정신분열병 외래 환자가 경험하는 낙인에 미치는 요인
Factors Affecting a Stigma That is Experienced by Outpatients with Schizophrenia
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives To identify various factors that might affect stigmas affecting outpatients with schizophrenia, and to further clarify the effects of both factors affected by the treatment and other factors on stigmas in a clinical setting. Methods Of patients who had been receiving outpatient treatments at the Donga University Hospital Department of Psychiatry and those who had been attending the community mental health center and community psychiatric rehabilitation center, 178 patients with a DSM-IV diagnosis of schizophrenia with stable symptoms were enrolled in this study. In these patients, through an interview or self-reporting, we assessed stigmas (the Korean version of Mental Health Consumers’ Experience of Stigmas), psychiatric symptoms (the Korean version of the Positive and Negative Syndrome Scale), social functions (the Korean version of the Social Functioning Scale), insight (the Self-Appraisal of Illness Questionnaire), empowerment (a Consumer-Constructed Empowerment Scale), and self-esteem (Rosenberg Self-Esteem Scale). In more detail, we performed an ANOVA in consideration of 11 factors (age, gender, the level of education, economic status, the duration of disease, the frequency of hospitalization, symptoms, insight, self-esteem, empowerment, and social functions) as explanatory variables for stigmas. Results On a multiple regression analysis using backward elimination, the following five factors were found to be significant explanatory variables for stigmas that are experienced by outpatients with schizophrenia : the disease of duration, self-esteem, insight, age, and gender. The coefficient of determination for these five explanatory variables was 0.44. Conclusion In conclusion, our results showed that five factors were found to be significant explanatory variables for stigmas that are experienced by outpatients with schizophrenia. These five factors were the duration of the disease, self-esteem, insight, age, and gender. Because these five variables accounted for only 44% of total stigmas, however, further studies in a larger group of patients are warranted to identify other factors that might affect stigmas.
Abstract
Objectives To identify various factors that might affect stigmas affecting outpatients with schizophrenia, and to further clarify the effects of both factors affected by the treatment and other factors on stigmas in a clinical setting. Methods Of patients who had been receiving outpatient treatments at the Donga University Hospital Department of Psychiatry and those who had been attending the community mental health center and community psychiatric rehabilitation center, 178 patients with a DSM-IV diagnosis of schizophrenia with stable symptoms were enrolled in this study. In these patients, through an interview or self-reporting, we assessed stigmas (the Korean version of Mental Health Consumers’ Experience of Stigmas), psychiatric symptoms (the Korean version of the Positive and Negative Syndrome Scale), social functions (the Korean version of the Social Functioning Scale), insight (the Self-Appraisal of Illness Questionnaire), empowerment (a Consumer-Constructed Empowerment Scale), and self-esteem (Rosenberg Self-Esteem Scale). In more detail, we performed an ANOVA in consideration of 11 factors (age, gender, the level of education, economic status, the duration of disease, the frequency of hospitalization, symptoms, insight, self-esteem, empowerment, and social functions) as explanatory variables for stigmas. Results On a multiple regression analysis using backward elimination, the following five factors were found to be significant explanatory variables for stigmas that are experienced by outpatients with schizophrenia : the disease of duration, self-esteem, insight, age, and gender. The coefficient of determination for these five explanatory variables was 0.44. Conclusion In conclusion, our results showed that five factors were found to be significant explanatory variables for stigmas that are experienced by outpatients with schizophrenia. These five factors were the duration of the disease, self-esteem, insight, age, and gender. Because these five variables accounted for only 44% of total stigmas, however, further studies in a larger group of patients are warranted to identify other factors that might affect stigmas.
참고문헌 (30)
- Allison-Bolger VY, "The original sin of madness--or how psychiatrists can stigmatize their patients", Int J Clin Pract, 53, pp.627~630 (1999)
- Tarrier N, "The subjective consequences of suffering a first episode psychosis: trauma and suicide behaviour", Soc Psychiatry Psychiatr Epidemiol, 42, pp.29~35 (2007)
- Birchwood M, "Social anxiety and the shame of psychosis: a study in first episode psychosis", Behav Res Ther, 45, pp.1025~1037 (2007)
- Corrigan PW, "The impact of stigma on severe mental illness", Cogn Behav Pract, 5, pp.202~222 (1998)
- Link BG, "Stigma as a barrier to recovery: The consequences of stigma for the selfesteem of people with mental illnesses", Psychiatr Serv, 52, pp.1621~1626 (2001)
- Wahl OF, "Family views of stigma", Schizophr Bull, 15, pp.131~139 (1989)
- Fabrega H Jr, "Psychiatric stigma in the classical and medieval period: a review of the literature", Compr Psychiatry, 31, pp.289~306 (1990)
- Farina A, "Stigma. Handbook of Social Functioning", pp.247~279 (1998), Boston MA: Allyn and Bacon
- Link BG, "Understanding labeling effects in the area of mental disorders: an assessment on the effects of expectations on rejection", Am Social Rev, 52, pp.96~112 (1987)
- Link BG, "The effectiveness of stigma coping orientations: can negative consequences of mental illness labeling be avoided", J Health Soc Behav, 32, pp.302~320 (1991)
- Brockington IF, "The community’s tolerance of the mentally ill", Br J Psychiatry, 162, pp.93~99 (1993)
- Hall P, "A comparison of responses to the mentally ill in two communities", Br J Psychiatry, 162, pp.99~108 (1993)
- Angermeyer MC, "Stigma perceived by patients attending modern treatment settings. Some unanticipated effects of community psychiatry reforms", J Nerv Ment Dis, 175, pp.4~11 (1987)
- Phelan JC, "Psychiatric illness and family stigma", Schizophr Bull, 24, pp.115~126 (1998)
- Staring AB, "Stigma moderates the associations of insight with depressed mood, low self-esteem, and low quality of life in patients with schizophrenia spectrum disorders", Schizophr Res, 115, pp.363~369 (2009)
- Mechanic D, "Effects of illness attribution and depression on the quality of life among persons with serious mental illness", Soc Sci Med, 39, pp.155~164 (1994)
- Link BG, "A modified labeling theory approach to mental disorders and empirical assessment", Am Sociol Rev, 54, pp.400~423 (1989)
- Rogers ES, "A consumer-constructed scale to measure empowerment among users of mental health services", Psychiatr Serv, 48, pp.1042~1047 (1997)
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders. 4th ed" (1994), Washington DC: American Psychiatric Association
- 이중서, "한국판 양성 및 음성증후군 척도(Positive and Negative Syndrome Scale)의 신뢰도와 타당도", 신경정신의학, 40(6), pp.1090~1105 (2001), 대한신경정신의학회
- Wahl OF, "Mental health consumers’ experience of stigma", Schizophr Bull, 25, pp.467~478 (1999)
- Chon HG, "The reliability and validity of the Korean version of psychiatric patients’ experience of stigma in the patients with schizophrenia", Korean J Schizophr Res, 13, pp.34~41 (2010)
- 김철권, "정신분열병 환자의 한국어판 사회기능척도 개발 : 신뢰도 및 타당도 연구", 생물정신의학, 16(2), pp.76~111 (2009), 대한생물정신의학회
- Marks KA, "Self-Appraisal of Illness Questionnaire (SAIQ): relationship to researcher-rated insight and neuropsychological function in schizophrenia", Schizophr Res, 45, pp.203~211 (2000)
- Rosenberg M, "Society and the Adolescent Self-Image", pp.125~136 (1965), Princeton, New Jersey: Princeton University Press
- Markowitz FE, "The effects of stigma on the psychological well-being and life satisfaction of persons with mental illness", J Health Soc Behav, 39, pp.335~347 (1998)
- Graham C, "The social functioning of older adults with schizophrenia", Aging Ment Health, 6, pp.149~152 (2002)
- Dickerson FB, "Experiences of stigma among outpatients with schizophrenia", Schizophr Bull, 28, pp.143~155 (2002)
- Link BG, "On stigma and its consequences: evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse", J Health Soc Behav, 38, pp.177~190 (1997)
- Corrigan PW, "Lessons from social psychology on discrediting psychiatric stigma", Am Psychol, 54, pp.765~776 (1999)
