Self-Stigma and Decision About Medication Use Among a Sample of Nigerian Outpatients With Schizophrenia
Self-Stigma and Decision About Medication Use Among a Sample of Nigerian Outpatients With Schizophrenia
复制标题
DOI：
10.1037/prj000408
复制
发表时间：
2020-09-01
影响因子：
1.9
通讯作者：
Adebowale, Timothy Olaolu
中科院分区：
文献类型：
--
作者：
Fadipe, Babatunde;Olagunju, Andrew Toyin;Adebowale, Timothy Olaolu
目的：自我污名是精神分裂症维持治疗和康复的常见障碍。我们调查了370名精神分裂症成年人不按处方用药的患病率，并描述了自我污名与这种决定的多维关系。方法：多变量二元Logistic回归模型被用来检查自我耻辱的具体方面（异化，感知歧视，耻辱阻力，刻板印象认可和社会退缩）和决定不服药之间的关系，同时控制其他临床变量。结果：在所有研究参与者中，16.5%的人报告了高度的自我耻辱，而39.2%的人决定不使用他们的药物。不使用药物的决定与高自我耻辱的整体得分，疏远，感知歧视和耻辱的阻力。刻板印象的认可和社会退缩并没有表现出与不使用药物的关系。回归分析后，不使用药物的决定与自我耻辱，特别是高度异化和感知歧视，以及其他因素，包括药物副作用，更糟糕的精神病理学，不独自生活，24小时药物使用回忆差，没有医疗合并症。结论和实践的启示：不使用药物和自我污名在精神分裂症维持治疗患者中普遍存在，并且相互关联。在随访期间获得有关药物使用的常规信息，包括副作用，症状特征，并进行重点污名筛查，可以在共同决策过程中为有关药物使用的临床讨论提供信息。
Objective: Self-stigma is a common barrier to maintenance therapy and recovery in schizophrenia. We investigated the prevalence of the decision not to use medication as prescribed and describe the multidimensional relationship of self-stigma with such a decision in 370 adults with schizophrenia. Method: A multivariate binary logistic regression model was used to examine the relationship between specific aspects of self-stigma (alienation, perceived discrimination, stigma resistance, stereotype endorsement and social withdrawal) and the decision not to take medication, while controlling for other clinical variables. Results: Of the total study participants, 16.5% reported high self-stigma while 39.2% decided not to use their medications. The decision not to use medication was associated with a high self-stigma global score, alienation, perceived discrimination and stigma resistance. Stereotype endorsement and social withdrawal did not demonstrate a relationship with nonuse of medication. Following regression analysis, the decision not to use medication was associated with self-stigma, especially high alienation and perceived discrimination, and other factors including medication side effects, worse psychopathology, not living alone, poor 24-hr medication use recall, and absence of medical comorbidity. Conclusions and Implications for Practice: Medication nonuse and self-stigma are prevalent and interrelated in patients on maintenance therapy for schizophrenia. Obtaining routine information during follow-up appointments about medication use including side effects, the symptom profile, and conducting a focused stigma screening can inform clinical discussions regarding medication use in a shared decision-making process.