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Schomerus G, Schindler S, Sander C, Baumann E, Angermeyer MC. Changes in mental illness stigma over 30 years - Improvement, persistence, or deterioration? Eur Psychiatry 2022; 65:e78. [PMID: 36328960 PMCID: PMC9724218 DOI: 10.1192/j.eurpsy.2022.2337] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/05/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Large efforts have been made to erase the stigma of mental illness, but it is unclear whether they have succeeded on a population level. We examine how attitudes toward people with depression or schizophrenia have evolved in Germany since 1990, and whether there are different developments for both disorders. METHODS Using data from the three decades, four wave repeated cross-sectional representative population study in the "old" (western) states in Germany with surveys in 1990 (n = 2,044), 2001 (n = 4,005), 2011 (n = 1,984), and 2020 (n = 2,449), we calculate time-trends for social distance and emotional reactions toward someone with major depression or acute schizophrenia. RESULTS Social distance worsened in six out of seven situations for schizophrenia, whereas improving in two out of seven situations for depression. Emotions related to fear and uneasiness increased for schizophrenia, whereas tending to decrease for depression. Pro-social reactions like the desire to help increased for depression, but decreased for schizophrenia. Initially observed differences, favoring depression over schizophrenia, widened over the 30-year study period. For schizophrenia, the biggest negative changes occurred between 1990 and 2001, whereas some improvements with regard to depression occurred more recently. CONCLUSION Contrary to expectations, stigma has become more severe regarding acute schizophrenia in Germany over the last 30 years, whereas only slightly improving for depression. The apparent normalization of mental health problems seems not to directly translate into improving attitudes toward people with severe mental illness. Re-focusing of anti-stigma efforts on people with severe mental illness seems necessary.
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Affiliation(s)
- Georg Schomerus
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany
| | - Stephanie Schindler
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany
| | - Eva Baumann
- Department of Journalism and Communication Research, Hannover University of Music, Drama, and Media, Hannover, Germany
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Angermeyer MC, Grausgruber A, Hackl E, Moosbrugger R, Prandner D. Evolution of public beliefs about schizophrenia and attitudes towards those afflicted in Austria over two decades. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1427-1435. [PMID: 33125508 PMCID: PMC8316207 DOI: 10.1007/s00127-020-01963-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/23/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE In the recent years, it was possible to observe two trends: First, there has been a trend to greater mental health literacy, in particular towards a biological model of schizophrenia. Secondly, an increase in public acceptance of professional help and psychiatric treatment has been observed in western countries. This indicates that the societal idea about mental illness and how it can be treated has changed. However, no changes or even changes to the worse occurred regarding the attitudes towards those suffering from the illness, particularly concerning schizophrenia. Thus, the question arises as to whether similar trends can also be found in Austria. METHODS We use data from two representative population surveys in Austria, conducted 1998 (n = 1042) and 2018 (n = 1010) using face-to-face interviews, the same sampling procedure, interview mode, and interview schedule. RESULTS The data show that today Austrians tend to opt less frequently for genetic factors and chronic stress as causes of schizophrenia than 20 years ago. There were only slight changes regarding intended first help-seeking actions except for a stronger endorsement of lay help. The believe in an effective treatment of schizophrenia has increased significantly and there was a marked trend towards preference of medication over psychotherapy. Social acceptance of people with schizophrenia has increased, but also the ascription of violence. CONCLUSION In summary, the evolution of attitudes and beliefs concerning schizophrenia in Austria shows a rather inconsistent pattern and differs to some extent from what has been observed in other western countries. This is important to know when planning awareness-raising or stigma-reducing initiatives.
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Affiliation(s)
- Matthias C. Angermeyer
- grid.22937.3d0000 0000 9259 8492Center for Public Mental Health, Untere Zeile 13, 3482 Gösing am Wagram, Austria
| | - Alfred Grausgruber
- Department for Sociology - Empirical Social Research Unit, Johannes Kepler University Linz, Altenbergerstraße 69, 4040, Linz, Austria.
| | - Elisabeth Hackl
- grid.9970.70000 0001 1941 5140Department for Sociology - Empirical Social Research Unit, Johannes Kepler University Linz, Altenbergerstraße 69, 4040 Linz, Austria
| | - Robert Moosbrugger
- grid.9970.70000 0001 1941 5140Department for Sociology - Empirical Social Research Unit, Johannes Kepler University Linz, Altenbergerstraße 69, 4040 Linz, Austria
| | - Dimitri Prandner
- grid.9970.70000 0001 1941 5140Department for Sociology - Empirical Social Research Unit, Johannes Kepler University Linz, Altenbergerstraße 69, 4040 Linz, Austria ,grid.7039.d0000000110156330Department for Political Science and Sociology, Paris Lodron University Salzburg, Kapitelgasse 4/6, 5020 Salzburg, Austria
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Read J. Bad things happen and can drive you crazy: The causal beliefs of 701 people taking antipsychotics. Psychiatry Res 2020; 285:112754. [PMID: 32086059 DOI: 10.1016/j.psychres.2020.112754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/28/2019] [Accepted: 01/01/2020] [Indexed: 01/22/2023]
Abstract
In almost all countries the public prefers psycho-social explanations of 'schizophrenia' to bio-genetic ones. The causal explanations of people who experience psychosis have been under-researched, and, if they diverge from the dominant bio-genetic paradigm, can be dismissed as 'lack of insight'. 701 people, from 30 countries, who completed an online survey about their experiences on antipsychotics, answered an open question about what had caused the problems for which they had been prescribed the drugs. On a 'Bio-Social' likert scale, from 1 = 'Purely Biological' to 5 = 'Purely Social', the mean score was 4.24. Thematic analysis of 1,063 causal statements produced seven themes: Social (49.9%), Psychological (12.1%), Bio-genetic (11.6%), Iatrogenic (11.3%), Drug and Alcohol (6.7%), Medical Condition (4.5%) and Insomnia (4.0%). Respondents were 13 times more likely to report predominantly or exclusively Social causes as to report predominantly or exclusively Bio-genetic causes. Those with a psychosis diagnosis were even more likely than others to report a Social cause. The causal beliefs of this sample are consistent with previous studies of people diagnosed with 'schizophrenia' and the beliefs of the public. They are also aligned with recent research into the social causes of psychosis. It is argued that rather than dismiss the beliefs as 'lack of insight' it is more respectful and productive to listen carefully and adjust our understandings and services accordingly.
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Affiliation(s)
- John Read
- School of Psychology, University of East London, London E15 4LZ, UK.
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Gilmore L, Hughes B. Perceptions of schizophrenia in the Australian community: 2005–2017. J Ment Health 2019; 30:440-446. [DOI: 10.1080/09638237.2019.1630720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Linda Gilmore
- Faculty of Education, Queensland University of Technology, Brisbane, Australia
| | - Brenda Hughes
- Faculty of Education, Queensland University of Technology, Brisbane, Australia
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Thorsteinsson EB, Bhullar N, Williams E, Loi NM. Schizophrenia literacy: the effects of an educational intervention on populations with and without prior health education. J Ment Health 2018; 28:229-237. [PMID: 30445875 DOI: 10.1080/09638237.2018.1521923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Mental health literacy is an important predictor of appropriate help-seeking behaviour. AIMS This study investigated (a) the effects of an educational intervention on schizophrenia mental health literacy, beliefs about causes, discrimination, treatment, and attitudes that promote recognition, and (b) whether schizophrenia literacy would be higher in people with prior education in a health-related area than people without such education. METHOD A randomised control design tested the effects of an educational intervention on schizophrenia literacy relative to a control group. Participants (N = 260; mean age = 31.18 years, SD = 11.43, female = 78.8%) answered a mental health literacy questionnaire, based on a vignette of a person with schizophrenia, before and after watching either an educational video on schizophrenia or a control video. RESULTS The intervention significantly increased schizophrenia identification and literacy, reduced personal stigma, and increased perceived discrimination in society. The health background group reported significantly greater schizophrenia identification than the no health background group. Participants thought help should be sought from health care professionals and through psychotherapy, close friends and physical activity. CONCLUSIONS Targeted education can significantly improve the ability to identify schizophrenia which may have positive implications for reducing the time individuals take to seek help.
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Affiliation(s)
| | - Navjot Bhullar
- a School of Psychology , University of New England , Armidale , Australia
| | - Elizabeth Williams
- a School of Psychology , University of New England , Armidale , Australia
| | - Natasha M Loi
- a School of Psychology , University of New England , Armidale , Australia
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The Singaporean public beliefs about the causes of mental illness: results from a multi-ethnic population-based study. Epidemiol Psychiatr Sci 2018; 27:403-412. [PMID: 28367774 PMCID: PMC6998867 DOI: 10.1017/s2045796017000105] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
AIMS To identify the common causal beliefs of mental illness in a multi-ethnic Southeast Asian community and describe the sociodemographic associations to said beliefs. The factor structure to the causal beliefs scale is explored. The causal beliefs relating to five different mental illnesses (alcohol abuse, depression, obsessive-compulsive disorder (OCD), dementia and schizophrenia) and desire for social distance are also investigated. METHODS Data from 3006 participants from a nationwide vignette-based study on mental health literacy were analysed using factor analysis and multiple logistic regression to address the aims. Participants answered questions related to sociodemographic information, causal beliefs of mental illness and their desire for social distance towards those with mental illness. RESULTS Physical causes, psychosocial causes and personality causes were endorsed by the sample. Sociodemographic differences including ethnic, gender and age differences in causal beliefs were found in the sample. Differences in causal beliefs were shown across different mental illness vignettes though psychosocial causes was the most highly attributed cause across vignettes (endorsed by 97.9% of respondents), followed by personality causes (83.5%) and last, physical causes (37%). Physical causes were more likely to be endorsed for OCD, depression and schizophrenia. Psychosocial causes were less often endorsed for OCD. Personality causes were less endorsed for dementia but more associated with depression. CONCLUSIONS The factor structure of the causal beliefs scale is not entirely the same as that found in previous research. Further research on the causal beliefs endorsed by Southeast Asian communities should be conducted to investigate other potential causes such as biogenetic factors and spiritual/supernatural causes. Mental health awareness campaigns should address causes of mental illness as a topic. Lay beliefs in the different causes must be acknowledged and it would be beneficial for the public to be informed of the causes of some of the most common mental illnesses in order to encourage help-seeking and treatment compliance.
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Abstract
BACKGROUND Lay beliefs about schizophrenia are an important factor associated with treatment-seeking behavior. AIMS This study was conducted to investigate the lay beliefs about the causes and treatments of schizophrenia in South Korea. METHODS A total of 654 adults (mean age, 35.96 ± 11.33 years) completed two questionnaires assessing their views on the causes and cures of schizophrenia. The factor structures of lay beliefs about the causes and treatments of schizophrenia were then analyzed and the correlations between the resultant factors investigated. RESULTS From the cause items, four factors were extracted: Health/Lifestyle, God/Fate, Social/Environmental and Biological. Four factors were also extracted from the treatment items: Self-Help/Stress Management, Physical Treatment/Health Management, Religious Help and Mental Health Service Utilization. Notably, most participants believed that items in the Social/Environmental and Biological factors were the causes of schizophrenia, while they believed that items in the Mental Health Service Utilization and Self-Help/Stress Management factors were the treatments. Participants' beliefs about the causes and treatments of schizophrenia were systematically correlated. CONCLUSION Overall, laypeople have reasonably accurate beliefs and a multidimensional view of the causes and treatments of schizophrenia. Nevertheless, our results suggest that public education about the etiology and treatment of schizophrenia are necessary to increase actual usage of mental health services and treatments for schizophrenia.
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Affiliation(s)
- Subin Park
- 1 Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Korea
| | - Minji Lee
- 1 Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Korea
| | - Adrian Furnham
- 2 Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Mina Jeon
- 3 Department of Psychology and Human Development, University College London, London, UK
| | - Young-Mi Ko
- 1 Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Korea
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Chou FHC, Tsai KY, Wu HC, Shen SP. Cancer in patients with schizophrenia: What is the next step? Psychiatry Clin Neurosci 2016; 70:473-488. [PMID: 27392126 DOI: 10.1111/pcn.12420] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/12/2016] [Accepted: 06/22/2016] [Indexed: 12/15/2022]
Abstract
People with schizophrenia, who constitute approximately 0.3-1% of the general population, have a nearly 20% shorter life expectancy than the general population. The incidence of varied types of cancers in patients with schizophrenia is controversial. The majority of previous research has demonstrated that patients who have schizophrenia and cancer have early mortality compared to the general population with cancer. The causes of early mortality in patients with schizophrenia and cancer might be attributed to a lower cancer screening rate and lack of effective treatment, including: (i) patient factors, such as poor lifestyle, passive attitude toward treatment, or comorbidity; (ii) physician factors, such as physician bias, which may decrease the delivery of care for individuals with mental disorders; and (iii) hospital administration factors, such as stigma and discrimination. Additional studies on patients with schizophrenia and cancer are warranted and should include the following: a comprehensive review of previous studies; a focus on differentiating the specific types of cancer; and methods for improvement. To decrease the early mortality of patients with schizophrenia, the following measures are proposed: (i) enhance early detection and early treatment, such as increasing the cancer screening rate for patients with schizophrenia; (ii) provide effective, timely treatment and rehabilitation; (iii) improve patients' psychiatric symptoms and cognitive impairment; (iv) promote healthy behavior in the general population and emphasize healthy lifestyles in vulnerable populations; and (v) remove the stigma of schizophrenia. To reduce disparities in physical health, public health strategies and welfare policies must continue to focus on this group of patients.
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Affiliation(s)
- Frank H-C Chou
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.,Graduate Institute of Health Care, Meiho University, Ping-Tong County, Taiwan
| | - Kuan-Yi Tsai
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Hung-Chi Wu
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Shih-Pei Shen
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.,Department of Public Health, China Medical University, Taichung, Taiwan
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Kye SY, Yoo J, Lee MH, Jun JK. Effects of a Cancer Prevention Advertisement on Beliefs and Knowledge about Cancer Prevention. Asian Pac J Cancer Prev 2015; 16:5793-800. [PMID: 26320453 DOI: 10.7314/apjcp.2015.16.14.5793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Outcome-expectation beliefs and knowledge may ultimately influence behavior for cancer prevention. The aims of this study were to measure changes in knowledge and beliefs about cancer prevention before and after viewing a television advertisement and identify the factors affecting receptivity to its messages. MATERIALS AND METHODS A one-group pretest-posttest design was used in this study of 1,000 individuals aged 20 to 65 years who were recruited online in November 2014. The outcome variables included cancer prevention beliefs based on the Health Belief Model (five items) and knowledge about risk factors for cancer (seven items). RESULTS Perceived susceptibility, perceived benefits, and self-efficacy increased significantly and their perceived severity and perceived barriers decreased significantly, after participants viewed the television advertisement. Correct responses to questions about risk factors also increased significantly, except for smoking. The main factors affecting changes in the outcome variables were age, interest in cancer prevention, social network, satisfaction with the ad, and pretest scores. CONCLUSIONS Television advertisements with positive frameworks can be an efficient channel of improving beliefs and knowledge about cancer prevention in a short period. The continuous development of intervention materials that consider the demographics, needs, and satisfaction of the target group will be necessary for future studies.
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Affiliation(s)
- Su Yeon Kye
- Cancer Information and Education Branch, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea E-mail :
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What do the general population know, believe and feel about individuals with autism and schizophrenia: Results from a comparative survey in Denmark. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2015; 20:496-508. [DOI: 10.1177/1362361315593068] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Few studies investigate what members of the general population know about individuals with autism. Only one study has previously investigated how beliefs about autism differ from those about other psychiatric disorders. This study surveyed a convenience sample of the general adult population, within the Northern Region of Denmark, about their knowledge, attitudes and beliefs about individuals with autism and schizophrenia. The respondents (N = 440) possessed basic knowledge and were able to differentiate between the two disorders. Schizophrenia was associated with perceived danger (32.8%), while autism was associated with high intelligence (40.1%) and creativity (27.3%). Respondents were more positive towards interacting with individuals with autism (p < 0.001), but desire for social distancing was pronounced for both disorders in more intimate relationships. Significantly, more respondents reported that they would find it difficult and feel ashamed with regard to being diagnosed with schizophrenia (p < 0.001). Conversely, respondents significantly reported being more likely to elaborate on their diagnosis of autism to their colleagues (p < 0.001). Perceived dangerousness decreased the willingness for social interactions, while knowing someone with autism or schizophrenia increased the willingness to socially interact. Misconceptions and stigma must be addressed in order to minimize the social stigma and rejection associated with these disorders and ultimately improve the quality of life and psychological well-being of affected individuals and their families.
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