Psychoeducation may reduce self-stigma of people with schizophrenia and schizoaffective disorder

Previous studies suggest that self-stigma is related to social isolation and discrimination. Although it is known that stigma has cultural and social impacts, only a few studies in Japan have explored self-stigma in people with schizophrenia. The present study was conducted to investigate self-stigma in people with schizophrenia and schizoaffective disorder in Japan under a typical clinical setting, and to examine the effect of psychoeducation on self-stigma. Fifty-six participants (44 men and 12 women) who met the DSM-IV criteria for schizophrenia and schizoaffective disorder were recruited. All participants completed several questionnaires including social distance scale. Collected data were classified into an experiential or non-experiential group according to hospital records. The experiential group received psychoeducation which focused on reducing self-stigma by correcting inaccurate ideas about schizophrenia, and the relation between schizophrenia and criminal activity or violence, by watching videotapes and analyzing data from a report published by the National Police Agency. After the intervention, participants completed the Japanese version of the Social Distance Scale (SDS-J), the Knowledge of Illness and Drugs Inventory (KIDI) questionnaire, the Drug Attitude Inventory 10 (DAI-10), and the Birchwood's Psychosis Insight Scale (BPIS). In addition Global Assessment of Functioning Scale (GAF) scores were calculated for each participant. Significant differences between the 2 groups were observed for the SDS-J, KIDI, and BPIS (P<0.01 for each). However, no significant differences were observed for the DAI-10, GAF, age, and duration of treatment. The results of a path analysis showed that increasing knowledge about schizophrenia and its treatment might play an important role in reducing the self-stigma associated with this disease. When performing psychoeducation for people with schizophrenia and schizoaffective disorder, we need to discuss the pervasive effects of stigma and discrimination.