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Caiada M, Felix S, Guionnet S, Valery KM, Bonilla-Guerrero J, Destaillats JM, Prouteau A. Promoting Intimate Relationships in Mental Illness: A Systematic Review of Interventions. Community Ment Health J 2024; 60:536-551. [PMID: 38015269 DOI: 10.1007/s10597-023-01204-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
Although persons with Serious Mental Illness (SMI) express a need for intimate relations with others, they still suffer from a severe lack of social participation in this domain. However, these unmet needs have received little attention until recently. This study reviews interventions that aim to facilitate the development and the maintenance of intimate relationships (IR) of persons with schizophrenia, bipolar disorder and major depression. A systematic review following PRISMA guidelines was conducted. Studies published in Scopus, PubMed, EBSCO (Psych INFO, Psych ARTICLES, Psychology and Behavioral Sciences Collection) from January 1, 2000, to December, 2021, were screened. The search using terms referring to "schizophrenia", "bipolar disorder", "major depression", "IR" and "interventions" revealed 11 studies. Among them, 10 reported interventions for persons with depression, including 9 for couple therapy. Most interventions targeted satisfaction with couple relationships as the main therapeutic objective. Heterogeneity in study design precludes any firm conclusions about their efficacy. Interestingly, only one intervention focused on single persons interested in developing IR. The results highlight the lack of interventions: (i) aimed at promoting IR, (ii) designed for single persons, and (iii) targeting persons with psychotic disorders. This result may reflect the persisting stigmatization of persons with psychotic disorders, and the taboo associated with the IR and sexuality of persons with mental illness. Further studies are needed to develop inclusive interventions promoting the development of IR in persons with mental illness.
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Affiliation(s)
- Meryl Caiada
- Laboratory of Psychology, LabPsy, UR 4139, University of Bordeaux, 33000, Bordeaux, France.
| | - Simon Felix
- Laboratory of Psychology, LabPsy, UR 4139, University of Bordeaux, 33000, Bordeaux, France
- Department of Adult Psychiatry, Jonzac Hospital, Jonzac, France
| | - Sarah Guionnet
- Laboratory of Psychology, LabPsy, UR 4139, University of Bordeaux, 33000, Bordeaux, France
| | - Kevin-Marc Valery
- Laboratory of Psychology, LabPsy, UR 4139, University of Bordeaux, 33000, Bordeaux, France
| | | | | | - Antoinette Prouteau
- Laboratory of Psychology, LabPsy, UR 4139, University of Bordeaux, 33000, Bordeaux, France
- Department of Adult Psychiatry, Jonzac Hospital, Jonzac, France
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Valery KM, Fournier T, Violeau L, Guionnet S, Bonilla-Guerrero J, Caria A, Carrier A, Destaillats JM, Follenfant A, Laberon S, Lalbin-Wander N, Martinez E, Quemper D, Staedel B, Touroude R, Vigneault L, Prouteau A. When mental health care is stigmatizing: A participative study in schizophrenia. Psychiatr Rehabil J 2023; 46:232-242. [PMID: 37326542 DOI: 10.1037/prj0000567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Mental health care has been identified as a major source of mental illness stigmatization. Detailed information about these stigmatization experiences is thus needed to reduce stigma in mental health practices. The study aimed to (a) identify the most relevant stigmatizing situations in mental health care encountered by users with schizophrenia and their families; (b) characterize the relative importance of these situations in terms of frequency, experienced stigmatization, and associated suffering; and (c) identify contextual and individual factors associated with these experiences. METHOD An online survey was conducted in France among users and family members to characterize situations of stigmatization in mental health care and identify associated factors. The survey content was first developed from a participative perspective, through a focus group including users. RESULTS A total of 235 participants were included in the survey: 59 participants with schizophrenia diagnosis, 96 with other psychiatric diagnoses, and 80 family members. The results revealed 15 relevant situations with different levels of frequency, stigmatization, and suffering. Participants with a diagnosis of schizophrenia experienced more situations of stigmatization, with a higher frequency. Moreover, contextual factors were strongly associated with experienced stigmatization, including recovery-oriented practices (negatively associated) and measures without consent (positively associated). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE These situations, as well as associated contextual factors, could be targeted to reduce stigmatization and related suffering in mental health practices. Results strongly underscore the potential of recovery-oriented practice as an instrument to fight stigma in mental health care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Sonia Laberon
- COMPTRASEC, UMR5114, Centre National de Recherche Scientifique
| | | | | | | | - Bérénice Staedel
- Centre Collaborateur de l'Organisation Mondiale de la Sante, Etablissement Public de Sante Mentale Lille-Metropole
| | - Roselyne Touroude
- Union nationale de familles et amis de personnes malades et/ou handicapees psychiques (UNAFAM)
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Valery KM, Violeau L, Fournier T, Yvon F, Arfeuillere S, Bonilla-Guerrero J, Caria A, Carrier A, Destaillats JM, Follenfant A, Laberon S, Lalbin-Wander N, Martinez E, Staedel B, Touroude R, Vigneault L, Roux S, Prouteau A. Part of the solution yet part of the problem: factors of schizophrenia stigma in mental health professionals. Int J Psychiatry Clin Pract 2022:1-11. [PMID: 36200837 DOI: 10.1080/13651501.2022.2129068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
BACKGROUND Stigma is highly prejudicial to persons with schizophrenia, their families, the society and the health care system. Mental health professionals (MHP) are considered to be one of the main sources of schizophrenia stigma. OBJECTIVES The aim of the study was to identify individual and contextual factors associated with stigma in MHP in its three dimensions (stereotypes, prejudices, discrimination, Fiske, 1998). METHODS An online survey was conducted with specific measures of MHP stigma (stereotypes, prejudices and discrimination). Four categories of potential associated factors were also measured: sociodemographic characteristics, contextual characteristics (e.g., Work setting), individual characteristics (e.g., Profession, Recovery-oriented practices) and theoretical beliefs (e.g., Biological beliefs, Perceived similarities, Continuum versus Categorical beliefs). RESULTS Responses of 357 MHP were analysed. Factors that were the most strongly associated with MHP stigma were Perceived similarities, Categorical beliefs, Biological beliefs, Recovery-oriented practice and Work setting (independent practice). Conversely, Gender, Specific trainings in stigma or recovery and Cognitive aetiology beliefs showed no association with any of MHP stigma dimension. Remaining factors show associations with a weak effect size. CONCLUSIONS The survey results suggest that MHP stigma is more influenced by individual factors such as theoretical beliefs and recovery-oriented practices than contextual factors. These original results provide perspectives for reducing stigma in mental health practices.Key pointsMental health professionals (MHP) considering they share similarities with persons with schizophrenia or believing that schizophrenia is not a discrete social category but rather the extreme on a continuum between 'normal' and 'pathologic' reported less stigmatisation.MHP holding higher professional utility beliefs and using recovery-oriented practice reported fewer stereotypes, prejudice and discrimination.Other factors such as age, academic level, contact frequency, familiarity and multidisciplinary practice show associations with a weak effect size.
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Affiliation(s)
- Kevin-Marc Valery
- LabPsy, Univ. Bordeaux, Bordeaux, France.,Adult Psychiatry Department, Jonzac Hospital, Jonzac, France
| | - Louis Violeau
- LabPsy, Univ. Bordeaux, Bordeaux, France.,Adult Psychiatry Department, Jonzac Hospital, Jonzac, France
| | - Thomas Fournier
- LabPsy, Univ. Bordeaux, Bordeaux, France.,Adult Psychiatry Department, Jonzac Hospital, Jonzac, France
| | | | | | | | | | | | | | | | | | | | - Eric Martinez
- Adult Psychiatry Department, Jonzac Hospital, Jonzac, France
| | | | | | | | | | - Antoinette Prouteau
- LabPsy, Univ. Bordeaux, Bordeaux, France.,Adult Psychiatry Department, Jonzac Hospital, Jonzac, France
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Valery KM, Prouteau A. Schizophrenia stigma in mental health professionals and associated factors: A systematic review. Psychiatry Res 2020; 290:113068. [PMID: 32474069 DOI: 10.1016/j.psychres.2020.113068] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/29/2020] [Accepted: 05/02/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The consequences of schizophrenia stigma are numerous and highly damaging to individuals, their families, the health care system and society. Mental health professionals (MHP) are considered to be one of the main sources of stigmatization. OBJECTIVES To identify the characteristics of MHP stigma in schizophrenia in comparison with other psychiatric disorders, the specificities of MHP compared with other social groups, and associated factors. METHODS Following PRISMA guidelines, we systematically searched multiple electronic databases for articles: (i) reporting original data published in English in peer-reviewed journals, (ii) reporting quantitative data with statistical analysis, (iii) assessing stigma in a broad sense, and (iv) including samples composed only of MHP. RESULTS A total of 38 articles published from 1999 to 2019 and involving 10,926 MHP fulfilled our inclusion criteria. Studies showed that schizophrenia is the most stigmatized mental illnesses in MHP, despite recent results suggesting that borderline personality disorder and substance abuse may be more stigmatized. In comparison with other social groups, MHP reported less dangerousness beliefs and more positive beliefs regarding pharmacological treatment. Nevertheless, results were less consistent regarding prognosis and desire for social distance. Age, education level, type of mental health profession, or length of practice were associated factors that showed inconsistent relations with stigma. Work setting and biological causal beliefs were more clearly associated with MHP stigma. CONCLUSION These findings provide strong support for the need to conduct specific research on schizophrenia stigma in MHP and the importance of controlling for several variables to identify predictors of stigma.
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Affiliation(s)
- Kevin-Marc Valery
- Laboratory of Psychology EA 4139, University of Bordeaux, 3 ter place de la Victoire, 33000 Bordeaux, France; Department of Adult Psychiatry, Jonzac Hospital, Jonzac, France; EDEA Association, Bordeaux, France.
| | - Antoinette Prouteau
- Laboratory of Psychology EA 4139, University of Bordeaux, 3 ter place de la Victoire, 33000 Bordeaux, France; Department of Adult Psychiatry, Jonzac Hospital, Jonzac, France
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