CORRELATES OF SELF-STIGMA IN ADULT PATIENTS WITH EARLY PSYCHOSIS IN HONG KONG

Abstract

Background: Self-stigma obstructs recovery from psychotic disorders yet factors contributing to self-stigma among these patients, especially those with early psychosis have been understudied. Accumulating evidence has also indicated that high self-stigma is already prevalent in the early course of illness. This study aimed to examine correlates of self-stigma in adult patients who had completed 3-year specialized early intervention service for first-episode psychosis (FEP) in Hong Kong. Methods: One hundred and one Chinese patients aged 26–55 years who completed 3-year specialized early intervention service for FEP in Hong Kong were recruited. Assessments encompassing illness onset, clinical, functional and self-stigma variables were conducted. Results: Univariate analyses showed that gender, educational level, age of onset, duration of untreated psychosis (DUP), higher scores on the Scale to Assess Unawareness of Mental Disorder (SUMD) and Apathy Evaluation Scale (AES) were related to self-stigma (measured by Self-Stigma Scale-Short form) (threshold set at p<0.1). Multiple linear regression analysis further revealed that female gender (p=0.03), older age at onset of psychosis (p=0.02), longer DUP (p=0.03), and better insight (measured by SUMD, p=0.04) were independently associated with higher levels of self-stigma in early psychosis patients. Discussion: Our results indicated that greater self-stigma is linked to female gender, older age of illness onset, treatment delay and better insight in the early stage of psychotic disorder. In particular, patients who have good insight and / or prolonged DUP may represent a vulnerable subgroup in early psychosis who requires more specific interventions to minimize risk of increased self-stigma. Further research is warranted to clarify longitudinal changes of self-stigma and the associated predictors to facilitate development of effective interventions.