Hector W H Tsang1, S C Ching2, K H Tang2, H T Lam2, Peggy Y Y Law2, C N Wan2. 1. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong. Electronic address: hector.tsang@polyu.edu.hk. 2. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
Abstract
OBJECTIVE: Internalized stigma can lead to pervasive negative effects among people with severe mental illness (SMI). Although prevalence of internalized stigma is high, there is a dearth of interventions and meanwhile a lack of evidence as to their effectiveness. This study aims at unraveling the existence of different therapeutic interventions and the effectiveness internalized stigma reduction in people with SMI via a systematic review and meta-analysis. METHODS: Five electronic databases were searched. Studies were included if they (1) involved community or hospital based interventions on internalized stigma, (2) included participants who were given a diagnosis of SMI>50%, and (3) were empirical and quantitative in nature. RESULTS: Fourteen articles were selected for extensive review and five for meta-analysis. Nine studies showed significant decrease in internalized stigma and two showed sustainable effects. Meta-analysis showed that there was a small to moderate significant effect in therapeutic interventions (SMD=-0.43; p=0.003). Among the intervention elements, four studies suggested a favorable effect of psychoeducation. Meta-analysis showed that there was small to moderate significant effect (SMD=-0.40; p=0.001). CONCLUSION: Most internalized stigma reduction programs appear to be effective. This systematic review cannot make any recommendation on which intervention is more effective although psychoeducation seems most promising. More Randomized Controlled Trials (RCT) on particular intervention components using standard outcome measures are recommended in future studies.
OBJECTIVE: Internalized stigma can lead to pervasive negative effects among people with severe mental illness (SMI). Although prevalence of internalized stigma is high, there is a dearth of interventions and meanwhile a lack of evidence as to their effectiveness. This study aims at unraveling the existence of different therapeutic interventions and the effectiveness internalized stigma reduction in people with SMI via a systematic review and meta-analysis. METHODS: Five electronic databases were searched. Studies were included if they (1) involved community or hospital based interventions on internalized stigma, (2) included participants who were given a diagnosis of SMI>50%, and (3) were empirical and quantitative in nature. RESULTS: Fourteen articles were selected for extensive review and five for meta-analysis. Nine studies showed significant decrease in internalized stigma and two showed sustainable effects. Meta-analysis showed that there was a small to moderate significant effect in therapeutic interventions (SMD=-0.43; p=0.003). Among the intervention elements, four studies suggested a favorable effect of psychoeducation. Meta-analysis showed that there was small to moderate significant effect (SMD=-0.40; p=0.001). CONCLUSION: Most internalized stigma reduction programs appear to be effective. This systematic review cannot make any recommendation on which intervention is more effective although psychoeducation seems most promising. More Randomized Controlled Trials (RCT) on particular intervention components using standard outcome measures are recommended in future studies.
Authors: Mario Maj; Jim van Os; Marc De Hert; Wolfgang Gaebel; Silvana Galderisi; Michael F Green; Sinan Guloksuz; Philip D Harvey; Peter B Jones; Dolores Malaspina; Patrick McGorry; Jouko Miettunen; Robin M Murray; Keith H Nuechterlein; Victor Peralta; Graham Thornicroft; Ruud van Winkel; Joseph Ventura Journal: World Psychiatry Date: 2021-02 Impact factor: 49.548
Authors: Z Xu; B Lay; N Oexle; T Drack; M Bleiker; S Lengler; C Blank; M Müller; B Mayer; W Rössler; N Rüsch Journal: Epidemiol Psychiatr Sci Date: 2018-01-31 Impact factor: 6.892
Authors: Hailey W Bulls; Edward Chu; Burel R Goodin; Jane M Liebschutz; Antoinette Wozniak; Yael Schenker; Jessica S Merlin Journal: Pain Date: 2022-02-01 Impact factor: 7.926