BACKGROUND: Current research attention has been moving toward the needs of patients and their consequences for the quality of life (QoL). Self-stigma is a maladaptive psychosocial phenomenon disturbing the QoL in a substantial number of psychiatric patients. In our study, we examined the relationship between demographic data, the severity of symptoms, self-stigma, and QoL in patients with schizophrenia spectrum disorder. METHODS: Probands who met International Classification of Diseases-10 criteria for schizophrenia spectrum disorder (schizophrenia, schizoaffective disorder, or delusional disorder) were recruited in the study. We studied the correlations between the QoL measured by the QoL Satisfaction and Enjoyment Questionnaire, self-stigma assessed by the Internalized Stigma of Mental Illness, and severity of the disorder measured by the objective and subjective Clinical Global Impression severity scales in this cross-sectional study. RESULTS: A total of 109 psychotic patients and 91 healthy controls participated in the study. Compared with the control group, there was a lower QoL and a higher score of self-stigmatization in psychotic patients. We found the correlation between an overall rating of self-stigmatization, duration of disorder, and QoL. The level of self-stigmatization correlated positively with total symptom severity score and negatively with the QoL. Multiple regression analysis revealed that the overall rating of objective symptom severity and the score of self-stigma were significantly associated with the QoL. CONCLUSION: Our study suggests a negative impact of self-stigma level on the QoL in patients suffering from schizophrenia spectrum disorders.

Department of Psychiatry Faculty of Medicine and Dentistry Palacky University Olomouc University Hospital Olomouc Olomouc Czech Republic

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Marwaha S, Johnson S. Schizophrenia and employment – a review. Soc Psychiatry Psychiatr Epidemiol. 2004;39(5):337–349. PubMed

Karagianis J, Novick D, Pecenak J, et al. Worldwide-schizophrenia outpatient health outcomes (W-SOHO): baseline characteristics of pan-regional observational data from more than 17,000 patients. Int J Clin Pract. 2009;63(11):1578–1588. PubMed

Remberk B, Hintze B, Rybakowski F. Executive functioning improves after remission of psychosis and may not deteriorate at short follow-up in early-onset schizophrenia. Neuro Endocrinol Lett. 2015;36(2):153–160. PubMed

Browne S, Roe M, Lane A, et al. Quality of life in schizophrenia: relationship to sociodemographic factors, symptomatology, and tardive dyskinesia. Acta Psychiatr Scand. 1996;94:118–124. PubMed

Skantze K, Malm U, Dencker SJ, May PR, Corrigan P. Comparison of the quality of life with standard of living in schizophrenic out-patients. Br J Psychiatry. 1992;161:797–801. PubMed

Wegener S, Redoblado-Hodge MA, Lucas S, Fitzgerald D, Harris A, Brennan J. Relative contributions of psychiatric symptoms and neuropsychological functioning to quality of life in first-episode psychosis. Aust N Z J Psychiatry. 2005;39:487–492. PubMed

Ritsner M, Kurs R, Gibel A, Ratner Y, Endicott J. Validity of an abbreviated quality of life enjoyment and satisfaction questionnaire (Q-LES-Q-18) for schizophrenia, schizoaffective, and mood disorder patients. Qual Life Res. 2005;14:1693–1703. PubMed

Yamauchi K, Aki H, Tomotake M, et al. Predictors of subjective and objective quality of life in outpatients with schizophrenia. Psychiatry Clin Neurosci. 2008;62:404–411. PubMed

Sidlova M, Prasko J, Jelenova D, et al. The quality of life of patients suffering from schizophrenia – a comparison with healthy controls. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2011;155(2):173–180. PubMed

Latalova K, Prasko J, Diveky T, Kamaradova D, Velartova H. Quality of life in patients with bipolar disorder – a comparison with schizophrenic patients and healthy controls. Psychiatr Danub. 2011;23(1):21–26. PubMed

Herrman H, Hawthorne G, Thomas R. Quality of life assessment in people living with psychosis. Soc Psychiatry Psychiatr Epidemiol. 2002;37(11):510–518. PubMed

Karow A, Naber D. Subjective well-being and quality of life under atypical antipsychotic treatment. Psychopharmacology (Berl) 2002;162(1):3–10. PubMed

Awad AG, Voruganti LNP. The impact of atypical antipsychotics on quality of life in patients with schizophrenia. CNS Drugs. 2004;18(13):877–893. PubMed

Awad AG, Voruganti LNP. Measuring quality of life in patients with schizophrenia: an update. Pharmacoeconomics. 2012;30(3):183–195. PubMed

Lehman AF. The effects of psychiatric symptoms on quality of life assessments among the chronic mentally ill. Eval Program Plann. 1983;6:143–151. PubMed

Boyer L, Baumstarck K, Boucekine M, Blanc J, Lançon C, Auquier P. Measuring quality of life in patients with schizophrenia: an overview. Expert Rev Pharmacoecon Outcomes Res. 2013;13(3):343–349. PubMed

Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med. 2010;71:2150–2161. PubMed

Corrigan PW, Rafacz J, Rüsch N. Examining a progressive model of self-stigma and its impact on people with serious mental illness. Psychiatry Res. 2011;189:339–343. PubMed PMC

Corrigan PW, Watson AC, Barr L. Understanding the self-stigma of mental illness. J Soc Clin Psychol. 2006;25:875–884.

Schulze B, Angermeyer MC. Subjective experiences of stigma: a focus group study of schizophrenic patients, their relatives, and mental health professionals. Soc Sci Med. 2003;56:299–312. PubMed

Ritsher JB, Phelan JC. Internalized stigma predicts the erosion of morale among psychiatric outpatients. Psychiatry Res. 2004;129:257–265. PubMed

Tsang HW, Fung KM, Chung RC. Self-stigma and stages of change as predictors of treatment adherence of individuals with schizophrenia. Psychiatry Res. 2010;180(1):10–15. PubMed

World Health Organization . The ICD-10 Classification of Mental and Behavioral Disorders: Diagnostic Criteria for Research. Geneva: World Health Organization; 1993.

Müllerova H. Mezikulturní přenos a validace dotazníku kvality života Q-LES-Q [Transcultural transmission and validation of the quality life questionnaire Q-LES-Q] Psychiatrie. 2001;5:80–87.

Ritsner M, Ben-Avi I, Ponizovsky A, Timinsky I, Bistrov E, Modai I. Quality of life and coping with schizophrenia symptoms. Qual Life Res. 2003;12(1):1–9. PubMed

Ociskova M, Prasko J, Vrbova K, Kamaradova D, Jelenova D, Latalova K. Stigma and self-stigma in patients with schizophrenia. Česká Slov Psychiatr. 2014;110(5):250–258.

Guy W. ECDEU Assessment Manual for Psychopharmacology. Rockville, MD: US Department of Health, Education, and Welfare; 1976.

WMA Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects [webpage on the Internet] 64th WMA General Assembly, Fortaleza, Brazil, October 2013. World Medical Association, Inc; 2016. Available from: http://www.wma.net/en/30publications/10policies/b3/

Bobes J, Garcia-Portilla MP, Bascaran MT, Saiz PA, Bousoño M. Quality of life in schizophrenic patients. Dialogues Clin Neurosci. 2007;9(2):215–226. PubMed PMC

Evans S, Huxley P, Priebe S. A comparison of the quality of life of severely mentally ill people in UK & German samples. Int J Soc Psychiatry. 2000;46(1):47–56. PubMed

Tang IC, Wu HC. Quality of life and self-stigma in individuals with schizophrenia. Psychiatr Q. 2012;83(4):497–507. PubMed

Vrbová K, Kamarádová D, Látalová K, et al. Self-stigma and adherence to medication in patients with psychotic disorders – cross-sectional study. Neuro Endocrinol Lett. 2014;35(7):645–652. PubMed

Gerlinger G, Hauser M, De Hert M, Lacluyse K, Wampers M, Correll CU. Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates, correlates, impact and interventions. World Psychiatry. 2013;12:155–164. PubMed PMC

Kamaradova D, Latalova K, Prasko J, et al. Sebestigmatizace, adherence kléčbě a vysazování medikace u psychických poruch – průřezová studie [Self-stigma, adherence to treatment and withdrawal of medication in psychiatric disorders – a cross-sectional study] Psychiatrie. 2015;19(4):175–183.

Tiggemann M, Winefield AH. The effects of unemployment on the mood, self-esteem, locus of control, and depressive affect of school-leavers. J Occup Psychol. 2011;57(1):33–42.

Adewuya AO, Owoeye AO, Erinfolami AO, Ola BA. Correlates of self-stigma among outpatients with mental illness in Lagos, Nigeria. Int J Soc Psychiatry. 2011;57(4):418–427. PubMed

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