Abstract
People with severe mental illness and a history of involuntary hospitalization may experience stigma-related stress and suffer negative consequences as a result. However, the long-term impact of stigma stress on suicidality in this population remains unknown. This longitudinal study therefore examined stigma stress, self-stigma, self-esteem and suicidal ideation among 186 individuals with mental illness and recent involuntary hospitalization. After adjusting for age, gender, diagnoses and symptoms, more stigma stress at baseline predicted suicidal ideation after 2 years, mediated by increased self-stigma and decreased self-esteem after 1 year. Anti-stigma interventions that reduce stigma stress and self-stigma could therefore support suicide prevention.
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References
Link B, Castille DM, Stuber J (2008) Stigma and coercion in the context of outpatient treatment for people with mental illnesses. Soc Sci Med 67:409–419
Rüsch N, Corrigan PW, Wassel A, Michaels P, Olschewski M, Wilkniss S, Batia K (2009) A stress-coping model of mental illness stigma: I. Predictors of cognitive stress appraisal. Schizophr Res 110:59–64
Farrelly S, Jeffery D, Rüsch N, Williams P, Thornicroft G, Clement S (2015) The link between mental health-related discrimination and suicidality: service user perspectives. Psychol Med 45:2013–2022
Corrigan PW, Larson JE, Rüsch N (2009) Self-stigma and the “why try” effect: impact on life goals and evidence-based practices. World Psychiatry 8:75–81
Katsakou C, Rose D, Amos T, Bowers L, McCabe R, Oliver D, Wykes T, Priebe S (2012) Psychiatric patients’ views on why their involuntary hospitalisation was right or wrong: a qualitative study. Soc Psychiatry Psychiatr Epidemiol 47:1169–1179
Carpiniello B, Pinna F (2017) The reciprocal relationship between suicidality and stigma. Front Psychiatry 8:35
Xu Z, Müller M, Heekeren K, Theodoridou A, Metzler S, Dvorsky D, Oexle N, Walitza S, Rössler W, Rüsch N (2016) Pathways between stigma and suicidal ideation among people at risk of psychosis. Schizophr Res 172:184–188
Oexle N, Rüsch N, Viering S, Wyss C, Seifritz E, Xu Z, Kawohl W (2017) Self-stigma and suicidality: a longitudinal study. Eur Arch Psychiatry Clin Neurosci 267:359–361
Rüsch N, Müller M, Lay B, Corrigan PW, Zahn R, Schönenberger T, Bleiker M, Lengler S, Blank C, Rössler W (2014) Emotional reactions to involuntary psychiatric hospitalization and stigma-related stress among people with mental illness. Eur Arch Psychiatry Clin Neurosci 264:35–43
Lay B, Salize HJ, Dressing H, Rüsch N, Schönenberger T, Bühlmann M, Bleiker M, Lengler S, Korinth L, Rössler W (2012) Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring. BMC Psychiatry 12:136
Rüsch N, Heekeren K, Theodoridou A, Müller M, Corrigan PW, Mayer B, Metzler S, Dvorsky D, Walitza S, Rössler W (2015) Stigma as a stressor and transition to schizophrenia after one year among young people at risk of psychosis. Schizophr Res 166:43–48
Kaiser CR, Major B, McCoy SK (2004) Expectations about the future and the emotional consequences of perceiving prejudice. Pers Soc Psychol Bull 30:173–184
Ritsher JB, Otilingam PG, Grajales M (2003) Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Res 121:31–49
Rosenberg M (1965) Society and the adolescent self-image. Princeton University Press, Princeton
Lukoff D, Liberman RP, Nuechterlein KH (1986) Symptom monitoring in the rehabilitation of schizophrenic patients. Schizophr Bull 12:578–602
Muthén L, Muthén B (1998–2002) Mplus user’s guide, 7th edn. Los Angeles
Oexle N, Rüsch N (2018) Stigma-risk factor and consequence of suicidal behavior [Stigma - Risikofaktor und Konsequenz suizidalen Verhaltens]. Nervenarzt. https://doi.org/10.1007/s00115-017-0450-8 (publ online)
Rüsch N, Abbruzzese E, Hagedorn E, Hartenhauer D, Kaufmann I, Curschellas J, Ventling S, Zuaboni G, Bridler R, Olschewski M, Kawohl W, Rössler W, Kleim B, Corrigan PW (2014) Efficacy of Coming Out Proud to reduce stigma’s impact among people with mental illness: pilot randomised controlled trial. Br J Psychiatry 204:391–397
Corrigan P, Larson J, Michaels P, Buchholz B, Del Rossi R, Fontecchio M, Castro D, Gause M, Krzyzanowski R, Rüsch N (2015) Diminishing the self-stigma of mental illness by Coming Out Proud. Psychiatry Res 229:148–154
Mulfinger N, Müller S, Böge I, Sakar V, Corrigan PW, Evans-Lacko S, Nehf L, Djamali J, Samarelli A, Kempter M, Ruckes C, Libal G, Oexle N, Noterdaeme M, Rüsch N (2018) Honest, Open, Proud for adolescents with mental illness: pilot randomized controlled trial. J Child Psychol Psychiatry. https://doi.org/10.1111/jcpp.12853 (publ online)
Evans-Lacko S, Brohan E, Mojtabai R, Thornicroft G (2012) Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychol Med 42:1741–1752
Acknowledgements
We are grateful to all participants. This study was supported by the Zürich Impulse Program for the Sustainable Development of Mental Health Services (http://www.zinep.ch).
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Xu, Z., Müller, M., Lay, B. et al. Involuntary hospitalization, stigma stress and suicidality: a longitudinal study. Soc Psychiatry Psychiatr Epidemiol 53, 309–312 (2018). https://doi.org/10.1007/s00127-018-1489-y
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DOI: https://doi.org/10.1007/s00127-018-1489-y