Psychopathological profile and antipsychotic treatment may be linked to internalised stigma in schizophrenia – a cross-sectional study

Purpose
The aim of this study was to assess the relationship between the internalised stigma of mental illness associated with the use of antipsychotic treatment and psychopathological profile among patients diagnosed with schizophrenia.

Method
The study group comprised 64 patients diagnosed with schizophrenia. The Internalised Stigma of Mental Illness Inventory was used to assess the degree of self-stigmatisation in five aspects: Alienation, Stereotype Endorsement, Discrimination experience, Social withdrawal and Stigma resistance. The symptoms were assessed by a psychiatrist using the Clinical Assessment of Schizophrenic Syndromes Scale. Other variables of interest included data on current pharmacotherapy, body-mass index (BMI) and general functioning. Multivariate linear regression models were created to assess the association between variables of interest and ISMI subscale scores. Results were considered statistically significant when p < 0.05.

Results
Zuclopenthixol, a long-acting injectable (LAI), was linked to greater Alienation, Stereotype endorsement and Discrimination experience, while risperidone LAI was associated with higher indices of Stereotype endorsement. Oral risperidone was linked to lower severity of Alienation and a greater level of Stigma resistance. A rise in the Lack of insight score predicted falls in Alienation, Stereotype endorsement, Discrimination experience and Social withdrawal scores. A rise in the Disturbances of Sense of Self score predicted rises in Alienation, Stereotype endorsement and Discrimination experience.

Conclusions
Internalised stigma among patients with schizophrenia is linked to the choice of antipsychotic treatment. Hence, it may be of clinical importance.