A comparative study of internalized stigma and quality of life among patients of schizophrenia and bipolar affective disorder under remission, visiting a tertiary care center

Abstract

Background: Patients with schizophrenia and bipolar affective disorder (BPAD) diagnosis often experience high levels of internalized stigma, where they internalize negative societal views about mental illness. This can profoundly impact their quality of life (QOL), help-seeking behavior, adherence to treatment, increased disability, and increase the economic burden. This study was taken up to determine and compare internalized stigma in remitted patients of schizophrenia and bipolar disorder and correlate the association between internalized stigma and QOL. Methodology: A cross-sectional comparative hospital-based study with a sample size of 100 (48 patients of schizophrenia and 52 patients of bipolar disorder in remission) was taken for the study as per the International Classification of Diseases-10 criteria. Basic demographic data were collected using a semi-structured questionnaire. Remission was assessed by the Clinical Global Impressions-Severity Scale. Stigma was assessed using the Internalized Stigma of Mental Illness Scale and quality of life (QOL) was assessed using the World Health Organization Quality of Life Brief version (WHOQOL BREF), insight grading as per Comprehensive Textbook of Psychiatry 10th Edition. The level of significance was set at 0.05 for all statistical analyses. Results: A total of 100 subjects participated in the study, of which 48 belong to the schizophrenia group and 52 belong to the BPAD group. Prevalence of internalized stigma among subjects with schizophrenia is 54% and BPAD is 50%. There was a statistically significant association between diagnosis and self-stigma. Self-stigma was found to be more among female gender (P = 0.001), single (0.014), and unemployed (P = 0.010). There was a statistically significant negative correlation between internalized stigma scores and QOL. Conclusion: The current study found a strong negative correlation between internal stigma and QOL, suggesting that internal stigma may have a negative impact on social relationships, community participation, and physical and psychological well-being of the individual. Considering this, psychiatrist should formulate strategies to address internal stigma along with clinical manifestations.