Association of media portrayals and negative interpersonal experiences with internalized stigma among outpatients with schizophrenia.

Objective

This study examined factors associated with internalized stigma among community-dwelling individuals with schizophrenia, focusing on associations with negative interpersonal experiences, media representations, and illness duration. Materials and

Methods

A cross-sectional survey was conducted with 80 outpatients at a university hospital using the Japanese version of the Internalized Stigma of Mental Illness Scale (ISMI-10). Associations between self-stigma and treatment duration, negative interpersonal reactions, and perceived discrepancies in media portrayals were analyzed. Binary logistic regression analysis was also performed, adjusting for treatment duration.

Results

The mean treatment duration was 23.6 ± 13.2 years. Internalized stigma was significantly associated with "negative reactions when disclosing illness or symptoms to others" (adjusted odds ratio: 3.88, 95% confidence interval: 1.27-11.87; P=0.018) and "perceived discrepancy between media portrayals of schizophrenia and reality" (adjusted odds ratio: 5.62, 95% confidence interval: 1.78-17.76, P=0.003). The adjusted odds ratio for perceived discrepancy between media portrayals and reality was numerically higher than that for negative interpersonal experiences after adjustment for treatment duration.

Conclusion

Internalized stigma in community-dwelling patients with schizophrenia is associated with negative interpersonal experiences and media-driven stereotypes. The strong link to media portrayal suggests that information dissemination in the digital age may exacerbate self-stigma. Support strategies in rural and local communities should focus on improving media literacy and collaborative efforts with residents to reconstruct social roles for individuals with schizophrenia.