조현병 외래환자에서 낙인을 많이 느끼는 군과 적게 느끼는 군에서의임상 요인 비교
Comparisons of the Clinical Variables between High and Low Self-Stigma Group in the Outpatients with Schizophrenia
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Objectives : The purpose of this research was to investigate the differences of clinical variables between high and low self-stigma group in the outpatients with schizophrenia. Methods : 209 schizophrenic outpatients were assigned to high self stigma group (n=76) and low self stigma group (n=133) based on the scores of perceived stigma, and compared age, sex, education, age of onset, duration of illness, number of hospitalization, symptom, social functioning, insight, self-esteem, empowerment between two groups. Results : 1) The high self-stigma group had significantly lower age of onset, higher duration of illness and number of hospitalizations compared to the low self-stigma group. 2) In the PANSS, the high self-stigma group showed significantly higher score in the total score and general symptoms compared to the low self-stigma group. No significant difference was found in the positive symptoms and negative symptoms between two groups. 3) The high self-stigma group had significantly lower empowerment and self-esteem compared to the low self-stigma group. 4) The high self-stigma group had significantly higher insight compared to the low self-stigma group. Conclusion : Self-stigma in patients with schizophrenia directly reduces self-esteem and empowerment, and may cause depression and a lower quality of life. Therefore, identifying self-stigma and its degree is one of the important factors for good outcome.
Abstract
Objectives : The purpose of this research was to investigate the differences of clinical variables between high and low self-stigma group in the outpatients with schizophrenia. Methods : 209 schizophrenic outpatients were assigned to high self stigma group (n=76) and low self stigma group (n=133) based on the scores of perceived stigma, and compared age, sex, education, age of onset, duration of illness, number of hospitalization, symptom, social functioning, insight, self-esteem, empowerment between two groups. Results : 1) The high self-stigma group had significantly lower age of onset, higher duration of illness and number of hospitalizations compared to the low self-stigma group. 2) In the PANSS, the high self-stigma group showed significantly higher score in the total score and general symptoms compared to the low self-stigma group. No significant difference was found in the positive symptoms and negative symptoms between two groups. 3) The high self-stigma group had significantly lower empowerment and self-esteem compared to the low self-stigma group. 4) The high self-stigma group had significantly higher insight compared to the low self-stigma group. Conclusion : Self-stigma in patients with schizophrenia directly reduces self-esteem and empowerment, and may cause depression and a lower quality of life. Therefore, identifying self-stigma and its degree is one of the important factors for good outcome.
참고문헌 (51)
- Thornicroft G, "Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey", Lancet, 373, pp.408~415 (2009)
- Corrigan PW, "The stigma of mental illness: explanatory models and methods for change", Appl Prev Psychol, 11, pp.179~190 (2005)
- Dinos S, "Stigma: the feelings and experiences of 46 people with mental illness", Br J Psychiatry, 184, pp.176~181 (2004)
- Birchwood M, "Social anxiety and the shame of psychosis: a study in first episode psychosis", Behav Res Ther, 45, pp.1025~1037 (2007)
- Barney LJ, "Stigma about depression and its impact on help-seeking intentions", Aust N Z J Psychiatry, 40, pp.51~54 (2006)
- Vrbova K, "Self-stigma and schizophrenia: a cross-sectional study", Neuropsychiatr Dis Treat, 12, pp.3011~3020 (2016)
- Link BG, "Conceptualizing stigma", Annu Rev Sociol, 27, pp.363~385 (2001)
- Wahl OF, "Family views of stigma", Schizophr Bull, 15, pp.131~ (1989)
- Bentz WK, "Concensus on attitudes toward mental illness: Between leaders and the general public in a rural community", Arch Gen Psychiatry, 22, pp.468~473 (1970)
- Jung S, "Changes in attitude towards people with mental illness in P-city, S. Korea: a comparison between the years 2000 and 2010", Asia Pac J Soc Work, 27, pp.83~95 (2017)
- Park YC, "Community leaders attitude toward mental illness", J Korean Neuropsychiatr Assoc, 22, pp.218~223 (1983)
- Kim CK, "Family burden of schizophrenics in the primary caregivers and siblings", J Korean Neuropsychiatr Assoc, 39, pp.113~127 (2000)
- Chung KF, "Changing the attitudes of Hong Kong medical students toward people with mental illness", J Nerv Ment Dis, 193, pp.766~768 (2005)
- Yang OK, "Social stigma on people with mental disorder", Korean J Soc Welf, 35 (1998)
- Hilton J, "Stereotypes", Annu Rev Psychol, 47, pp.237~271 (1996)
- Corrigan PW, "The impact of stigma on severe mental illness", Cogn Behav Pract, 5, pp.201~222 (1998)
- Jetten J, "Discrimination constrained and justified: Variable effects of group variability and in-group identification", J Exp Soc Psychol, 36, pp.329~356 (2000)
- Miller CE, "Some social psychological effects of group decision rules", J Pers Soc Psychol, 52, pp.325~332 (1987)
- Crocker J, "The Psychology of Prejudice: The Ontario Symposium Vol 7", pp.289~314 (1994), Lawrence Erlbaum
- 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)
- Ritsher JB, "Internalized stigma of mental illness: psychometric properties of a new measure", Psychiatry Res, 121, pp.31~49 (2003)
- Watson AC, "Self-stigma in people with mental illness", Schizophr Bull, 33, pp.1312~1318 (2007)
- Lysaker PH, "Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders", Schizophr Bull, 33, pp.192~199 (2007)
- Lysaker PH, "Associations of multiple domains of self-esteem with four dimensions of stigma in schizophrenia", Schizophr Res, 98, pp.194~200 (2008)
- Yanos PT, "Pathways between internalized stigma and outcomes related to recovery in schizophrenia spectrum disorders", Psychiatr Serv, 59, pp.1437~1442 (2008)
- Vauth R, "Self-efficacy and empowerment as outcomes of self-stigmatizing and coping in schizophrenia", Psychiatry Res, 150, pp.71~80 (2007)
- 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)
- Rosenfield S, "Labeling mental illness: the effects of received services and perceived stigma on life satisfaction", Am Sociol Rev, 62, pp.660~672 (1997)
- 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)
- Wright ER, "Deinstitutionalization, social rejection, and the self-esteem of former mental patients", J Health Soc Behav, 41, pp.68~90 (2000)
- Link BG, "Stigma as a barrier to recovery: the consequences of stigma for the self-esteem of people with mental illness", Psychiatr Serv, 52, pp.1621~1626 (2001)
- Perlick DA, "Stigma as a barrier to recovery: adverse effects of perceived stigma on social adaption of persons diagnosed with bipolar affective disorder", Psychiatr Serv, 52, pp.1627~1632 (2001)
- Sirey JA, "Stigma as a barrier to recovery: perceived stigma and patient-related severity of illness as predictors of antidepressant drug adherence", Psychiatr Serv, 52, pp.1615~1620 (2001)
- American Psychiatric Association, "The diagnostic and statistical manual of mental disorder" (1994), American Psychiatirc Press
- 김영신, "The Reliability and Validity of Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version (K-SADS-PL-K)", Yonsei Medical Journal, 45(1), pp.81~89 (2004), 연세대학교의과대학
- 이중서, "한국판 양성 및 음성증후군 척도(Positive and Negative Syndrome Scale)의 신뢰도와 타당도", 신경정신의학, 40(6), pp.1090~1105 (2001), 대한신경정신의학회
- 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)
- Rogers ES, "A Consumer-constructed Scale to Measure Empowerment Among Users of Mental Health Services", Psychiatr Serv, 48, pp.1042~1047 (1997)
- Rosenberg M, "Society and the Adolescent Self-Image", pp.125~136 (1965), Princeton University Press
- Phillips MR, "Stigma and expressed emotion: a study of people with schizophrenia and their family members in China", Br J Psychiatry, 181, pp.488~493 (2002)
- Goldin CS, "Stigma, biomedical efficacy, and institutional control", Soc Sci Med, 30, pp.895~900 (1990)
- Karidi MV, "Perceived social stigma, self-concept, and self-stigmatization of patient with schizophrenia", Compr Psychiatry, 51, pp.19~30 (2010)
- Link BG, "Understanding labeling effects in the area of mental disorders: an assessment of the effects of expectations of rejection", Am Sociol Rev, 52, pp.96~112 (1987)
- Cuffel BJ, "Awareness of illness in schizophrenia and outpatient treatment compliance", J Nerv Ment Dis, 184, pp.653~659 (1996)
- Lysaker PH, "Psychosocial function and insight in schizophrenia", J Nerv Ment Dis, 186, pp.432~436 (1998)
- Schwartz RC, "The relationship between insight, illness and treatment outcome in schizophrenia", Psychiatr Q, 69, pp.1~22 (1998)
- Mintz AR, "Insight in schizophrenia: a meta-analysis", Schizophr Res, 61, pp.75~88 (2003)
- Warner R, "Acceptance of the mental illness label by psychotic patients: effects on functioning", Am J Orthopsychiatry, 59, pp.389~409 (1989)
- Hasson-Ohayon I, "Insight into psychosis and quality of life", Compr Psychiatry, pp.265~269 (2006)
- Roe D, "Different ways of being aware of and acknowledging a psychiatric disability. A multifunctional narrative approach to insight into mental disorder", J Nerv Ment Dis, 191, pp.417~424 (2003)
