Factors Influencing Self-Stigma in the First Year of First-Episode Psychosis

Self-stigma negatively impacts recovery, treatment adherence and functioning in patients with first-episode psychosis (FEP). Despite its clinical importance, little is known about which early clinical factors are associated with increased self-stigma during the first year after onset.

To study sex differences in self-stigma in a FEP sample. Additionally, examine which demographic, clinical and psychosocial variables predict self-stigma in people with a FEP.

Seventy-two individuals (26 females; 46 males) with a FEP participated in this descriptive, cross-sectional study. All participants were recruited from the Mental Health care sector of Parc Sanitari Sant Joan de Déu and the Child and Maternal Hospital of Sant Joan de Déu and Hospital Germans Trias i Pujol in the city of Barcelona and its metropolitan area. The Internalised Stigma of Mental Health Inventory (ISMI) was administered to assess self-stigma. This scale is divided into five subscales: alienation, stereotype endorsement, perceived or experienced discrimination, social isolation and stigma resistance. In addition to the ISMI, psychotic symptoms (PANSS; Emsley five-factor), functioning (PSP), duration of untreated psychosis (DUP), diagnosis and cannabis (THC) use were also recorded.

No sex differences were found in any self-stigma subscale, nor in the total score. A longer DUP, a higher consumption of THC and greater anxiety/depression Emsley factor emerged as the strongest predictors of higher self-stigma.

The variables most strongly associated with self-stigma are DUP, THC use and the anxiety/depression Emsley factor. Early interventions focused on these aspects could significantly enhance the self-concept of individuals with FEP and reduce the long-term negative impact of self-stigma.