Internalized stigma among people with schizophrenia: Relationship with socio-demographic, clinical and medication-related features

Background: People with schizophrenia are at high risk of suffering from stigma and internalizing it. Recently, a better understanding of the stigma process has shifted the attention from public stigma to self-stigma, which is deeply debilitating. This study aimed to assess factors associated to self-stigma by evaluating socio-demographic, clinical and treatment-related variables in a group of subjects diagnosed with schizophrenia and to identify predictors of high internalized stigma.

Methods: Ninety-four inpatients accessing rehabilitative centers with a diagnosis of schizophrenia were included in this cross-sectional study. Measures included both patient-rated scales, assessing internalized stigma, attitude toward medications, side effects experience and subjective well-being, and clinician-rated scales, assessing schizophrenia symptoms and global clinical severity and antipsychotic-related side effects.

Results: Twenty-one patients (22.3%) showed high internalized stigma while 73 (77.7%) did not. Patients experiencing more medication adverse effects and worse subjective well-being were more likely to suffer from internalized stigma according to a logistic regression analysis. Extrapyramidal, psychic and some autonomic reactions also emerged as individual predictors of self-stigma in a separate regression analysis.

Conclusions: Self-stigma and subjective medication side effects perception represent a relevant issue in patients' life and should be carefully taken into account in clinical practice.