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THEME SECTION: STIGMA IN PSYCHIATRIC DISORDERS: REVIEW ARTICLE
Year : 2016  |  Volume : 32  |  Issue : 2  |  Page : 134-142

Stigma associated with mental illness: Conceptual issues and focus on stigma perceived by the patients with schizophrenia and their caregivers


Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Sandeep Grover
Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9962.181095

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Among the various psychiatric disorders, schizophrenia is considered to be associated with high level of stigma. The stigmatizing experience is not only limited to the patients but is also experienced by their close relatives. This article reviews the conceptual issues in understanding stigma, mainly in relation to schizophrenia. Further, this article reviews the existing literature in terms of extent and correlates of stigma experienced by patients with schizophrenia and their close relatives. Stigma experienced by the patients can be categorized as public stigma and personal stigma. The personal stigma is further understood as perceived stigma, experienced stigma, and self-stigma. Stigma experienced by caregivers of patients with mental illness is called associative or courtesy stigma and affiliate stigma. A number of tools have been developed for assessment of stigma among patients with mental illnesses and their close relatives. Depending on the type of instrument used to assess stigma, the prevalence of stigma among patients with schizophrenia varied from 6% to 87%. Much of the literature on stigma in the patients with schizophrenia is from developed countries. There is limited literature from India and majority from Southern and Central part of the country. Stigma associated with schizophrenia is highly prevalent across regions and varies according to different sociodemographic and clinical correlates. The experience of stigma among patients of schizophrenia is influenced by the type and severity of psychopathology, insight, coping, causal beliefs, depression, social support, self-esteem, self-efficacy, and self-directness. Stigma influences medication compliance, quality of life, and social functioning. Research is scanty with regard to stigma perceived by caregivers of patients with schizophrenia. Besides the caregiver variables, different patient variables uniquely modify the stigma experienced by the caregivers. Different interventions may reduce the stigma experienced by patients and their caregivers. Studies evaluating stigma experienced by patients with schizophrenia and their caregivers suggest that stigma is highly prevalent among patients and their relatives. Data on correlates of stigma are limited. There is a need for further research on stigma for a better understanding of the concept so as to find ways to reduce it and prevent its adverse consequences.


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