Effect of self-stigma on personal recovery: sex differences in people with psychotic spectrum disorders

Abstract

Self-stigma; Schizophrenia; Sex differences

Autoestigma; Esquizofrènia; Diferències sexuals

Autoestigma; Esquizofrenia; Diferencias sexuales

Introduction: Recently, there has been growing evidence on self-stigma and personal recovery in people with psychotic spectrum disorders. However, despite the influence of sex on mental health and the social component of self-stigma and recovery, the evidence regarding self-stigma, personal recovery, and sex is limited and inconsistent. This research aims to study the role of sex in the effect that self-stigma has on the personal recovery of people with psychotic spectrum disorders.Methods: A sample of 118 patients with a psychosis diagnose participated in the study (55.9% men). They were recruited from 9 clinical centers in Spain. Data were collected through the Internalized Stigma of Mental Illness and the Recovery Assessment Scale.Results: The effect of self-stigma on personal recovery differed according to the sex of the person. Specifically, in women, personal recovery decreased as self-stigma and alienation increased. Also, a higher self-stigma was associated with a lower personal confidence, hope and symptom control. In contrast, in men, a higher alienation was associated with higher personal confidence, hope and success orientation. These results were adjusted for educational level, comorbidity, number of psychotic episodes, and the time between symptom onset and treatment initiation.

Discussion: These findings highlight the urgent need to explore further the role of sex on recovery and to have a sex-sensitive approach in policies and interventions in this population. This would benefit their recovery and, in consequence, their quality of life. Future studies should expand the sample and explore other factors that could be influencing the process of recovery and self-stigma.

The author(s) declare that financial support was received for the research and/or publication of this article. This work was funded by the Spanish Ministry of Science and Innovation through the State Research Agency (Ref. No. PID2020- 118907RA-I00/AEI/10.13039/501100011033) under the 2020 call for R&D&I Research Challenges projects (RTI). In addition, this manuscript has been elaborated with the support of the Ministry of Research and Universities of the Government of Catalonia to the Research Group COGen-MH “Cognition and Gender: Implications for Mental Health” (Code: 2021 SGR 000534).