Carmen Simonsen1, Sofie R Aminoff2, Anja Vaskinn3, Elizabeth A Barrett4, Ann Faerden5, Torill Ueland6, Ole A Andreassen7, Kristin Lie Romm8, Ingrid Melle9. 1. NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Norway. Electronic address: c.e.simonsen@medisin.uio.no. 2. NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Norway. Electronic address: s.r.aminoff@medisin.uio.no. 3. NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway. Electronic address: anja.vaskinn@medisin.uio.no. 4. NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Norway. Electronic address: elanba@ous-hf.no. 5. NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway. Electronic address: ann.faerden@medisin.uio.no. 6. NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway; Department of Psychology, University of Oslo, Norway. Electronic address: torill.ueland@psykologi.uio.no. 7. NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway. Electronic address: o.a.andreassen@medisin.uio.no. 8. NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Norway. Electronic address: k.l.romm@medisin.uio.no. 9. NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway. Electronic address: Ingrid.melle@medisin.uio.no.
Abstract
OBJECTIVES: Perceived/experienced stigma and its relationship with clinical outcome were investigated across the first year of treatment in a large sample with first-episode psychosis (FEP). METHODS: FEP participants (n=112) in the TOP study were investigated at baseline and 1-year follow-up. Perceived/experienced stigma was measured with items from the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), assessing problems because of barriers and hindrances, and living with dignity because of attitudes and actions of others. Clinical outcome included: symptoms, global functioning, self-rated disability and self-rated life satisfaction. RESULTS: In the total sample, 46% perceived/experienced stigma at baseline, which decreased significantly to 32% at 1-year follow-up. Perceived/experienced stigma was present in 1/5 at both time-points (Sustained stigma), in 2/5 at only one time-point (Transient stigma), and in 2/5 it was not present at either time-point (No stigma). Compared to the No stigma group, the Sustained stigma group had significantly higher levels of positive, excited and depressive symptoms and self-rated disability, as well as lower levels of global functioning and life satisfaction at 1year follow-up, while the Transient stigma group only had poorer functioning and higher self-rated disability. Yet the outcome variables improved across the first year of treatment in all three stigma groups. CONCLUSION: Perceived/experienced stigma was common in FEP, yet the rate decreased across the first year of treatment. Although there was some clinical improvement across the first year of treatment irrespective of stigma, stigma was related to poorer clinical outcome in a bidirectional manner. This suggests that perceived/experienced stigma is an important target in the early stages of treatment.
OBJECTIVES: Perceived/experienced stigma and its relationship with clinical outcome were investigated across the first year of treatment in a large sample with first-episode psychosis (FEP). METHODS: FEP participants (n=112) in the TOP study were investigated at baseline and 1-year follow-up. Perceived/experienced stigma was measured with items from the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), assessing problems because of barriers and hindrances, and living with dignity because of attitudes and actions of others. Clinical outcome included: symptoms, global functioning, self-rated disability and self-rated life satisfaction. RESULTS: In the total sample, 46% perceived/experienced stigma at baseline, which decreased significantly to 32% at 1-year follow-up. Perceived/experienced stigma was present in 1/5 at both time-points (Sustained stigma), in 2/5 at only one time-point (Transient stigma), and in 2/5 it was not present at either time-point (No stigma). Compared to the No stigma group, the Sustained stigma group had significantly higher levels of positive, excited and depressive symptoms and self-rated disability, as well as lower levels of global functioning and life satisfaction at 1year follow-up, while the Transient stigma group only had poorer functioning and higher self-rated disability. Yet the outcome variables improved across the first year of treatment in all three stigma groups. CONCLUSION: Perceived/experienced stigma was common in FEP, yet the rate decreased across the first year of treatment. Although there was some clinical improvement across the first year of treatment irrespective of stigma, stigma was related to poorer clinical outcome in a bidirectional manner. This suggests that perceived/experienced stigma is an important target in the early stages of treatment.
Authors: Joseph S DeLuca; LeeAnn Akouri-Shan; Samantha Y Jay; Samantha L Redman; Emily Petti; Alicia Lucksted; Pamela Rakhshan Rouhakhtar; Mallory J Klaunig; Sarah M Edwards; Gloria M Reeves; Jason Schiffman Journal: J Abnorm Psychol Date: 2021-08
Authors: Eshetu Girma; Bezawit Ketema; Tesfahun Mulatu; Brandon A Kohrt; Syed Shabab Wahid; Eva Heim; Petra C Gronholm; Charlotte Hanlon; Graham Thornicroft Journal: Int J Ment Health Syst Date: 2022-06-23
Authors: Mao-Sheng Ran; Yi-Zhou Wang; Pei-Yi Lu; Xue Weng; Tian-Ming Zhang; Shu-Yu Deng; Ming Li; Wei Luo; Irene Yin-Ling Wong; Lawrence H Yang; Graham Thornicroft; Lin Lu Journal: Lancet Reg Health West Pac Date: 2022-03-03