Self-stigma, quality of life and schizophrenia: An outpatient clinic survey in Nigeria

Temilola J Mosanya · Adegoke Oloruntoba Adelufosi · Timothy Olaolu Adebowale · Adegboyega Ogunwale · Olaide K Adebayo

98 citations0/0 files storedInternational Journal of Social Psychiatry

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Mental Health Treatment and Access Schizophrenia research and treatment Mental Health and Psychiatry

Abstract

BACKGROUND: Stigma is a major obstacle to the treatment and recovery of people with mental illness. In Nigeria, there is a dearth of information on internalization of stigma and its effect on treatment outcome measures such as quality of life. AIM AND OBJECTIVES: The aim of the study was to assess self-stigma among patients with schizophrenia attending a psychiatric hospital outpatient clinic, and the relationship of self-stigma to the socio-demographic, clinical characteristics and quality of life of the patients. METHOD: Two hundred and fifty-six consecutive outpatient attendees of the Neuropsychiatric Hospital, Aro, Abeokuta in Nigeria with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnosis of schizophrenia were recruited for the study. The diagnosis of schizophrenia was established with the Structured Clinical Interview Schedule for DSM-IV Axis I disorder (SCID), while item 17 of the Present State Examination was used to ascertain the presence of insight into the illness. The subjects were interviewed with a socio-demographic questionnaire, the Internalized Stigma of Mental Illness (ISMI) scale, the Brief Psychiatric Rating Scale (BPRS) and the World Health Organization's Quality of Life (WHOQOL-Bref) questionnaire. RESULTS: The mean age of the subjects was 39.5 (SD = 10.6) years with males constituting 52.0% of the sample. High self-stigma was found in 18.8% of the subjects. The socio-demographic and clinical correlates of high self-stigma found using univariate analysis were low educational level (χ(2) = 22.69, p < .001), unemployment (χ(2) = 15.9, p < .001), low income (χ(2) = 25.03, p < .001), source of income (χ(2) = 12.52, p = .007) and severity of psychopathology (t = 8.245, p < .001). High self-stigma was associated with poor quality of life in all the domains of WHOQOL-Bref. CONCLUSION: This study revealed that self-stigma was common among subjects with schizophrenia. It is associated with poor treatment outcome, highlighting the need to incorporate stigma intervention strategies into mental health care delivery.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 1962The Brief Psychiatric Rating Scale 2004How stigma interferes with mental health care.2003Internalized stigma of mental illness: psychometric properties of a new measure 1987Understanding Labeling Effects in the Area of Mental Disorders: An Assessment of the Effects of Expectations of Rejection 2000Stigmatisation of people with mental illnesses 2009Self‐stigma and the “why try” effect: impact on life goals and evidence‐based practices 2001Stigma as a Barrier to Recovery: Perceived Stigma and Patient-Rated Severity of Illness as Predictors of Antidepressant Drug Adherence

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