A Study Of Stigma And Related Factors In Schizophrenic Patients

Objective The patients will produce a discreditable inner experience which be called as stigma because of illness. For social stereotype and cognition on mental illness, patients with schizophrenia may experience more discrimination and disgrace. As some researches confirmed from abroad, the stigma may correlated with the level of self-esteem, self-efficacy and some other factors in patients with schizophrenia. But there have a very few domestic researches on stigma in patients with mental illness, this research will investigate the stigma, discuss the related factors with stigma in patients with schizophrenia, and supply some measures to reduce stigma in patients, promote their psychological rehabilitation. In the meantime, we will translate and edit the Stigma Scale for Mental Illness (SSMI), and examine the reliability and validity of this scale.Methods In study one, three hundred and thirty-two patients with schizophrenia were investigated. The investigation was carried out with Stigma Scale for Mental Illness and some related scales. T test, ANOVA, correlated analysis and linear regression analysis were used to analyze the relationship between several factors and stigma. In study two, a total of 339 patients with schizophrenia were tested.A factor analysis procedure was used to explore the factor structure of SSMI-C, which used 172 patients'data of all.And another factor analysis procedure was used to confirm the factor structure of SSMI-C, which used another 167 patients'data. Totally 101 patients completed SSMI-C retest 2 weeks later. The criterion-related validity was evaluated through correlating SSMI with Stigma Interview for Mental Illness(SIMI)and Rosenberg Self-esteem Scale(SES).Results In study one, there were some statistical correlations between stigma and self-esteem, self-efficacy, personality, social support, alexithymia, et al. (P<0.05). Taking patients'stigma as dependent variable, taking factors mentioned above as independent variable, a linear regression analysis was performed. The results showed that standard coefficient of neuroticism, self-esteem, objective support, depressive factor, factor DDF of Tas-20 were 0.247,-0.191,-0.189,0.130,0.141. In study two, exploratory factor analysis extracted 3 components and the percentage of variance explained was 39.3%, and factor loading for all items of SSMI-C ranged from 0.415 to 0.791 except for the sixth item. The indexes of confirmatory factor analysis were as follows, GFI=0.89, NNFI=0.92, CFI=0.94,χ2/df =1.81, and REMEA=0.07. Significant correlations were found between SSMI-C and SIMI(r=0.78, P <0.01), SSMI-C and SES(r=-0.40,P <0.01). The Cronbach'αcoefficient of SSMI-C was 0.82 (P <0.01), and the test-retest reliability was 0.75(P <0.01). The correlation coefficients of the three factors with the total scale score ranged from 0.48 to 0.83. The correlation coefficients of the three factors ranged from 0.124 to 0.34.Conclusion In study one, stigma of schizophrenia patients is associated with several factors, among which, neuroticism, self-esteem, objective support, depressive factor, factor DDF of Tas-20 might play important roles on stigma in schizophrenia patients. In study two, the SSMI-C has good psychometrics properties, with adequate reliability and validity, and can be applicable to assess the stigma of Chinese patients with schizophrenia.