale, internalized stigma was measured using the Internalized Stigma of Mental Illness scale (ISMI), and demographic information including employment status was collected. For the purpose of analysis, employment status was categorised into two groups, with the employed group consisting of those under full-time and part-time employment, as well as full-time students. While the unemployed group consisted of individuals who were unemployed at the time of assessment. The ISMI assesses five domains of internalized stigma, which are alienation, stereotype endorsement, discrimination experience, social withdrawal and stigma resistance. Multiple logistic regression, controlling for demographic and clinical factors, was conducted to identify the domains of internalized stigma associated with predictors of employment status.ResultsOne hundred and two participants were employed and seventy-seven were unemployed. The employed group was younger, had shorter duration of illness, more years of education and less severe illness level (all p < .001). The unemployed group consisted of more females and divorced individuals (all p < .05). The unemployed group reported significantly higher levels of internalized stigma in the total score, as well as stereotype endorsement, discrimination experience, and social withdrawal domains (all p < .05). Mean total ISMI scores for employed and unemployed groups were 62.15 (SD = 13.69) and 67.52 (SD = 13.94) respectively. Multiple logistic regression analysis, controlling for demographic and clinical factors, found that years of education (OR = 0.835, p < .05), and two domains of the internalised stigma scale, stereotype endorsement (OR = 1.210, p < .05) and stigma resistance (OR = 0.854, p < .05), were associated with employment status.DiscussionMore years of education and higher level of stigma resistance were found to be associated with being employed, suggesting that stigma resistance along with education may play protective roles in both obtaining and sustaining employment in patients. Higher level of stereotype endorsement was found to be associated with being unemployed, suggesting that patients who agree with the stereotypes about mental illness may face greater difficulties in gaining and sustaining employment. Hence, tailored interventions focused on specific domains of internalized stigma may be crucial components of any services targeted at improvement of occupational functioning in patients with schizophrenia.

Schizophrenia and the Family Burden During the Pandemic

This article focuses on the issue of the burden that families with people with schizophrenia in care are confronted with. The pandemic caused significant disruption to the family dynamics of people caring for individuals with schizophrenia due to their higher risk of infection and worse outcomes. Families with patients with schizophrenia should pay close attention to detect both respiratory and psychiatric symptoms as early as possible. They may need health care professional support, guidance and help to prevent COVID-19 infection among people diagnosed with schizophrenia. However, the issue of the difficulties that families with people diagnosed with schizophrenia face remains a serious matter.