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Relationships between social stigma, stigma experience and self-stigma and impaired quality of life in schizophrenia across three Latin-American countries

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Abstract

The relationships between stigma and quality of life in schizophrenia (QoL) have been extensively explored but have mostly focused on self-stigma and self-esteem and have never been explored in Latin-America. The objective of this study was to determine which stigma dimensions were associated with QoL in a sample of community-dwelling SZ subjects of three Latin-American countries. Stabilized outpatients with SZ were recruited in three Mental Health Services in three Latin-American countries: Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). Stigma and Qol-SZ were evaluated by self-administered questionnaires, the Internalized Stigma of Mental Illness scale (ISMI-12) and the SQoL-18. 253 participants were included. In multivariate analyses, QoL has been associated with each stigma dimension (social stigma, stigma experience and self-stigma), independently of age, gender, education level, ethnicity, age at illness onset, illness symptomatology and mental health treatment. More specifically, social stigma was significantly associated with impaired psychological and physical well-being, self-esteem and friendship. Self-stigma was significantly associated with impaired psychological well-being, self-esteem and autonomy. The present results confirm the importance of stigma in QoL of SZ subjects and identify new targets to develop stigma-orientated programs. Most of the previous programs have focused on self-stigma while social stigma has shown to be associated with a wide range of impaired QoL areas. Stigma and QoL may have a bidirectional relationship and targeting some specific QoL areas (like autonomy through self-empowerment approaches) may also improve the effectiveness of these programs to reduce stigma impact on the quality of life of subjects with schizophrenia. Future studies should also explore differences across countries as subjects from Bolivia were more frequently Aymara and reported higher stigma and lower QoL than SZ subjects from other countries.

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Funding

This research was funded in part by the Universidad de Tarapacá through Proyecto Mayor de Investigación Científica y Tecnológica UTA no. 3732-16.

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Authors and Affiliations

  1. Instituto de Alta Investigación, Universidad de Tarapacá, Arica, Chile

    Alejandra Caqueo-Urízar

  2. Universidad Católica del Norte, Avda. Angamos 0610, Antofagasta, Chile

    Alfonso Urzúa

  3. Aix-Marseille Univ, School EA 3279: CEReSS - Health Service Research and Quality of Life Center, 13005, Marseille, France

    Julia Habib, Anderson Loundou, Mohamed Boucekine, Laurent Boyer & Guillaume Fond

  4. Assistance publique des hôpitaux de Marseille, AP-HM, 27 Boulevard Jean Moulin, 13005, Marseille, France

    Guillaume Fond

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  1. Alejandra Caqueo-Urízar
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Caqueo-Urízar, A., Urzúa, A., Habib, J. et al. Relationships between social stigma, stigma experience and self-stigma and impaired quality of life in schizophrenia across three Latin-American countries. Eur Arch Psychiatry Clin Neurosci 270, 513–520 (2020). https://doi.org/10.1007/s00406-019-01035-8

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