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Improving Treatment, Prevention, and Rehabilitation

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The Stigma of Mental Illness - End of the Story?

Abstract

The stigmatization of mental disorders, of persons with mental disorders, and of the people and institutions delivering mental health care are significant barriers to mental healthcare seeking and use of mental healthcare services. However, results about these associations are few and to some degree variable, indicating that there are important differences between societies and/or individuals. Effective treatment of mental disorders may have de-stigmatizing effects on individuals and preventing mental disorders may be a major factor in alleviating the societal burden of stigmatization of mental disorders in the future. This chapter shows how progress in the prevention, treatment and rehabilitation of mental disorders may reduce stigmatization, and reviews results of some studies addressing the intricate relationship between these aspects.

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References

  • Anderson KK, Fuhrer R, Malla AK (2013) “There are too many steps before you get to where you need to be”: help-seeking by patients with first-episode psychosis. J Ment Health 22:384–395

    Article  PubMed  Google Scholar 

  • Bond GR, Drake RE (2008) Predictors of competitive employment among patients with schizophrenia. Curr Opin Psychiatry 21:362–369

    Article  PubMed  Google Scholar 

  • Bowie CR, McGurk SR, Mausbach B et al (2012) Combined cognitive remediation and functional skills training for schizophrenia: effects on cognition, functional competence, and real-world behavior. Am J Psychiatry 169:710–718

    Article  PubMed  Google Scholar 

  • Boyd JE, Otilingam PG, Deforge BR (2014) Brief version of the Internalized Stigma of Mental Illness (ISMI) scale: psychometric properties and relationship to depression, self esteem, recovery orientation, empowerment, and perceived devaluation and discrimination. Psychiatr Rehabil J 37:17–23

    Article  PubMed  Google Scholar 

  • Burns T, Catty J, Becker T et al (2007) The effectiveness of supported employment for people with severe mental illness: a randomised controlled trial. Lancet 370:1146–1152

    Article  PubMed  Google Scholar 

  • Campellone TR, Caponigro JM, Kring AM (2014) The power to resist: the relationship between power, stigma, and negative symptoms in schizophrenia. Psychiatry Res 215:280–285

    Article  PubMed  Google Scholar 

  • Corrigan PW (2003) Towards an integrated, structural model of psychiatric rehabilitation. Psychiatr Rehabil J 26:346–358

    Article  PubMed  Google Scholar 

  • Corrigan PW, Morris SB, Michaels PJ et al (2012a) Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv 63:963–973

    Article  PubMed  Google Scholar 

  • Corrigan PW, Powell KJ, Rüsch N (2012b) How does stigma affect work in people with serious mental illnesses? Psychiatr Rehabil J 35:381–384

    Article  PubMed  Google Scholar 

  • Cox GR, Fisher CA, De Silva S et al (2012) Interventions for preventing relapse and recurrence of a depressive disorder in children and adolescents. Cochrane Database Syst Rev 11:CD007504

    PubMed  Google Scholar 

  • Defina LF, Willis BL, Radford NB et al (2013) The association between midlife cardiorespiratory fitness levels and later-life dementia: a cohort study. Ann Intern Med 158:162–168

    Google Scholar 

  • Eisner E, Drake R, Barrowclough C (2013) Assessing early signs of relapse in psychosis: review and future directions. Clin Psychol Rev 33:637–653

    Article  PubMed  Google Scholar 

  • Evans-Lacko S, Brohan E, Mojtabai R et al (2012) Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychol Med 42:1741–1752

    Article  CAS  PubMed  Google Scholar 

  • Fernandez Y-Garcia E, Duberstein P, Paterniti DA et al (2012) Feeling labeled, judged, lectured, and rejected by family and friends over depression: cautionary results for primary care clinicians from a multi-centered, qualitative study. BMC Fam Pract 13:64

    Article  PubMed  PubMed Central  Google Scholar 

  • Fryers T, Brugha T (2013) Childhood determinants of adult psychiatric disorder. Clin Psychol Rev 33:637–653

    Article  Google Scholar 

  • Fusar-Poli P, Carpenter WT, Woods SW et al (2014) Attenuated psychosis syndrome: ready for DSM-5.1? Annu Rev Clin Psychol 10:155–192

    Article  CAS  PubMed  Google Scholar 

  • Gaebel W, Baumann A, Zäske H (2004) Gesellschaftsrelevante Ansätze zur Überwindung von Stigma und Diskriminierung. In: Rössler W (ed) Psychiatrische rehabilitation. Springer, Berlin, pp 875–886 [Article in German]

    Chapter  Google Scholar 

  • Gaebel W, Weinmann S, Sartorius N et al (2005) Schizophrenia practice guidelines: international survey and comparison. Br J Psychiatry 187:248–255

    Article  PubMed  Google Scholar 

  • Gaebel W, Riesbeck M, Wobrock T (2011) Schizophrenia guidelines across the world: a selective review and comparison. Int Rev Psychiatry 23:379–387

    Article  PubMed  Google Scholar 

  • Garber J, Clarke GN, Weersing VR et al (2009) Prevention of depression in at-risk adolescents: a randomized controlled trial. JAMA 301:2215–2224

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gerlinger G, Hauser M, De Hert M et al (2013) Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates, correlates, impact and interventions. World Psychiatry 12:155–164

    Article  PubMed  PubMed Central  Google Scholar 

  • Glass JE, Mowbray OP, Link BG et al (2013) Alcohol stigma and persistence of alcohol and other psychiatric disorders: a modified labeling theory approach. Drug Alcohol Depend 133:685–692

    Article  PubMed  PubMed Central  Google Scholar 

  • Griffiths KM, Carron-Arthur B et al (2014) Effectiveness of programs for reducing the stigma associated with mental disorders. A meta-analysis of randomized controlled trials. World Psychiatry 13:161–175

    Article  PubMed  PubMed Central  Google Scholar 

  • Henshaw EJ (2014) Too sick, not sick enough?: effects of treatment type and timing on depression stigma. J Nerv Ment Dis 202:269–292

    Article  Google Scholar 

  • Hill K, Startup M (2013) The relationship between internalized stigma, negative symptoms and social functioning in schizophrenia: the mediating role of self-efficacy. Psychiatry Res 206:151–157

    Article  PubMed  Google Scholar 

  • Holmes A, Spanagel R, Krystal JH (2013) Glutamatergic targets for new alcohol medications. Psychopharmacol (Berl) 229:539–554

    Article  CAS  Google Scholar 

  • Jaeger M, Rössler W (2010) Attitudes towards long-acting depot antipsychotics: a survey of patients, relatives and psychiatrists. Psychiatry Res 175:58–62

    Article  CAS  PubMed  Google Scholar 

  • Kaner EF, Beyer F, Dickinson HO et al (2007) Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev 2:CD004148

    Google Scholar 

  • Keeley RD, West DR, Tutt B et al (2014) A qualitative comparison of primary care clinicians’ and their patients’ perspectives on achieving depression care: implications for improving outcomes. BMC Fam Pract 15:13

    Article  PubMed  PubMed Central  Google Scholar 

  • Kelly CM, Jorm AF (2007) Stigma and mood disorders. Curr Opin Psychiatry 20:13–16

    Article  PubMed  Google Scholar 

  • Kishimoto T, Agarwal V, Kishi T et al (2013) Relapse prevention in schizophrenia: a systematic review and meta-analysis of second-generation antipsychotics versus first-generation antipsychotics. Mol Psychiatry 18:53–66

    Article  CAS  PubMed  Google Scholar 

  • Lauber C, Rössler W (2004) Empowerment: Selbstbestimmung oder Hilfe zur Selbsthilfe. In: Rössler W (ed) Psychiatrische rehabilitation. Springer, Berlin, pp 146–156 [Article in German]

    Chapter  Google Scholar 

  • Leucht S, Corves C, Arbter D et al (2009) Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 373:31–41

    Article  CAS  PubMed  Google Scholar 

  • Lieberman JA, First MB (2007) Renaming schizophrenia. BMJ 334:108

    Article  PubMed  PubMed Central  Google Scholar 

  • Lysaker PH, Davis LW, Warman DM et al (2007) Stigma, social function and symptoms in schizophrenia and schizoaffective disorder: associations across 6 months. Psychiatry Res 149:89–95

    Article  PubMed  Google Scholar 

  • Mammen G, Faulkner G (2013) Physical activity and the prevention of depression: a systematic review of prospective studies. Am J Prev Med 45:649–657

    Article  PubMed  Google Scholar 

  • McGorry PD, Yung A, Phillips L. (2001) Ethics and early interventions in psychosis: keeping up the pace and staying in step. Schizophr Res. 51:17–29

    Google Scholar 

  • McQueen J, Howe TE, Allan L et al (2011) Brief interventions for heavy alcohol users admitted to general hospital wards. Cochrane Database Syst Rev 8:CD005191

    Google Scholar 

  • Mittal D, Sullivan G, Chekuri L et al (2012) Empirical studies of self-stigma reduction strategies: a critical review of the literature. Psychiatr Serv 63:974–981

    Article  PubMed  Google Scholar 

  • Morriss R, Vinjamuri I, Faizal MA et al (2013) Training to recognise the early signs of recurrence in schizophrenia. Cochrane Database Syst Rev 2:CD005147

    Google Scholar 

  • Nelson B, Yung AR (2011) Should a risk syndrome for first episode psychosis be included in the DSM-5? Curr Opin Psychiatry 24:128–133

    Article  PubMed  Google Scholar 

  • NICE National Institute for Health and Care Excellence (2014) Psychosis and schizophrenia in adults NICE clinical guideline 178; http://guidance.nice.org.uk/cg178. Accessed 29 Aug 2014

  • NICE National Institute for Health and Clinical Excellence (2009) Schizophrenia. Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care (update). http://guidance.nice.org.uk/CG82 Accessed 29 Aug 2014

  • Penadés R, Catalán R, Pujol N et al (2012) The integration of cognitive remediation therapy into the whole psychosocial rehabilitation process: an evidence-based and person-centered approach. Rehabil Res Pract 2012:386895

    PubMed  PubMed Central  Google Scholar 

  • Piras S, Casu G, Casu MA et al (2014) Prediction and prevention of the first psychotic episode: new directions and opportunities. Ther Clin Risk Manag 10:241–253

    PubMed  PubMed Central  Google Scholar 

  • Roberts DL, Velligan DI (2012) Can social functioning in schizophrenia be improved through targeted social cognitive intervention? Rehabil Res Pract 2012:742106

    PubMed  PubMed Central  Google Scholar 

  • Rodgers M, Asaria M, Walker S et al (2012) The clinical effectiveness and cost-effectiveness of low-intensity psychological interventions for the secondary prevention of relapse after depression: a systematic review. Health Technol Assess 16:1–130

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Rüsch N (2014) Prävention und das Stigma psychischer Erkrankungen. In: Rössler W, Ajdacic-Gross V (eds) Prävention psychischer Störungen. Kohlhammer, Stuttgart, pp 19–28

    Google Scholar 

  • Sandler I, Wolchik SA, Cruden G et al (2014) Overview of meta-analyses of the prevention of mental health, substance use, and conduct problems. Annu Rev Clin Psychol 10:243–273

    Article  PubMed  PubMed Central  Google Scholar 

  • Sato M (2006) Renaming schizophrenia: a Japanese perspective. World Psychiatry 5:53–55

    PubMed  PubMed Central  Google Scholar 

  • Saxena S, Jané Llopis E, Hosman CMH (2006) Prevention of mental and behavioral disorders: implications for policy and practice. World Psychiatry 5:1

    Google Scholar 

  • Scarmeas N, Stern Y, Mayeux R et al (2009) Mediterranean diet and mild cognitive impairment. Arch Neurol 66:216–225

    PubMed  PubMed Central  Google Scholar 

  • Schrank B, Amering M, Hay AG et al (2013) Insight, positive and negative symptoms, hope, depression and self-stigma: a comprehensive model of mutual influences in schizophrenia spectrum disorders. Epidemiol Psychiatr Sci. doi:10.1017/S2045796013000322

    Google Scholar 

  • Scior K (2011) Public awareness, attitudes and beliefs regarding intellectual disability: a systematic review. Res Dev Disabil 32:2164–2182

    Article  PubMed  Google Scholar 

  • Seeman MV, Seeman N (2012) The meaning of antipsychotic medication to patients with schizophrenia. J Psychiatr Pract 18:338–348

    Article  PubMed  Google Scholar 

  • Skala K, Caputo F, Mirijello A et al (2014) Sodium oxybate in the treatment of alcohol dependence: from the alcohol withdrawal syndrome to the alcohol relapse prevention. Expert Opin Pharmacother 15:245–257

    Article  CAS  PubMed  Google Scholar 

  • Svanberg J, Evans JJ (2013) Neuropsychological rehabilitation in alcohol-related brain damage: a systematic review. Alcohol Alcohol 48:704–711

    Article  PubMed  Google Scholar 

  • Stuart H (2006) Mental illness and employment discrimination. Curr Opin Psychiatry. 19:522–526

    Google Scholar 

  • Takahashi H, Ideno T, Okubo S et al (2009) Impact of changing the Japanese term for “schizophrenia” for reasons of stereotypical beliefs of schizophrenia in Japanese youth. Schizophr Res 112:149–152

    Article  PubMed  Google Scholar 

  • Tanskanen S, Morant N, Hinton M et al (2011) Service user and carer experiences of seeking help for a first episode of psychosis: a UK qualitative study. BMC Psychiatry 11:157

    Article  PubMed  PubMed Central  Google Scholar 

  • Torrey EF (2011) Stigma and violence: isn’t it time to connect the dots? Schizophr Bull 37:892–896

    Article  PubMed  PubMed Central  Google Scholar 

  • Tranulis C, Goff D, Henderson DC et al (2011) Becoming adherent to antipsychotics: a qualitative study of treatment-experienced schizophrenia patients. Psychiatr Serv 62:888–892

    Article  PubMed  Google Scholar 

  • Umehara H, Fangerau H, Gaebel W et al (2011) [From “schizophrenia” to “disturbance of the integrity of the self”: causes and consequences of renaming schizophrenia in Japan in 2002]. Nervenarzt 82:1160–1168 [Article in German]

    Article  CAS  PubMed  Google Scholar 

  • Van der Pol P, Liebregts N, de Graaf R et al (2013) Facilitators and barriers in treatment seeking for cannabis dependence. Drug Alcohol Depend 133:776–780

    Article  PubMed  Google Scholar 

  • Van Zoonen K, Buntrock C, Ebert DD et al (2014) Preventing the onset of major depressive disorder: a meta-analytic review of psychological interventions. Int J Epidemiol 43:318–329

    Article  PubMed  PubMed Central  Google Scholar 

  • Wallhed Finn S, Bakshi AS, Andréasson S (2014) Alcohol consumption, dependence, and treatment barriers: perceptions among nontreatment seekers with alcohol dependence. Subst Use Misuse 49:762–769

    Article  PubMed  Google Scholar 

  • WHO (1981) Disability prevention and rehabilitation. Report of the WHO Expert Committee on Disability Prevention and Rehabilitation, WHO Technical Report Series 668. WHO, Geneva, http://whqlibdoc.who.int/trs/WHO_TRS_668.pdf

    Google Scholar 

  • Wilson K, Halsey A, Macpherson H (2012) The psycho-social rehabilitation of patients with alcohol-related brain damage in the community. Alcohol Alcohol 47:304–311

    Article  PubMed  Google Scholar 

  • Yap MB, Wright A, Jorm AF (2011) The influence of stigma on young people’s help-seeking intentions and beliefs about the helpfulness of various sources of help. Soc Psychiatry Psychiatr Epidemiol 46:1257–1265

    Article  PubMed  Google Scholar 

  • Yung AR, Nelson B, Thompson AD et al (2010) Should a “Risk Syndrome for Psychosis” be included in the DSMV? Schizophr Res 120:7–15

    Article  PubMed  Google Scholar 

  • Yung AR, Woods SW, Ruhrmann S et al (2012) Whither the attenuated psychosis syndrome? Schizophr Bull 38:1130–1144

    Article  PubMed  PubMed Central  Google Scholar 

  • Zäske H, Cleveland HR, Gaebel W (2010) Die Semantik des Begriffs “Schizophrenie” und das damit verbundene Stigma. Was lässt sich von der japanischen Umbenennung lernen? Kerbe Forum Sozialpsychiatrie 28:26–28 [Article in German]

    Google Scholar 

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Correspondence to Wolfgang Gaebel .

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Gaebel, W., Riesbeck, M., Siegert, A., Zäske, H., Zielasek, J. (2017). Improving Treatment, Prevention, and Rehabilitation. In: Gaebel, W., Rössler, W., Sartorius, N. (eds) The Stigma of Mental Illness - End of the Story?. Springer, Cham. https://doi.org/10.1007/978-3-319-27839-1_30

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  • DOI: https://doi.org/10.1007/978-3-319-27839-1_30

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