High internalized stigma among community-dwelling patients with schizophrenia: Associations with sociodemographic and clinical characteristics, personality traits and health-related quality of life

Stigma attached to schizophrenia among patients is a global concern to mental health advocates. The extent of internalized stigma experienced by consumers with schizophrenia living in the community and its correlates have not been fully explored. This study aimed to examine the prevalence of high internalized stigma and its association with sociodemographic and clinical characteristics, personality traits and aspects of health-related quality of life among community-dwelling consumers with schizophrenia. A descriptive, correlational study with a cross-sectional design was conducted with 149 consumers from outpatient psychiatric clinics of two hospitals in Taiwan. Face-to-face interviews with structured questionnaires were adopted. Data were analysed with descriptive statistics, chi-squares tests, independent t-tests and a binary logistic regression analysis. Approximately 41.6% of consumers with schizophrenia experienced high internalized stigma. In the subscales, a high experience of discrimination experience (43.6%) was reported, followed by alienation (34.2%), social withdrawal (28.2%), stereotype endorsement (24.8%) and stigma resistance (20.8%). Being younger at the onset of schizophrenia, attaining lower education, having a history of suicidality, fewer positive personality traits and poor aspects of health-related quality of life were significantly associated with high internalized stigma. Personality traits in the domains of emotional stability and conscientiousness and social and environmental aspects of health-related quality of life appeared to be the most relevant to risk of high internalized stigma. Anti-stigma initiatives coupled with personality-traits modules and modifications of health-related quality of life are suggested for mental health professionals and policy makers to ameliorate internalized stigma among community-dwelling consumers with schizophrenia.