How Stigma and Discrimination are Perceived by Rural or Urban Patients Suffering from Schizophrenia? An Exploratory Cross – Sectional Study fromWestern India

  • Bharat Agarwal Assistant Professor Department of Psychiatry, Ananta Institute of Medical Sciences and Research Centre, Rajsamand
  • Sunil Kumar Senior Resident, Department of Psychiatry, Ananta Institute of Medical Sciences and Research Centre, Rajsamand.
  • G. K. Vankar Department of Psychiatry, GFC Dutta Meghe Institute of Medical Sciences University, Vardha.
Keywords: Schizophrenia, Stigma, Discrimination, Experiences, Attitude.

Abstract

Background: Stigma is conceptualized as an attribute which is deeply discrediting and makes the person carrying it different from other and of a less desirable kind. Current study aimed to describe the nature and direction of experienced stigma; and discrimination reported by people with schizophrenia. Methods: One hundred and fifty patients diagnosed with Schizophrenia were selected from the Out Patient service of Psychiatry Department of a medical college general hospital. The experiences of stigma and discrimination were assessed using a semi-structured instrument developed by national working group for India by the world psychiatric association steering committee. Results: Differences were seen between rural and urban respondents. Patients from rural background more often reported these experiences: society treats differently, ridiculing by others, offensive comments, hiding from relatives, rejecting attitude of peoples around, attribution of supernatural cause as most common source of stigma, social exploitation, not fully accepted in the family, pushed into unacceptable social situation and sexual harassment. Reported narratives provided the direct view of these patients. Conclusions: Stigma experience is pervasive: it deeply affects the social, occupational and emotional wellbeing of patients with schizophrenia and should be included in clinical management. Effective anti-stigma intervention should target on improving attitudes and the condition for social integration in the community, empowering people with schizophrenia to challenge self-stigmatization and discrimination behavior towards them.

Downloads

Download data is not yet available.

References

1. Dinan TG. Schizophrenia: illness, stigma and misconceptions Ir J Psych Med 1999; 16(1): 3-4.
2. Report of the international pilot study of schizophrenia. Geneva; 1973. World Health Organization.
3. Waxler-Morrison N. Commentary on Cohen, prognosis for schizophrenia in the third world. Culture Med Psychiatry. 1992; 16:77–80.
4. Cohen A. Prognosis for schizophrenia in the third world: A reevaluation of cross-cultural research. Culture Med Psychiatry. 1992; 16:53–75.
5. Cooper J, Sartorius N. Cultural and temporal variations in schizophrenia: A speculation on the importance of industrialization. Br J Psychiatry. 1977; 130:50–5.
6. Weiss M, Jadhav S, Raguram R, Vounatsou P, Littlewood R. Psychiatric stigma across cultures: Local validation in Bangalore and London. Anthropol Med 2001; 8:71.
7. Raguram R, Weiss MG, Channabasavanna SM, Diop M. Stigma, depression and somatization in South India. Am J Psychiatry 1996; 153:1043-9.
8. Thara R, Srinivasan TN. How stigmatizing is schizophrenia in India? Int J Soc Psychiatry 2000;46: 135-41.
9. Raguram R, Weiss MG, Keval H, Channabasavanna SM. Cultural dimensions of clinical depression in Bangalore, India. Anthropol Med 2001; 8:31.
10. Srinivasa DK, Trivedi S. Knowledge and attitude of mental diseases in a rural community of South India. Soc Sci Med 1982;16:1635-9.
11. Wig NN, Suleiman MA, Routledge R, Murthy RS, Ladrido-Ignacio L, Ibrahim HH, et al . Community reactions to mental disorders: A key informant study in three developing countries. Acta Psychiatr Scand 1980; 61:111-26.
12. Verghese A, Beig A. Public attitudes towards mental illness: The Vellore Study. Indian J Psychiatry 1974;16:8-18
13. Murthy R.S. Stigma of mental illness in the Third world. In: Okasha A., Stefanis C.N., editors. Perspectives on the Stigma of Mental Illness. World Psychiatric Association; Cairo: 2005.
14. Jadhav S, Littlewood R, Ryder AG, Chakraborty A, Jain S, Barua M. Stigmatization of severe mental illness in India: Against the simple industrialization hypothesis. Indian Journal of Psychiatry. 2007; 49(3):189-194.
15. Loganathan S, Murthy SR. Experiences of stigma and discrimination endured by people suffering from schizophrenia. Indian Journal of Psychiatry. 2008; 50(1):39-46.
16. Weiss MG, Jadhav S, Raguram R, Vounatsou P, Littlewood R. Psychiatric stigma across cultures: Local validation in Bangalore and London. Anthropol Med 2001; 8:71-87.
17. Pearson, V. (1993) Families in China: an undervalued resource in mental health. Journal of Family Therapy, 15, 163 -185.
18. Li, S. X. & Phillips, M. R. (1990) Witch doctors and mental illness in mainland China: a preliminary report. American Journal of Psychiatry, 147, 221 -224
19. Drake RE, Mchugo GJ, Becker DR, Anthony WA, Clark RE: The New Hampshire study of supported employment for people with severe mental illness. J Consult ClinPsychol 1996, 64(2):391-399.
20. Drake RE, Mchugo GJ, Bebout RR, Becker DR, Harris M, Bond GR, Quimby E: A randomized clinical trial of supported employment for inner-city patients with severe mental disorders. Arch Gen Psychiatry 1999, 56(7):627-633.
21. Breier A, Schreiber L, Dyer J, Pickar D: National Institute of Mental Health Longitudinal Study of Chronic Schizophrenia. Prognosis and Predictors of Outcome. Arch Gen Psychiatry 1991, 48(3):239-246.
22. Brekke JS, Levin S, Wolkon GH, Sobel E, Slade E: Psychosocial functioning and subjective experience in Schizophrenia. SchizophrBull1993, 19(3):599-608
23. Lehmann A: The well-being of chronic mental patients.ArchGen Psychiatry1983, 40:369-373.
24. Warner R: Recovery from schizophrenia Routledge & Kegan Paul: London; 1985.
25. Alexander LA & Link BG: The impact of contact on stigmatizing attitudes toward people with mental illness. Journal of Mental Health (June 2003) 12, 3, 271–289
26. Couture SM & Penn DL: Interpersonal contact and the stigma of mental illness: A review of the literature Journal of Mental Health (June 2003) 12, 3, 291 – 305
27. Lin, T. L. & Lin, M. C. (1981) Love, denial and rejection: responses of Chinese families to mental illness. In Normal and Abnormal Behaviour in Chinese Culture (eds A. Kleinman & T. Lin), pp. 387-401. London: Reidel.
28. Lee S, Lee MTY, Chiu MYL, Kleinman A: Experience of social stigma by people with schizophrenia in Hong Kong: The British Journal of Psychiatry Jan 2005, 186(2),p:153-157
Published
2018-03-20
How to Cite
1.
Agarwal B, Kumar S, Vankar G. How Stigma and Discrimination are Perceived by Rural or Urban Patients Suffering from Schizophrenia? An Exploratory Cross – Sectional Study fromWestern India. IABCR [Internet]. 20Mar.2018 [cited 21Sep.2018];4(1):14-8. Available from: https://iabcr.org/index.php/iabcr/article/view/256