Stigma and discrimination in individuals with first episode psychosis; one year after first contact with psychiatric services

• Published in: Psychiatry research Vol. 270; pp. 298 - 305
• Main Authors: Kinson, Rochelle Melina, Hon, Charlene, Lee, Helen, Abdin, Edimansyah Bin, Verma, Swapna
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.12.2018
• Subjects: Experienced discrimination; First episode psychosis; Overcoming stigma; Positive treatment; Stigma; First episode psychosis; Experienced discrimination; Overcoming stigma; Stigma; Positive treatment
• ISSN: 0165-1781; 1872-7123; 1872-7123
• DOI: 10.1016/j.psychres.2018.09.044

•Three quarters of participants reported at least one experience of discrimination; females experiencing more discrimination.•Higher baseline, 3 month PANSS total score was associated with lower positive treatment, higher stopping self respectively.•Higher GAF score at 12 months was associated with higher overcoming stigma scores.•Lower PHQ 9 scores was correlated with overcoming stigma. Stigma and discrimination in psychotic illness has not been robustly studied in those presenting with their first episode of psychosis (FEP). We prospectively examined patterns of stigma and discrimination one year after index presentation with FEP and correlates with baseline demographic, symptom burden, depression and level of functioning. We surveyed 101 subjects using the Discrimination and Stigma Scale-12 (DISC-12) and administered the Positive and Negative Syndrome Scale (PANSS), Global Assessment of Function (GAF) and the Patient Health Questionnaire (PHQ-9).  Discrimination was experienced in 76%; being shunned by people because of mental illness, making and keeping friends and from family were most affected. Older age, female gender, marital status and a family history of mental illness were significantly associated with higher unfair treatment. Higher PANSS score at baseline, 3-month and 12-month was significantly associated with lower positive treatment, higher stopping self-scores and lower overcoming stigma scores, respectively. Higher GAF score at 12-month was associated with higher overcoming stigma scores. Lower PHQ-9 scores was significantly correlated with overcoming stigma. In conclusion, stigma and discrimination is highly prevalent among individuals with FEP; the extent is associated with specific demographic variables, symptom burden, presence of depression and level of functioning. Limitations include selection bias of subjects, potential underestimation of stigma from participants who defaulted or refused to participate and inability to establish causality.