본문 바로가기
KERD
논문KCI 등재

조현병 환자의 내재화된 낙인과 관련된 요인

Factors Related to Internalized Stigma in Patients with Schizophrenia

2

조회

0

다운로드

7

인용

0

참고문헌

키워드

주제분류정신과학

초록

Objectives:Patients with schizophrenia have high levels of self-perceived stigma, which frequently hinders successful treatment. The aim of this study was to investigate the factors related with internalized stigma in patients with schizophrenia. Methods:A total of 123 patients with schizophrenia according to Diagnostic and Statistical Manual of Mental disorders 5th edition(DSM-5) criteria were enrolled. Sociodemographic and clinical variables including previous suicidal attempt history were assessed. Self-perceived stigma was assessed using Korean version of Internalized Stigma of Mental Illness Scale(K-ISMI). Clinical characteristics and psychopathology were measured using the Positive and Negative Syndrome Scale(PANSS), Beck Depression Inventory(BDI), Beck Hopelessness Scale-7(BHS-7), Rosenberg Self Esteem Scale(R-SES), and EuroQol-5 dimensions visual analog scale(EQ5D-VAS). Results:The K-ISMI total scores had significantly negative correlations with scores on the R-SES and EQ-VAS, and significantly positive correlations with scores on the BDI, BHS-7, and PANSS negative and general psychopathology subscales after controlling age and duration of illness. Patients with previous suicidal attempt history showed significantly higher scores on the K-ISMI scores. Conclusion:Internalized stigma of patients with schizophrenia was associated with low self-esteem, poor quality of life, history of suicidal attempt and higher level of depression, hopelessness, and negative symptoms. Clinicians should carefully evaluate and manage self-perceived stigma of patients with schizophrenia.

Abstract

Objectives:Patients with schizophrenia have high levels of self-perceived stigma, which frequently hinders successful treatment. The aim of this study was to investigate the factors related with internalized stigma in patients with schizophrenia. Methods:A total of 123 patients with schizophrenia according to Diagnostic and Statistical Manual of Mental disorders 5th edition(DSM-5) criteria were enrolled. Sociodemographic and clinical variables including previous suicidal attempt history were assessed. Self-perceived stigma was assessed using Korean version of Internalized Stigma of Mental Illness Scale(K-ISMI). Clinical characteristics and psychopathology were measured using the Positive and Negative Syndrome Scale(PANSS), Beck Depression Inventory(BDI), Beck Hopelessness Scale-7(BHS-7), Rosenberg Self Esteem Scale(R-SES), and EuroQol-5 dimensions visual analog scale(EQ5D-VAS). Results:The K-ISMI total scores had significantly negative correlations with scores on the R-SES and EQ-VAS, and significantly positive correlations with scores on the BDI, BHS-7, and PANSS negative and general psychopathology subscales after controlling age and duration of illness. Patients with previous suicidal attempt history showed significantly higher scores on the K-ISMI scores. Conclusion:Internalized stigma of patients with schizophrenia was associated with low self-esteem, poor quality of life, history of suicidal attempt and higher level of depression, hopelessness, and negative symptoms. Clinicians should carefully evaluate and manage self-perceived stigma of patients with schizophrenia.

참고문헌 (64)

  1. Goffman E, "Stigma" (1963), Prentice-Hall
  2. Yang OK, "Social stigma on people with mental disorder", Korean J Soc Welf, 35, pp.231~261 (1998)
  3. Cho EY, "Study on the stigmatization process toward the people with mental illness", pp.2000
  4. Borinstein AB, "Public attitudes toward persons with mental illness", Health Aff, 11, pp.186~196 (1992)
  5. 강상경, "지역사회정신보건 재활서비스에 대한 소비자 만족도, 자기효능감 및 삶의 질 - 자기효능감의 매개효과를 중심으로 -", 사회복지연구, (33), pp.185~213 (2007), 한국사회복지연구회
  6. Corrigan PW, "How does stigma affect work in people with serious mental illnesses?", Psychiatr Rehabil J, 35, pp.381~ (2012)
  7. Link BG, "Understanding labeling effects in the area of mental disorders: an assessment of the effects of expectations of rejection", Am Sociol Rev, pp.96~112 (1987)
  8. Link BG, "Conceptualizing stigma", Annual review of Sociology, pp.363~385 (2001)
  9. Rüsch N, "Longitudinal course of self-labeling, stigma stress and well-being among young people at risk of psychosis", Schizophr Res, 158, pp.82~84 (2014)
  10. 유태영, "Relationship between Suicidality and Low Self-esteem in Patients with Schizophrenia", Clinical Psychopharmacology and Neuroscience, 13(3), pp.296~301 (2015), 대한정신약물학회
  11. Gong SJ, "The perceptions and attitudes of lay person toward the mentally ill", J Korean Acad Psychiatr Ment Health Nurs, 6, pp.265~277 (1997)
  12. Lee EH, "The attitudes of the inhabitants of Kwangju towards the persons with mental illness", J Korean Neuropsychiatr Assoc, 39, pp.495~506 (2000)
  13. Ko BJ, "Attitudes toward ex-mental patients: a community survey", pp.1979
  14. Kim KI, "Public knowledge and attitude toward mental illness in Korea", Ment Health Res, 8, pp.118~132 (1989)
  15. Kim KI, "Community leaders’ attitude toward mental illness", J Korean Neuropsychiatr Assoc, 22, pp.218~232 (1983)
  16. Ahn DS, "Community leaders’ reactions to mental disorders", Seoul J Psychiatr, 11, pp.281~297 (1986)
  17. Kim CK, "Family burden of schizophrenics in the primary caregivers and siblings", J Korean Neuropsychiatr Assoc, 39, pp.113~127 (2000)
  18. Yang OK, "Family of the mentally ill-care burden, coping and service needs", J Korean Neuropsychiatr Assoc, 34, pp.809~929 (1995)
  19. Kwak UH, "A study on the perceived stigma of mental disorders", pp.2000
  20. Kim YS, "A preliminary study of attitudes toward mental illness", Seoul J Psychiatr, 13, pp.27~36 (1988)
  21. Kim SW, "The analysis of newspaper article on psychosis", J Korean Neuropsychiatr Assoc, 39, pp.838~848 (2000)
  22. Kommana S, "Dispelling the stigma of schizophrenia", Psychiatr Serv, 48, pp.1393~1395 (1997)
  23. Williams M, "Mental illness: media perpetuation of stigma", Contemp Nurse, 4, pp.41~46 (1995)
  24. Kim SW, "Are current labeling terms suitable for people who are at risk of psychosis?", Schizophr Res (2017)
  25. Link BG, "A modified labeling theory approach to mental disorders: An empirical assessment", Am Sociol Rev, pp.400~423 (1989)
  26. Livingston JD, "Correlates and consequences of internalized stigma for people living with mental illness:a systematic review and meta-analysis", Soc Sci Med, 71, pp.2150~2161 (2010)
  27. Hill K, "The relationship between internalized stigma, negative symptoms and social functioning in schizophrenia: the mediating role of self-efficacy", Psychiatry Res, 206, pp.151~157 (2013)
  28. Cavelti M, "Selfstigma and its relationship with insight, demoralization, and clinical outcome among people with schizophrenia spectrum disorders", Compr Psychiatry, 53, pp.468~479 (2012)
  29. Seo MK, "Measuring perceived stigma and coping by psychiatric patients", Ment Health Soc Work, 1, pp.145~158 (1994)
  30. 한경례, "정신분열병 환자의 낙인에 영향을 주는 요인", 신경정신의학, 41(6) (2002), 대한신경정신의학회
  31. Sung JM, "A study on the perceived stigma and coping orientations of discharged psychiatric patients", pp.1996
  32. Ritsher JB, "Internalized stigma predicts erosion of morale among psychiatric outpatients", Psychiatry Res, 129, pp.257~265 (2004)
  33. American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorder" (2013), American Psychiatric Publishing
  34. Kay SR, "The positive and negative syndrome scale(PANSS) for schizophrenia", Schizophr Bull, 13, pp.261~276 (1987)
  35. 이중서, "한국판 양성 및 음성증후군 척도(Positive and Negative Syndrome Scale)의 신뢰도와 타당도", 신경정신의학, 40(6), pp.1090~1105 (2001), 대한신경정신의학회
  36. 황태연, "한국판 정신질환의 내재화된 낙인 척도의 신뢰도 및 타당도 연구", 신경정신의학, 45(5), pp.418~426 (2006), 대한신경정신의학회
  37. Beck AT, "An inventory for measuring depression", Arch Gen Psychiatry, 4, pp.561~571 (1961)
  38. Hahn HM, "Standardization study of Beck Depression Inventory in Korea", J Korean Neuropsychiatr Assoc, 25, pp.487~502 (1986)
  39. Beck AT, "The measurement of pessimism: the hopelessness scale", J Consult Clin Psychol, 42, pp.861~865 (1974)
  40. Abbey JG, "Hopelessness at the end of life: the utility of the Hopelessness Scale with terminally ill cancer patients", Br J Health Psychol, 11, pp.173~183 (2006)
  41. Rosenberg M, "Society and the adolescent self-image" (1965), princeton university press
  42. The EuroQol Group, "EuroQol: a new facility for the measurement of health-related quality of life", Health Policy, 16, pp.199~208 (1990)
  43. 서미경, "지각된 낙인이 정신장애인의 삶의 만족과 자아존중감에 미치는 영향", 한국사회복지학, 56(4), pp.173~194 (2004), 한국사회복지학회
  44. 김성용, "정신장애인의 스티그마가 자아존중감에 미치는 영향:스티그마에 대한 자기보호적 속성을 중심으로", 정신보건과 사회사업, 42(3), pp.91~120 (2014), 한국정신보건사회복지학회
  45. Link BG, "Stigma as a barrier to recovery: the consequences of stigma for the self-esteem of people with mental illnesses", Psychiatr Serv, 52, pp.1621~1626 (2001)
  46. 김성완, "Effects of Group Cognitive-Behavioral Therapy in Young Patients in the Early Stage of Psychosis", PSYCHIATRY INVESTIGATION, 14(5), pp.609~617 (2017), 대한신경정신의학회[DOI]
  47. Moritz S, "Detecting and defusing cognitive traps:metacognitive intervention in schizophrenia", Curr Opin Psychiatry, 23, pp.561~569 (2010)
  48. Koreen AR, "Depression in first-episode schizophrenia", Am J Psychiatry, 150, pp.1643~1648 (1993)
  49. Kim SW, "Diagnostic validity of the assessment scales for depression in patients with schizophrenia", Psychiatry Res, 144, pp.57~63 (2006)
  50. 이지수, "차별경험과 자기 낙인이 장애인의 삶의 만족도에 미치는 영향", 사회과학연구, 27(1), pp.277~299 (2011), 사회과학연구소
  51. Farrelly S, "The link between mental health-related discrimination and suicidality: service user perspectives", Psychol Med, 45, pp.2013~2022 (2015)
  52. Cohen LJ, "Suicide and schizophrenia:data from a prospective community treatment study", Am J Psychiatry, 147, pp.602~607 (1990)
  53. Roy A, "Attempted suicide in chronic schizophrenia", Br J Psychiatry, 144, pp.303~306 (1984)
  54. Caldwell CB, "Schizophrenia-a high-risk factor for suicide: clues to risk reduction", Life Threat Behv, 22, pp.479~493 (1992)
  55. Hawton K, "Schizophrenia and suicide: systematic review of risk factors", Br J Psychiatry, 187, pp.9~20 (2005)
  56. 김성완, "‘조현병-정신분열병’ 병명에 따른 낙인 비교", 신경정신의학, 51(4), pp.210~217 (2012), 대한신경정신의학회
  57. 정신질환자에 대한 차별과 편견 실태조사, "서미경", 국가인권위원회, ~ (2008)
  58. Kim SW, "The stigmatization of psychosis in Korean Newspaper articles", Korean J Schizophr Res, 14, pp.42~49 (2011)
  59. Couture SM, "Interpersonal contact and the stigma of mental illness: a review of the literature", J Ment Health, 12, pp.291~305 (2003)
  60. 서미경, "정신장애인에 대한 일반인의 스티그마와 정신장애인이 지각하는 스티그마의 비교 연구", 신경정신의학, 44(3), pp.371~375 (2005), 대한신경정신의학회
  61. Link B, "Reconsidering the social rejection of ex-mental patients: levels of attitudinal response", Am J Commun Psychol, 11, pp.261~273 (1983)
  62. Ben-Zeev D, "Predictors of Self-Stigma in Schizophrenia: new Insights Using Mobile Technologies", J Dual Diagn, 8, pp.305~314 (2012)
  63. Hodges E, "Individual risk and social risk as interacting determinants of victimization in the peer group", Dev Psychology, 33, pp.1032~1039 (1997)
  64. Krupnick J, "Victims of violence: Psychological responses, treatment implications", Evaluation and change, pp.42~46 (1980)

관련 논문AI추천

이 간행물의 다른 논문 (2건)