Comparisons of the Clinical Variables between High and Low Self-Stigma Group in the Outpatients with Schizophrenia

Jung Hyun Han; Chul Kwon Kim

doi:10.16946/kjsr.2017.21.1.28

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Han and Kim: Comparisons of the Clinical Variables between High and Low Self-Stigma Group in the Outpatients with Schizophrenia

Original Article

Korean J Schizophr Res 2017;21(1):28-36.

Published online: 20 January 2017

DOI: https://doi.org/10.16946/kjsr.2017.21.1.28

Comparisons of the Clinical Variables between High and Low Self-Stigma Group in the Outpatients with Schizophrenia

Jung Hyun Han, MD, Chul Kwon Kim, MD, PhD

Department of Psychiatry, College of Medicine, Dong-A University, Busan, Korea

Address for correspondence: Chul Kwon Kim, Department of Psychiatry, College of Medicine, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Korea Tel: 051-240-5467, Fax: 051-253-3452 E-mail: kimck@dau.ac.kr

Received 23 December 2017 Revised 8 March 2018 Accepted 13 March 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The purpose of this research was to investigate the differences of clinical variables between high and low self-stigma group in the outpatients with schizophrenia.

Methods

209 schizophrenic outpatients were assigned to high self stigma group (n=76) and low self stigma group (n=133) based on the scores of perceived stigma, and compared age, sex, education, age of onset, duration of illness, number of hospitalization, symptom, social functioning, insight, self-esteem, empowerment between two groups.

Results

: 1) The high self-stigma group had significantly lower age of onset, higher duration of illness and number of hospitalizations compared to the low self-stigma group. 2) In the PANSS, the high self-stigma group showed significantly higher score in the total score and general symptoms compared to the low self-stigma group. No significant difference was found in the positive symptoms and negative symptoms between two groups. 3) The high self-stigma group had significantly lower empowerment and self-esteem compared to the low self-stigma group. 4) The high self-stigma group had significantly higher insight compared to the low self-stigma group.

Conclusion

: Self-stigma in patients with schizophrenia directly reduces self-esteem and empowerment, and may cause depression and a lower quality of life. Therefore, identifying self-stigma and its degree is one of the important factors for good outcome.

Keywords: Self-stigma, Internalized stigma, Schizophrenia, Social functioning, Insight, Self-esteem, Empowerment.

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Fig. 1.

ROC curve of 9 items of stigma scale.

Table 1.

Sociodemographc and clinical characteristics of the low and high self-stigma group in the patient with schizophrenia

	Total (N=209)		Low stigma (N=133)		High stigmma (N=76)		t	p
	Mean	SD	Mean	SD	Mean	SD
Age (years)	38.67	8.01	38.08	8.47	39.70	7.05	1.40	0.16
Onset age (years)			24.43	6.82	21.74	5.11	–2.98	0.003
Duration of illness (years)	14.55	8.59	12.80	8.56	17.68	7.80	3.52	0.001
Education (years)	12.81	2.09	12.84	2.26	12.76	1.81	–0.26	0.79
Number of hospitalization	3.17	3.5	2.63	3.05	4.05	4.01	2.83	0.005
Positive and negative syndrome scale
Total	62.39	17.35	59.87	15.74	66.74	19.17	2.73	0.007
Positive	13.58	5.25	13.17	4.73	14.29	6.02	1.44	0.15
Negative	16.15	5.99	15.75	6.18	16.84	5.61	1.22	0.22
General	32.66	9.19	30.94	8.08	35.62	10.24	3.56	＜0.001
Social function scale
Total	717.48	68.85	720.38	70.32	712.42	66.36	–0.80	0.42
Social engagement/ Withdrawal			101.35	10.40	99.49	13.16	–1.12	0.26
Interpersonal communication			104.76	15.19	103.97	18.59	–0.33	0.74
Indenpendence-performance			103.41	17.86	102.03	17.56	–0.54	0.58
Independence-competence			101.70	18.25	100.96	13.36	–0.30	0.75
Recreation			102.05	17.89	100.13	16.38	–0.76	0.44
Prosocial			103.02	17.69	102.22	19.05	–0.30	0.76
Employment/Occupation			104.09	11.19	103.62	10.44	–0.30	0.76
Consumer constructed empowerment scale	65.33	7.74	64.28	7.75	67.18	7.41	2.64	0.009
Rosenberg self-esteem scale	23.52	4.23	22.89	4.12	24.62	4.22	2.89	0.004
Self-appraisal of illness questionnaire	38.83	6.04	39.65	5.82	37.39	6.19	–2.62	0.009
	N	N	N	N	N	N	χ²	p
Sex (male/female);	122/87		75/58		47/29		0.59	0.47

Table 2.

Comparison of general psychopathology scale scores of the PANSS between low and high self-stigma group in the patient with schizophrenia

	Low stigma (N=133)	High stigma (N=76)	t	p
	Mean±SD		Mean±SD
G1. Somatic concern	1.92±0.77	2.22±0.44	2.38	0.01
G2. Anxiety	2.26±0.68	2.70±0.98	3.76	＜0.001
G3. Guilt feelings	2.27±0.78	2.54±0.11	2.13	0.03
G4. Tension	2.49±0.64	2.47±0.84	–0.14	0.89
G5. Mannerisms/posturing	1.92±0.93	1.95±0.91	0.22	0.83
G6. Depression	2.19±0.82	2.75±0.76	4.85	＜0.001
G7. Motor retardation	1.81±0.79	1.91±0.95	0.77	0.44
G8. Uncooperativeness	1.83±0.81	1.93±0.88	0.78	0.44
G9. Unusual thought content	2.10±0.66	2.24±0.63	1.49	0.14
G10. Disorientation	1.18±0.44	1.17±0.47	–0.14	0.89
G11. Poor attention	2.05±0.88	2.07±0.96	0.16	0.88
G12. Lack of judgment/ insight	2.71±0.71	2.16±0.78	–4.49	＜0.001
G13. Disturbance of volition	2.25±0.89	2.24±0.91	–0.08	0.93
G14. Poor impulse control	2.17±0.86	2.24±0.86	0.52	0.61
G15. Preoccupation	2.18±0.74	2.24±0.83	0.51	0.61
G16. Active social avoidance	2.29±0.79	2.95±0.82	5.67	＜0.001

t: independent t-test, PANSS:Positive and Negative Syndrome Scale

Table 3.

Comparison of the perceived stigma scores between low and high self-stigma group in the patient with schizophrenia

	Low stigma (N=133)	High stigma (N=76)	t	p
	Mean±SD	Mean±SD	t	p
1. I have worried that others will view me unfavorably because	2.70±0.99	3.63±1.07	6.38	＜0.001
I am a psychiatric patient.
2. I have been in situations where I have heard others say	2.47±1.01	3.45±0.99	6.72	＜0.001
unfavorable or offensive things about psychiatric patients
and their illnesses.
3. I have seen or read things in the mass media	2.32±1.06	3.47±0.82	8.14	＜0.001
(e.g., television, movies, books) about psychiatric patients
and their illnesses that I find hurtful or offensive.
4. I have avoided telling others outside my immediate family	2.95±1.35	3.76±1.36	4.21	＜0.001
that I am a psychiatric patient.
5. I have been treated as less competent by others when	2.20±1.09	3.87±1.01	10.91	＜0.001
they learned I am a psychiatric patient.
6. I have been shunned or avoided when it was revealed that	1.91±0.93	3.39±1.28	9.69	＜0.001
I am a psychiatric patient.
7. I have been advised to lower my expectations in life	1.95±0.96	3.11±1.34	7.24	＜0.001
because I am a psychiatric patient.
8. I have been treated fairly by others who know I am a	2.94±1.31	2.94±1.31	0.65	0.52
psychiatric patient.
9. Friends who learned I am a psychiatric patient have been supportive and understanding.	2.74±1.37	3.13±1.37	1.98	0.05

t: independent t-test

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