Ai Guiju,Jin Ming,Shao Quanming,Liu Yanni,Wang Xianzhen,Luo Hong,Relationship between internalized stigma and quality of life in patients with schizophrenia::the chain mediating role of self-esteem and severity of negative symptoms[J].SICHUAN MENTAL HEALTH,2025,(2):172-177
Relationship between internalized stigma and quality of life in patients with schizophrenia::the chain mediating role of self-esteem and severity of negative symptoms
DOI:10.11886/scjsws20240729002
English keywords:Schizophrenia  Quality of life  Stigma  Self-esteem  Negative symptoms
Fund projects:湖北省大学生创新创业项目(项目名称:精神分裂症患者症状体验的同期症状网络研究,项目编号:S202410519027)
Author NameAffiliationPostcode
Ai Guiju Hubei University of Arts and Science Xiangyang 441053 China 441053
Jin Ming Hubei University of Arts and Science Xiangyang 441053 China 441053
Shao Quanming Xiangyang Anding Hospital Xiangyang 441000 China 441000
Liu Yanni Xiangyang Anding Hospital Xiangyang 441000 China 441000
Wang Xianzhen* China-Japan Union Hospital of Jilin University Changchun 130033 China 130033
Luo Hong Hubei University of Arts and Science Xiangyang 441053 China 441053
Hits:
Download times:
English abstract:
      Background Patients with schizophrenia experience low quality of life, and internalized stigma is considered an important indicator for quality of life, while the mediating role of self-esteem and severity of negative symptoms in the relationship between internalized stigma and quality of life remains underexplored.Objective To examine the mediating role of self-esteem and severity of negative symptoms in the relationship between internalized stigma and quality of life, so as to provide references for improving their quality of life.Methods A total of 342 patients with schizophrenia who were hospitalized in 6 hospitals in Xiangyang City, Siping City and Changchun City from April to September 2023 were included, and all of whom met the diagnostic criteria for schizophrenia according to the International Classification of Diseases, tenth edition (ICD-10). Internalized Stigma of Mental Illness Scale (ISMI), Schizophrenia Quality of Life Scale (SQLS), Self-Esteem Scale (SES) and negative symptom subscale of Positive and Negative Symptom Scale (PANSS) were administered to all patients. Spearman correlation analysis was adopted to determine correlations between the different scales. A structural equation modeling was constructed using Amos 28.0, and Bootstrap method was employed to verify the mediating effect of self-esteem and negative symptom severity in the association between internalized stigma and quality of life.Results A total of 309 patients (90.35%) completed questionnaires in this study. The ISMI score of schizophrenia patients was positively correlated with both SQLS score and the PANSS negative symptom subscale score (r=0.612, 0.492, P<0.01), while was negatively correlated with SES score (r=-0.513, P<0.01). The SQLS score was negatively associated with the SES score (r=-0.555, P<0.01) and positively associated with PANSS negative symptom subscale score (r=0.672, P<0.01). The SES score was negatively correlated with PANSS negative symptom subscale score (r=-0.433, P<0.01).The total effect value of internalized stigma on quality of life was 0.746 (95% CI: 0.680~0.806). Self-esteem and severity of negative symptoms independently mediated the relationship between internalized stigma and quality of life, and the indirect effect values were 0.151 (95% CI: 0.062~0.254) and 0.126 (95% CI: 0.047~0.205), accounting for 20.24% and 16.89% of the total effect, respectively. In addition, a chained mediation effect of self-esteem and quality of life was also demonstrated, the indirect effect value was 0.102 (95% CI: 0.049~0.165), accounting for 13.67% of the total effect).Conclusion Internalized stigma in patients with schizophrenia patients can not only directly affect the quality of life, but also indirectly affect the quality of life of patients through either separate or chained mediation of self-esteem and the severity of negative symptoms. [Funded by Hubei Provincial Undergraduate Innovation and Entrepreneurship Project (number, S202410519027)]
View Full Text   View/Add Comment  Download reader
Close