Reducing self-stigma in psychosis: A systematic review and meta-analysis of psychological interventions

The burden of self-stigma in psychosis has been widely studied, leading to the development and implementation of self-stigma reduction programmes to ameliorate its impact. In order to successfully improve self-stigma in psychosis, we must evaluate the effect of available interventions to help clinicians select the most appropriate approach for their patients. This systematic review and meta-analysis aimed to evaluate the effect of self-stigma reduction interventions in people with psychosis while considering the interventions' characteristics as an important moderator of their effect. The results from this systematic review suggest that interventions involving more than one component, particularly those combining psychoeducation, social skills training and cognitive approaches, were most effective at reducing self-stigma in people with psychosis. Additionally, shorter interventions were found best reduced self-stigma at post-treatment evaluation. A meta-analysis mirrored these results, finding an overall favourable effect of interventions but high heterogeneity in the sample. Subgroup analyses found larger self-stigma reductions following multi-component interventions compared to single-component interventions. An analysis of risk of bias revealed a trend suggesting studies with lower risk of bias produced smaller effects. The results of this review can inform practitioners select and develop interventions to reduce self-stigma in psychosis.