Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-25T19:02:56.556Z Has data issue: false hasContentIssue false
  • English
  • Français

The impact of the social network, stigma and empowerment on the quality of life in patients with schizophrenia

Published online by Cambridge University Press:  16 April 2020

I. Sibitz ,
M. Amering ,
A. Unger ,
M.E. Seyringer ,
A. Bachmann ,
B. Schrank ,
T. Benesch ,
B. Schulze  and
A. Woppmann
I. Sibitz*
Affiliation:
Medical University of Vienna, Department of Psychiatry and Psychotherapy, Währinger Gürtel 18-20, 1090 Vienna, Austria Ludwig Boltzmann Institute for Social Psychiatry, Vienna, Austria Dublin City University, School of Nursing, Dublin, Ireland
M. Amering
Affiliation:
Medical University of Vienna, Department of Psychiatry and Psychotherapy, Währinger Gürtel 18-20, 1090 Vienna, Austria Ludwig Boltzmann Institute for Social Psychiatry, Vienna, Austria
A. Unger
Affiliation:
Medical University of Vienna, Department of Psychiatry and Psychotherapy, Währinger Gürtel 18-20, 1090 Vienna, Austria
M.E. Seyringer
Affiliation:
Medical University of Vienna, Department of Psychiatry and Psychotherapy, Währinger Gürtel 18-20, 1090 Vienna, Austria Ludwig Boltzmann Institute for Social Psychiatry, Vienna, Austria
A. Bachmann
Affiliation:
Medical University of Vienna, Department of Psychiatry and Psychotherapy, Währinger Gürtel 18-20, 1090 Vienna, Austria
B. Schrank
Affiliation:
Medical University of Vienna, Department of Psychiatry and Psychotherapy, Währinger Gürtel 18-20, 1090 Vienna, Austria
T. Benesch
Affiliation:
Medical University of Vienna, Core Unit for Medical Statistics and Informatics, Vienna, Austria
B. Schulze
Affiliation:
University of Zurich, Research Unit for Clinical und Social Psychiatry, Zurich, Switzerland
A. Woppmann
Affiliation:
Medical University of Vienna, Department of Psychiatry and Psychotherapy, Währinger Gürtel 18-20, 1090 Vienna, Austria
*
*Corresponding author. Tel.: +0043/1/40400 3546; fax: +0043/1/40400-3605. E-mail address: ingrid.sibitz@meduniwien.ac.at(I. Sibitz)
Get access

Abstract:

Objective:

The quality of life (QOL) of patients with schizophrenia has been found to be positively correlated with the social network and empowerment, and negatively correlated with stigma and depression. However, little is known about the way these variables impact on the QOL. The study aims to test the hypothesis that the social network, stigma and empowerment directly and indirectly by contributing to depression influence the QOL in patients with schizophrenia and schizoaffective disorders.

Method:

Data were collected on demographic and clinical variables, internalized stigma, perceived devaluation and discrimination, empowerment, control convictions, depression and QOL. Structural equation modelling (SEM) was applied to examine the impact of the above-mentioned constructs on QOL.

Results:

The influences of the social network, stigma, empowerment and depression on QOL were supported by the SEM. A poor social network contributed to a lack of empowerment and stigma, which resulted in depression and, in turn, in poor QOL. Interestingly, however, the social network and stigma did not show a direct effect on QOL.

Conclusions:

Following a recovery approach in mental health services by focusing on the improvement of the social network, stigma reduction and especially on the development of personal strength has the potential to reduce depression in patients with psychosis and improving their QOL.

Keywords

SchizophreniaQuality of lifeSocial networkStigmaEmpowermentStructural equation modelling
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 1 , January 2011 , pp. 28 - 33
Copyright
Copyright © Elsevier Masson SAS 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angermeyer MC, Killian R, Matschinger H. WHOQOL-100 and WHO-BREF Addendum. Handbook for the German version of the WHO instruments for the assessment of Quality of Life. Göttingen: Hogrefe; 2000 [in German]..Google Scholar
Bengtsson-Tops, AHansson, LQuantitative and qualitative aspects of the social network in schizophrenic patients living in the community. Relationship to sociodemographic and clinical factors and subjective quality of life. Int J Soc Psychiatry 2001; 47: 67–77.CrossRefGoogle ScholarPubMed
Bengtsson-Tops, AMastery in patients with schizophrenia living in the community: relationship to sociodemographic and clinical characteristics, needs for care and support, and social network. J Psychiatr Ment Health Nurs 2004; 11: 298–304.CrossRefGoogle ScholarPubMed
Bengtsson-Tops, AHansson, LSandlund, MBjamason, OKorkeila, JMerinder, Let al.Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: a Nordic multicentre study. Qual Life Res 2005; 14: 221–229.CrossRefGoogle ScholarPubMed
Bobes, JGarcìa-Portilla, MPQuality of life in schizophrenia. 2nd ed.Katschnig, HFreeman, HSatorius, N editors. Quality if life in mental disorders. 2006 John Wiley & Sons Chichester New Yorkp. 153–67.Google Scholar
Borras, LBoucherie, MMohr, SLecomte, TPerroud, NHuguelet, PIncreasing self-esteem: efficacy of a group intervention for individuals with severe mental disorders. Eur Psychiatry 2009; 24: 307–316.CrossRefGoogle ScholarPubMed
Byrne, BStructural equation modeling with AMOS. Basic concepts, applications and programming. 2nd ed., New York: Routledge; 2009.Google Scholar
Chamberlin, JOn our own: patient-controlled alternatives to the mental health system. New York: McGraw-Hill: 1978.Google Scholar
Corrigan, PWFaber, DRashid, FLeary, MThe construct validity of empowerment among consumers of mental health services. Schizophr Res 1999; 38: 77–84.CrossRefGoogle ScholarPubMed
Corrigan, PWWatson, ACThe paradox of self-stigma and mental illness. Clin Psychol 2002; 9: 35–53.Google Scholar
Corrigan, PWLarson, JERüsch, NSelf-stigma and the “why try” effect: impact on life goals and evidence-based practices. World Psychiatry 2009; 8: 75–81.CrossRefGoogle ScholarPubMed
Deegan, PESpirit breaking: when the helping professions hurt. Human Psychol 1990; 18: 301–313.Google Scholar
Depla, MFde Graaf, Rvan Weeghel, JHeeren, TJThe role of stigma in the quality of life of older adults with severe mental illness. Int J Geriatr Psychiatry 2005; 20: 146–153.CrossRefGoogle ScholarPubMed
El-Badri, SMellsop, GStigma and quality of life as experienced by people with mental illness. Australas Psychiatry 2007; 15: 195–200.CrossRefGoogle ScholarPubMed
Graf, JLauber, CNordt, CRüesch, PMeyer, PCRössler, WPerceived stigmatization of mentally ill people and its consequences for the quality of life in a Swiss population. J Nerv Ment Dis 2004; 192: 542–547.CrossRefGoogle Scholar
Häfner, HLöffler, WMaurer, KHambrecht, Man-der-Heiden, WDepression, negative symptoms, social stagnation and social decline in the early course of schizophrenia. Acta Psychiatr Scand 1999; 100: 105–118.CrossRefGoogle ScholarPubMed
Hautzinger, MBailer, MADS. Allgemeine Depressions Skala. Göttingen: Beltz: 1993.Google Scholar
Hogan, BELinden, WNajarian, BSocial support interventions: do they work? Clin Psychol Rev 2002; 22: 383–442.CrossRefGoogle ScholarPubMed
König, HHRoick, CAngermeyer, MCValidity of the EQ-5D in assessing and valuing health status in patients with schizophrenic, schizotypal or delusional disorders. Eur Psychiatry 2007; 22: 177–187.CrossRefGoogle ScholarPubMed
Krampen, GF.K.K. Fragebogen zu Kompetenz- und Kontrollüberzeugungen. Göttingen: Hogrefe: 1991.Google Scholar
Lecomte, TCyr, MLesage, ADWilde, JLeclerc, CRicard, NEfficacy of a self-esteem module in the empowerment of individuals with schizophrenia. J Nerv Ment Dis 1999; 187: 406–413.CrossRefGoogle ScholarPubMed
Lieberman, JAStroup, TSMcEvoy, JPSwartz, MSRosenheck, RAPerkins, DOet al.Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353: 1209–1223.CrossRefGoogle ScholarPubMed
Link, BGCullen, FTStruening, EShrout, PDohrenwend, BPA modified labeling theory approach in the area of mental disorders: an empirical assessment. Am Soc Rev 1989; 54: 400–423.CrossRefGoogle Scholar
Lundberg, BHansson, LWentz, EBjörkman, TStigma, discrimination, empowerment and social networks: a preliminary investigation of their influence on subjective quality of life in a Swedish sample. Int J Soc Psychiatry 2008; 54: 47–55.CrossRefGoogle Scholar
Markowitz, FEThe effects of stigma on the psychological well-being and life satisfaction of persons with mental illness. J Health Soc Behav 1998; 39: 335–347.CrossRefGoogle ScholarPubMed
Matschinger, HAngermeyer, MCLink, BCVariation der Antwortstrukturen in Abhängigkeit vom Grad der persönlichen Betroffenheit. Eine Methodenstudie am Beispiel der “Discrimination-Devaluation-Scale”. Psychother Psychosom Med Psychol 1991; 41: 278–283.Google Scholar
Mechanic, DMcAlpine, DRosenfield, SDavis, DEffects of illness attribution and depression on the quality of life among persons with serious mental illness. Soc Sci Med 1994; 39: 155–164.CrossRefGoogle ScholarPubMed
Müller, BNordt, CLauber, CRuesch, PMeyer, PCRössler, WSocial support modifies perceived stigmatization in the first years of mental illness: a longitudinal approach. Soc Sci Med 2006; 62: 39–49.CrossRefGoogle Scholar
Ozbay, FFitterling, HCharney, DSouthwick, SSocial support and resilience to stress across the life span: a neurobiological framework. Curr Psychiatry Rep 2008; 10: 304–310.CrossRefGoogle Scholar
Radloff, LSThe CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1997; 1: 385–401.CrossRefGoogle Scholar
Ritsher, JBOtilingam, PGGrajales, MInternalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Res 2003; 121: 31–49.CrossRefGoogle ScholarPubMed
Ritsher, JBPhelan, JCInternalized stigma predicts erosion of morale among psychiatric outpatients. Psychiatry Res 2004; 129: 257–265.CrossRefGoogle ScholarPubMed
Rogers, ESChamberlin, JEllison, MLCrean, TA consumer-constructed scale to measure empowerment among users of mental health services. Psychiatr Serv 1997; 48: 1042–1047.Google ScholarPubMed
Rosenfield, SFactors contributing to the subjective quality of life of the chronic mentally ill. J Health Soc Behav 1992; 33: 299–315.CrossRefGoogle ScholarPubMed
Rosenfield, S“Labeling Mental Illness”: the effects of received services and perceived stigma on life satisfaction. Am Soc Rev 1997; 62: 660–672.CrossRefGoogle Scholar
Schmid, RNeuner, TCording, CSpiessl, HSchizophrenic patients’ quality of life--association with coping, locus of control, subjective well-being, satisfaction and patient-judged caregiver burden. Psychiatr Prax 2006; 33: 337–343.CrossRefGoogle ScholarPubMed
Sibitz, I, Amering, M, Unger, A, Seyringer, M, Bachmann, A, Benesch, T. Internalisiertes Stigma bei Personen mit einer Erkrankung aus dem schizophrenen Formenkreis: Validierung der ISMI (Internalized Stigma of Mental Illness) Skala. Forschungsbericht an den Medizinisch-Wissenschaftlichen Fonds des Bürgermeisters der Bundeshauptstadt Wien, Projekt Nr. 2396. 2006..Google Scholar
Sibitz, IUnger, AWoopmann, AZidek, TAmering, MStigma resistance in patients with schizophrenia. Schizophr Bull 200910.1093/schbul/sbp048 [Epub ahead of print].Google ScholarPubMed
Staring, ABPVan der Gaag, MVan den Berge, MDuivenvoorden, HJMulder, CLStigma moderates the associations of insight with depressed mood, low self-esteem, and low quality of life in patients with schizophrenia spectrum disorders. Schizophr Res 2009; 115: 363–369.CrossRefGoogle ScholarPubMed
Stastny, PNowotny, M. Selbsthilfe- Erfahrene berichten. Eine Vergleichsuntersuchung von Selbsthilfegruppen in Neurologie und Psychiatrie. Forschungsbericht and die Österreichische Nationalbank Jubiläumsfonds, Projekt Nr. 7947. 2001..Google Scholar
Stuart, HFighting the stigma caused by mental disorders: past perspectives, present activities, and future directions. World Psychiatry 2008; 7: 185–188.CrossRefGoogle ScholarPubMed
Switaj, PWciórka, JSmolarska-Switaj, JGrygiel, PExtent and predictors of stigma experienced by patients with schizophrenia. Eur Psychiatry 2009; 24: 513–520.CrossRefGoogle ScholarPubMed
The WHOQOL Group Development of the World Health Organization WHOQOL-BREF. Quality of Life Assessment. Psychol Med 1998; 28: 551–558.CrossRefGoogle Scholar
Vauth, RKleim, BWirtz, MCorrigan, PWSelf-efficacy and empowerment as outcomes of self-stigmatizing and coping in schizophrenia. Psychiatry Res 2007; 150: 71–80.CrossRefGoogle Scholar
Watson, ACCorrigan, PLarson, JESells, MSelf-stigma in people with mental illness. Schizophr Bull 2007; 33: 1312–1318.CrossRefGoogle ScholarPubMed
West, SGFinch, JFCurran, PJStructural equation models with nonnormal variables: problem and remedies. In: Hoyle, RH editors. Structural equation modeling. Concepts, issues and applications. Thousand Oaks: Sage Publications; 1995.Google Scholar
Yanos, PTRosenfield, SHorowitz, AVNegative and supportive social interactions and quality of life among persons diagnosed with severe mental illness. Community Ment Health J 2001; 37: 405–419.CrossRefGoogle ScholarPubMed
Yanos, PTMoos, RHDeterminants of functioning and well-being among individuals with schizophrenia: an integrated model. Clin Psychol Rev 2007; 27: 58–77.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.