Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-30T16:04:18.099Z Has data issue: false hasContentIssue false

Patterns of experienced and anticipated discrimination in patients with Schizophrenia. Italian results from the INDIGO international multisite project

Published online by Cambridge University Press:  11 April 2011

Davide Maggiolo
Affiliation:
Dipartimento di Sanità Pubblica e Medicina di Comunità, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Verona
Chiara Buizza
Affiliation:
Unità Operatiba di Riabilitazione Psichiatrica, IRCCS “Centro S. Giovanni di Dio”, Fatebenefratelli, Brescia
Michela Vittorielli
Affiliation:
Unità Operatiba di Riabilitazione Psichiatrica, IRCCS “Centro S. Giovanni di Dio”, Fatebenefratelli, Brescia
Mariangela Lanfredi
Affiliation:
Unità Operatiba di Riabilitazione Psichiatrica, IRCCS “Centro S. Giovanni di Dio”, Fatebenefratelli, Brescia
Giuseppe Rossi
Affiliation:
Unità Operatiba di Riabilitazione Psichiatrica, IRCCS “Centro S. Giovanni di Dio”, Fatebenefratelli, Brescia
Alessandro Ricci
Affiliation:
Dipartimento di Sanità Pubblica e Medicina di Comunità, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Verona
Alessia Cicolini
Affiliation:
Dipartimento di Sanità Pubblica e Medicina di Comunità, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Verona
Antonio Lasalvia*
Affiliation:
Dipartimento di Sanità Pubblica e Medicina di Comunità, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Verona
*
Address for correspondence: Dr. A. Lasalvia, Dipartimento di Sanità Pubblica e Medicina di Comunità, Sezione di Psichiatria e Psicologia Clinica, Università di Verona, Policlinico [G.B. Rossi], P.le Scuro 10, 37134 Verona. E-mail: antonio.lasalvia@univr.it

Summary

Aims — To describe patterns of experienced andanticipated discrimination in a sample of schizophrenic patients recruited in Italy in the context of the International Study of Discrimination and Stigma Outcomes (INDIGO). Methods — Cross-sectional survey on a sample of 50 people with clinical diagnosis of schizophrenia recruited in the Italian INDIGO sites of Verona and Brescia. The 41-item interview-based Discrimination and Stigma Scale (DISC-10), which assesses how experienced and anticipated discrimination affects the life of people with schizophrenia, was used. Results — The most frequently occurring areas of experienced discrimination were discrimination by family members (44%), making and keeping friends (33%), keeping (36%) and finding a job (34%), getting or keeping a driving licence (32%). Anticipated discrimination was common in applying for work, training or education (58%), lookingfor close relationships (50%) and doing something important (48%); 68% felt the need to conceal their diagnosis. Positive experiences were rare, and getting welfare benefits/disability pensions was the only area where participants reported being treated with advantage (34%) more commonly than with disadvantage (8%). Overall, experienced discrimination reported by Italian patients was in the intermediate position of the score range of all INDIGO sites, whereas anticipated discrimination was lower than that reported in the other countries. Conclusions — Interventions to reduce discrimination against people with schizophrenia may need to address both actual and anticipated discrimination. Targeted therapeutic strategies aiming to improve self-esteem of people with schizophrenia may be usefulto facilitate their social participation and full inclusion in the community.

Declaration of Interest: The authors declare they have not competing interests.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

BIBLIOGRAFIA

Al-Krenawi, A., Graham, J.R., Dean, Y.Z. & Eltaiba, N. (2004). Crossnational study of attitudes towards seeking professional help: Jordan, United Arab Emirates (UAE) and Arabs in Israel. International Journal of Social Psychiatry 50, 102114.CrossRefGoogle ScholarPubMed
Angermeyer, M.C. & Schulze, B. (2001). Reducing the stigma of schizophrenia: understanding the process and option for intervention. Epidemiologia e Psichiatria Sociale 10, 17.CrossRefGoogle Scholar
Angermeyer, M.C. & Matschinger, H. (2005a). Causal belief and attitudes to people with schizophrenia. Trend analysis based on data from two population surveys in Germany. British Journal of Psychiatry 186, 331334.CrossRefGoogle ScholarPubMed
Angermeyer, M.C. & Matschinger, H. (2005b). Labelling — stereotype — discrimination. An investigation of the stigma process. Social Psychiatry and Psychiatric Epidemiology 40, 391395.CrossRefGoogle ScholarPubMed
Angermeyer, M.C., Beck, M. & Matschinger, H. (2003). Determinants of the public's preference for social distance from people with schizophrenia. Canadian Journal of Psychiatry 48, 663668.CrossRefGoogle ScholarPubMed
Bag, B., Yilmaz, S. & Kirpinar, I. (2006). Factors influencing social distance from people with schizophrenia. International Journalof Clinical Practice 60, 289294.CrossRefGoogle ScholarPubMed
Brenner, H.D., Hodel, B., Roder, V. & Corrigan, P. (1992). Treatment of cognitive dysfunction and behavioural deficits in schizophrenia. Schizophrenia Bulletin 18, 2126.CrossRefGoogle Scholar
Corrigan, P.W. (1998). The impact of stigma on severe mental illness. Cognitive and Behavioural Practice 5, 201222.CrossRefGoogle Scholar
Corrigan, P.W. (2004). Target-specific stigma change: a strategy for impacting mental illness stigma. Psychiatric Rehabilitation Journal 28, 113121.CrossRefGoogle Scholar
Corrigan, P.W. & Watson, A.C. (2002). The paradox of self-stigma and mental illness. Clinical psychology: Science and Practice 9, 3553.Google Scholar
Corrigan, P., Thompson, V., Lambert, D., Sangster, Y., Noel, J.G. & Campbell, J. (2003). Perceptions of discrimination among persons with serious mental illness. Psychiatric Services 54, 11051110.CrossRefGoogle ScholarPubMed
Corrigan, P.W., Markovitz, F.E. & Watson, A.C. (2004). Structural levels of mental illness and discrimination. Schizophrenia Bulletin 30, 481491.CrossRefGoogle ScholarPubMed
Corrigan, P.W., Larson, J.L. & Rüsch, N. (2009). Self-stigma and the “why try” effect: impact on life goals and evidence-based practices. World Psychiatry 8 7581.CrossRefGoogle ScholarPubMed
de Toledo Piza, P.E. & Blay, S.L. (2004). Community perception of mental disorders - a systematic review of Latin American and Caribbean studies. Social Psychiatry and Psychiatric Epidemiology 39, 955961.Google Scholar
Dietrich, S., Beck, M., Bujantugs, B., Kenzine, D., Matschinger, H. & Amgermeyer, M.C. (2004). The relationship between public causal belief and social distance toward mentally ill people. Australian and New Zealand Journal of Psychiatry 38, 348354.CrossRefGoogle ScholarPubMed
Estroff, S. (1981). Making It Crazy: Ethnography of Psychiatric Clients in an American Community. University of California Press: Berkeley.Google Scholar
Gaebel, W., Baumann, A., Witte, A.M. & Zaeske, H. (2002). Public attitudes towards people with mental illness in six German cities: results of a public survey under special consideration of schizophrenia. European Archives of Psychiatry and Clinical Neuroscience 252, 278287.CrossRefGoogle ScholarPubMed
Hinshaw, S.P. & Cicchetti, D. (2000). Stigma and mental disorder: conceptions of illness, public attitudes, personal disclosure, and social policy. Development and Psychopathology 12, 555598.CrossRefGoogle ScholarPubMed
Hugo, C.J., Boshoff, D.E., Traut, A., Zungu-Dirwayi, N. & Stein, D.J.(2003). Community attitudes toward and knowledge of mental illness in South Africa. Social Psychiatry and Psychiatric Epidemiology 38, 715719.CrossRefGoogle ScholarPubMed
Jorm, A.F. (2000). Mental health literacy. Public knowledge and beliefs about mental disorder. British Journal of Psychiatry 177, 396401.CrossRefGoogle Scholar
Kadri, N., Manoudi, F., Berrada, S. & Moussaoui, D. (2004). Stigma impact on Moroccan families of patients with schizophrenia. Canadian Journal of Psychiatry 49, 625629.CrossRefGoogle ScholarPubMed
Lasalvia, A. & Tansella, M. (2008). Combattere la discriminazione e lo stigma verso le persone con disturbi mentali. Epidemiologia e Psichiatria Sociale 17, 19.CrossRefGoogle Scholar
Lasalvia, A., Gentile, B., Ruggeri, M., Marcolin, A., Nose, F., Cappellari, L., Lamonaca, D., Toniolo, E., Busana, C., Campedelli, A., Cuccato, G., Danieli, A., De Nardi, F., De Nardo, V., Destro, E., Favaretto, G., Frazzingaro, S., Giacopuzzi, M., Pristinger, P., Pullia, G., Rodighiero, S., Tito, P., Aprile, F., Nicolaou, S., Coppola, G., Garzotto, N., Gottardi, U., Lazzarin, E., Migliorini, G., Pavan, L., Ramaciotti, F., Roveroni, P., Russo, S., Urbani, P., Tansella, M., Gruppo PICOS-Veneto (2007). Heterogeneity of the Departments of Mental Health in the Veneto Region tenyears after the National Plan 1994–96 for Mental Health. Which implication for clinical practice? Findings from the PICOS Project. Epidemiologia e Psichiatria Sociale 16, 5970.CrossRefGoogle Scholar
Lasalvia, A., Ricci, A., Garzotto, N., Cicolini, A., Cristofalo, D. & Ariosto, F. (2010). Resoconto ed efficacia di un intervento informativo/educativo sullo stigma legato alla malattia mentale rivolto agli operato-ri della Polizia di Stato di Verona. Psichiatria di Comunità 9, 3949.Google Scholar
Link, B.G. & Phelan, J.C. (2001). Conceptualising stigma. American Sociological Review 27, 363385.CrossRefGoogle Scholar
Link, B.G., Phelan, J.C., Bresnahan, M., Stueve, A. & Pescosolido, B.A. (1999). Public conceptions of mental illness: labels, causes, dange-rousness, and social distance. American Journal of Public Health 89, 13281333.CrossRefGoogle ScholarPubMed
Link, B.G., Yang, L.H., Phelan, J.C. & Collins, P.Y. (2004). Measuring mental illness stigma. Schizophrenia Bulletin 30, 511541.CrossRefGoogle ScholarPubMed
Littlewood, R. (1998). Cultural variation in the stigmatisation of mental illness. Lancet 352, 10561057.CrossRefGoogle ScholarPubMed
Magliano, L., Fiorillo, A., De Rosa, C., Marangone, C. & Maj, M. (2004). Belief about schizophrenia in Italy: a comparative nationwide survey of the general public, mental health professionals and patient' relatives. Canadian Journal of Psychiatry 49, 323331.CrossRefGoogle Scholar
Oliver, M.I., Pearson, N., Coe, N. & Gunnell, D. (2005). Help-seeking behaviour in men and women with common mental health problems: cross-sectional study. British Journal of Psychiatry 186, 297301.CrossRefGoogle ScholarPubMed
Pekkala, E. & Merinder, L. (2000). Psychoeducation for schizophrenia (Cochrane Review). Cochrane Database Systems Review Issue 4, CD002831.Google Scholar
Phillips, M.R., Pearson, V., Li, F., Xu, M. & Yang, L. (2002). Stigmaand expressed emotion: a study of people with schizophrenia and their family members in China. British Journal of Psychiatry 181, 488493.CrossRefGoogle Scholar
Rose, D. (2001). Users' Voices, The Perspectives of Mental Health Service Users on Community and Hospital Care. The Sainsbury Centre: London.Google Scholar
Rüsch, N., Angermeyer, M.C. & Corrigan, P.W. (2005). The stigma of mental illness: concepts, forms, and consequences. Psychiatrische Praxis 32, 221232.CrossRefGoogle ScholarPubMed
Rüsch, N., Lieb, K., Bohus, M. & Corrigan, P.W. (2006). Self-stigma, empowerment, and perceived legitimacy of discrimination among women with mental illness. Psychiatric Services 57, 399402.CrossRefGoogle ScholarPubMed
Sartorius, N. & Schulze, H. (2005). Reducing the Stigma of Mental Illness. A Report from a Global Programme of the World Psychiatric Association. Cambridge University Press: Cambridge.CrossRefGoogle Scholar
Sayce, L. (1998). Stigma, discrimination and social exclusion: what's in a word? Journal of Mental Health 7, 331344CrossRefGoogle ScholarPubMed
Shibre, T., Negash, A., Kullgren, G., Kebede, D., Alem, A., Fekadu, A., Madhin, G. & Jacobsson, L. (2001). Perception of stigma among family members of individuals with schizophrenia and major affective disorders in rural Ethiopia. Social Psychiatry and Psychiatric Epidemiology 36, 299303.CrossRefGoogle ScholarPubMed
Stuart, H. & Arboleda-Florez, J. (2001). Community attitudes toward people with schizophrenia. Canadian Journal of Psychiatry 46, 245252.CrossRefGoogle ScholarPubMed
Thornicroft, G., Brohan, E., Kassman, A. & Lewis-Holmes, E. (2008). Reducing stigma and discrimination: Candidate interventions. International Journals of Mental Health Systems 2, 3.CrossRefGoogle ScholarPubMed
Thornicroft, G., Brohan, E., Rose, D., Sartorius, N., Leese, M. & INDIGO Study Group. (2009). Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet 373, 408415.CrossRefGoogle ScholarPubMed
Toniolo, E., Guareschi, S., Andreotti, L., Marangoni, R., Grossi, A. & Lasalvia, A. (2009). Le opinioni riguardo le persone con disturbi mentali el'assistenza psichiatrica. I risultati di un'indagine nell'area polesana. Psichiatria di Comunità 8, 142155.Google Scholar
Wearden, A.J., Tarrier, N., Barrowclough, C., Zastowny, T.R. & Rahill, A.A. (2000). A review of expressed emotion research in health care. Clinical Psychological Review 20, 633666.CrossRefGoogle ScholarPubMed