Association between self-stigma and self-compassion in patients with schizophrenia: A longitudinal study from hospital admission to first follow-up after discharge

Aim: Self-stigma is a major factor preventing the recovery of individuals with schizophrenia. Psychosocial interventions can reduce self-stigma, and mental health nurses may play a crucial role in leading them, but little is known about the modifiable factors that should be targeted. We aimed to investigate the association between self-stigma and self-compassion in patients with schizophrenia from admission to the first follow-up after discharge.

Methods: Twenty-three patients with schizophrenia were recruited from an acute psychiatric ward in a private psychiatric hospital in Japan. Participants filled out the Japanese versions of the Internalized Stigma of Mental Illness (ISMI) scale, the Self-Compassion Scale (SCS), and the Positive and Negative Syndrome Scale (PANSS) at the following three time points: 1 month after admission, discharge, and first follow-up after discharge at outpatient care. We used a linear mixed model to examine the association between self-stigma, self-compassion, and the symptoms. In the first model, we used self-stigma as a dependent variable and included time of assessment and positive and negative symptoms as independent variables. In the second model, we added self-compassion to the independent variables.

Results: Self-stigma did not change over time. Regarding the linear mixed model, the first model showed that participants with more positive symptoms tended to report worse self-stigma (p = .052). The second model showed a significant association between increasing self-stigma and higher over-identification (p = .001).

Conclusions: Our results suggest that interventions focusing on over-identification can reduce self-stigma. Nurse-led intervention programs with a focus on over-identification should be further developed for effectiveness.