Psychosis often leads to stigmatization and reduction of social power and prestige of the individual, hence leading further o social rejection and shame.

The current study assessed the role of external shame on psychiatric patients.

The present study aimed at evaluating external shame in psychiatric patients who where cared by the Department of Psychiatry at the University Hospital of Alexandroupolis, Greece.

45 patients suffering from schizophrenia participated to the present study (18 men and 27 women with mean age of 44.09 SD = 11.55, ranged 19–75). The measures used were: a) the Other As Shamer scale (OAS) b), a questionnaire concerning socio-demographic information,

The average of the external shame (OAS total) was 11.11 ± 5.22, without any statistical significant difference among gender in their comparison with the t-Test (p = .864). This ismuch lower than the average normal external shame the Greek population (17.74 ± 9.02).The analysis of variance between age groups showed that age, place of residence and educational level did not affect the external shame in psychotic patients. The marital status demonstrated a significant effect on external shame of psychotic patients where the application of the Bonferonni criterion was found that a) married participants demonstrated statistical significant difference from widowed (p = .030) and b) differed significantly from divorced widows (p = .011). Indeed, the widowed psychiatric patients exhibited greater levels of external shame.

Low levels of external shame may reflect difficulties in interpersonal relationships. Our findings illuminate the external shame in psychiatric patients.

Whilst shame has an important role in shaping psychopathology, nonetheless it is often a feeling ignored. Therefore, the etiologic role of psychosis requires further investigation.

This study examined the role of internal shame on psychiatric patients.

The present study evaluated internal shame in psychiatric patients who where cared by the Department of Psychiatry at University Hospital of Alexandroupolis, Greece.

45 patients suffering from schizophrenia participated (18 men and 27 women with mean age 44.09 SD=11.55, ranged 19–75). The measuring tools used were: a) the Experience of Shame Scale (ESS), b) a questionnaire concerning socio-demographic information.

High levels of internal shame were observed among patients. In specific, the average of the internal shame (ESS total) was 52.31 ± 12.76, without having statistically significant difference among gender in their comparison with the t-Test (p = .859). This is much higher than the average normal external shame in Greek population (47.09 ± 13.69). The analysis of variance between age groups showed that age, place of residence and educational level did not affect the internal shame in psychotic patients. Marital status had a significant effect on internal shame of psychotic patients where the application of the Bonferonni criterion found that unmarried participants demonstrated a statistical significant difference from those divorced (p = .020), the latter had higher levels of internal shame.

Psychiatric patients have high levels of internal shame and this shame is a constant factor in placing the individual and not a transient response to specific situations.

The participation of informal caregivers in the café of patients with psychotic symptoms in coordination with self-help groups have been found to reduce the expressed emotion in combination with psychoeducations interventions help create a supportive environment.

This study investigates the differences in the family atmosphere of informal caregivers of patients with psychotic symptoms.

To compare whether or not the participation of informal caregivers of patients with psychotic symptoms in self-organized associations helps to foster a supportive family environment, hence reducing the risk of relapse.

Snowballing sampling consisting of 510 informal caregivers of patients with psychotic symptoms was used in the current study. The Family Environment Scale of Moos and Moos and socio-demographic questions were implemented to collect the data. Control Cronbach's Alpha reliability of scale gave value a = 0.795.

The comparison showed that informal caregivers of patients with psychotic symptoms irrespective of their participation or not in self-help associations do not show significant differences in Family Environment Scale. Significant statistical difference between the two groups (P < 0.05) only occurred in the subcategory “organization”, as the first group (m = 4.68, df = ± 2.233) were found to have lower values compared to the other group (m = 5.21, df = ± 2.233).

The study demonstrated that informal caregivers of patients with psychotic symptoms involved in self-help groups do not show to have a particular difference in the family atmosphere than families who do not participate in self-help associations.

The authors have not supplied their declaration of competing interest.