[The effect of medical and psychotherapeutic treatment models for schizophrenia on stigma and recovery expectations]

Nervenarzt. 2020 Sep;91(9):799-807. doi: 10.1007/s00115-020-00949-2.
[Article in German]

Abstract

Background: It is common practice to inform patients about causes and treatment models when starting psychiatric treatment or psychotherapy for schizophrenia. However, previous research indicates that focusing on etiological models increases stigmatizing beliefs. This raises the question of whether contemporary, medical or cognitive behavioral therapy (CBT)-based treatment models share this negative side effect.

Aim: This experiment tested whether providing information about medical vs. CBT-based vs. combined treatment models affects stigmatizing attitudes towards schizophrenia and the expected efficacy of these treatments.

Methods: Participants received a case vignette of a person with schizophrenia including either: (1) no treatment details, or a description of treatment with (2) medication, (3) CBT, or (4) medication and CBT. Next, stigmatizing attitudes (stereotypes, affective reactions, and desired social distance) were assessed and participants rated the perceived effectiveness of different treatment methods.

Results: No treatment model showed an effect on stigmatizing attitudes. Medical and CBT treatment information (alone or in combination) had a positive effect on subjective efficacy ratings for the respective treatment.

Conclusion: There appear to be no negative side effects of (biogenetic) models when presented in a context emphasizing recovery. Moreover, medication and CBT treatment information showed additive positive effects on the rating of treatment strategies. A combined treatment model integrating various evidence-based methods appears to be most useful in clinical practice.

Keywords: Etiological models; Psychosis; Stigmatization; Treatment expectations; Treatment models.

MeSH terms

  • Humans
  • Motivation
  • Psychological Distance
  • Schizophrenia* / diagnosis
  • Schizophrenia* / therapy
  • Social Stigma
  • Stereotyping