Prediction of self-stigma in early psychosis: 3-Year follow-up of the randomized-controlled trial on extended early intervention

Schizophr Res. 2018 May:195:463-468. doi: 10.1016/j.schres.2017.09.004. Epub 2017 Sep 7.

Abstract

Background: Self-stigma represents a major barrier to recovery in people with psychotic disorders but is understudied in early illness stage. Longitudinal investigation of prediction for self-stigma is scarce and none is conducted in early psychosis. We aimed to prospectively examine baseline predictors of self-stigma in early psychosis patients in the context of a 3-year follow-up of a randomized-controlled trial (RCT) comparing 1-year extension of early intervention (EI) with step-down psychiatric care for first-episode psychosis (FEP).

Method: One hundred sixty Chinese patients were recruited from a specialized EI program for FEP in Hong Kong after they had completed this 2-year EI service, and underwent a 12-month RCT. Participants were followed up and reassessed 3years after inclusion to the trial. Comprehensive evaluation encompassing clinical, functional, subjective quality of life and treatment-related variables were conducted. Data analysis was based on 136 participants who completed self-stigma assessment at 3-year follow-up.

Results: Fifty patients (36.8%) had moderate to high levels of self-stigma at 3-year follow-up. Multivariate regression analysis revealed that female gender, prior psychiatric hospitalization, longer duration of untreated psychosis and greater positive symptom severity at study intake independently predicted self-stigma at the end of 3-year study period.

Conclusion: Our results of more than one-third of early psychosis patients experienced significant self-stigma underscore the clinical needs for early identification and intervention of self-stigmatization in the initial years of psychotic illness. Further research is warranted to clarify prediction profile and longitudinal course of self-stigma in the early illness phase.

Keywords: Duration of untreated psychosis; Early psychosis; Internalized stigma; Longitudinal follow-up; Self-stigma.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Early Intervention, Educational / methods*
  • Female
  • Hong Kong
  • Humans
  • Longitudinal Studies
  • Male
  • Psychotherapy / methods*
  • Psychotic Disorders / psychology*
  • Psychotic Disorders / rehabilitation*
  • Quality of Life / psychology
  • Regression Analysis
  • Single-Blind Method
  • Social Stigma*
  • Treatment Outcome*
  • Young Adult