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Stigma resistance is associated with advanced stages of personal recovery in serious mental illness patients enrolled in psychiatric rehabilitation

Published online by Cambridge University Press:  16 November 2020

J. Dubreucq Open the ORCID record for J. Dubreucq [Opens in a new window] ,
J. Plasse ,
F. Gabayet ,
M. Faraldo ,
O. Blanc ,
I. Chereau ,
S. Cervello ,
G. Couhet ,
C. Demily  and
N. Guillard-Bouhet
...Show all authors
J. Dubreucq*
Affiliation:
Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, France Centre référent de réhabilitation psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France Fondation FondaMental, Créteil, France Réseau Handicap Psychique, Grenoble, France
J. Plasse
Affiliation:
Centre ressource de réhabilitation psychosociale et de remédiation cognitive, Hôpital Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, France Centre référent lyonnais de réhabilitation psychosociale CL3R, centre hospitalier Le Vinatier, Lyon, France
F. Gabayet
Affiliation:
Centre référent de réhabilitation psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France Fondation FondaMental, Créteil, France
M. Faraldo
Affiliation:
Centre référent de réhabilitation psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France Fondation FondaMental, Créteil, France
O. Blanc
Affiliation:
CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
I. Chereau
Affiliation:
Fondation FondaMental, Créteil, France CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
S. Cervello
Affiliation:
Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, France Centre ressource de réhabilitation psychosociale et de remédiation cognitive, Hôpital Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, France Centre référent lyonnais de réhabilitation psychosociale CL3R, centre hospitalier Le Vinatier, Lyon, France
G. Couhet
Affiliation:
Centre référent de réhabilitation psychosociale C2RP Nouvelle-Aquitaine Sud, Pôle de réhabilitation psychosociale, Centre de la Tour de Gassies, Bruges, France
C. Demily
Affiliation:
Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, France Centre de référence maladies rares Génopsy, pôle ADIS, centre hospitalier Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, France
N. Guillard-Bouhet
Affiliation:
CREATIV & URC Pierre Deniker, CH Laborit, Poitiers, France
B. Gouache
Affiliation:
Centre référent de réhabilitation psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France
N. Jaafari
Affiliation:
CREATIV & URC Pierre Deniker, CH Laborit, Poitiers, France
G. Legrand
Affiliation:
Centre Hospitalier Sainte Marie de Clermont Ferrand, 33 rue Gabriel Péri, CS 9912, 63037 Clermont-Ferrand Cedex 1, France
E. Legros-Lafarge
Affiliation:
Centre Référent de Réhabilitation Psychosociale de Limoges C2RL, CH Esquirol, Limoges, France
R. Pommier
Affiliation:
REHALise, CHU de Saint-Etienne, France
C. Quilès
Affiliation:
Centre référent de réhabilitation psychosociale C2RP Nouvelle Aquitaine Sud, Pôle universitaire de psychiatrie adulte, centre hospitalier Charles Perrens, Bordeaux& Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team pharmacoepidemiology, UMR 1219, F-33000 Bordeaux, France
D. Straub
Affiliation:
Centre de Réhabilitation Psychosociale, Centre Hospitalier de Roanne, France
H. Verdoux
Affiliation:
Centre référent de réhabilitation psychosociale C2RP Nouvelle Aquitaine Sud, Pôle universitaire de psychiatrie adulte, centre hospitalier Charles Perrens, Bordeaux& Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team pharmacoepidemiology, UMR 1219, F-33000 Bordeaux, France
F. Vignaga
Affiliation:
Dispositif de Soins de Réhabilitation Psychosociale, Centre Psychothérapeutique de l'Ain, France
C. Massoubre
Affiliation:
REHALise, CHU de Saint-Etienne, France
N. Franck
Affiliation:
Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, France Centre ressource de réhabilitation psychosociale et de remédiation cognitive, Hôpital Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, France Centre référent lyonnais de réhabilitation psychosociale CL3R, centre hospitalier Le Vinatier, Lyon, France
*
Author for correspondence: J. Dubreucq, E-mail: jdubreucq@ch-alpes-isere.fr
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Abstract

Background

Stigma resistance (SR) is defined as one's ability to deflect or challenge stigmatizing beliefs. SR is positively associated with patient's outcomes in serious mental illness (SMI). SR appears as a promising target for psychiatric rehabilitation as it might facilitate personal recovery.

Objectives

The objectives of the present study are: (i) to assess the frequency of SR in a multicentric non-selected psychiatric rehabilitation SMI sample; (ii) to investigate the correlates of high SR

Methods

A total of 693 outpatients with SMI were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluation included standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, and personal recovery and a large cognitive battery. SR was measured using internalized stigma of mental illness – SR subscale.

Results

Elevated SR was associated with a preserved executive functioning, a lower insight into illness and all recovery-related outcomes in the univariate analyses. In the multivariate analysis adjusted by age, gender and self-stigma, elevated SR was best predicted by the later stages of personal recovery [rebuilding; p = 0.004, OR = 2.89 (1.36–4.88); growth; p = 0.005, OR = 2.79 (1.30–4.43)). No moderating effects of age and education were found.

Conclusion

The present study has indicated the importance of addressing SR in patients enrolled in psychiatric rehabilitation. Recovery-oriented psychoeducation, metacognitive therapies and family interventions might improve SR and protect against insight-related depression. The effectiveness of psychiatric rehabilitation on SR and the potential mediating effects of changes in SR on treatment outcomes should be further investigated in longitudinal studies.

Keywords

stigma resistanceserious mental illnessprevalencecorrelatespsychiatric rehabilitation
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 11 , August 2022 , pp. 2155 - 2165
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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