Self-stigma and its correlates in first-episode psychosis patients in Hong Kong

Abstract

BACKGROUND: Stigma has been identified as a significant barrier to psychiatric treatment and intervention for psychosis patients. In particular, self-stigma significantly affects one’s life goals and quality of life. Yet, few studies have measured the stigma of both patients and their caregivers. The present study aimed to examine (1) the relationships between perceived public stigma, self-stigma, and affiliate stigma; and (2) the correlates of self-stigma for patients presenting with first-episode psychosis in Hong Kong. METHODS: A total of 44 patients (23 males) presenting with first-episode psychosis and their caregivers were recruited. Patients were all diagnosed with schizophrenia or schizophreniform disorders. Patients completed assessments on demographics, clinical and psychological measurements, while caregivers completed assessments on affiliate stigma and perceived public stigma. RESULTS: Correlation analyses were performed to examine the relationships of patient’s self-stigma with potential correlates. There were no significant associations between self-stigma and affiliate stigma. However, the perceived public stigma of patients was correlated with the perceived public stigma of caregivers (r = 0.33, p < 0.05). Correlation analyses revealed that loss of face (r = 0.56, p < 0.0001), medication attitude (r = –0.36, p < 0.05), perceived public stigma (r = 0.63, p < 0.0001), and psychological health of quality of life (r = –0.31, p < 0.05) were correlated with patient’s self-stigma. Multiple regression demonstrated that loss of face (odds ratio = 0.35, p < 0.01) and higher degree of perceived public stigma (odds ratio = 0.46, p < 0.01) were independently associated with the high level of patient’s self-stigma. CONCLUSION: In a group of Chinese young patients with first-episode psychosis and their caregivers, we found that perceived public stigma between patients and caregivers were related, but not the self-stigma and affiliate stigma. Loss of face and higher degree of perceived public stigma were shown to independently associate with patient’s self-stigma. Further research can investigate the psychosocial intervention to address these factors for the sake of minimising the development of patient’s self-stigma.