Skip to main content
Top
Published in: BMC Psychiatry 1/2014

Open Access 01-12-2014 | Research article

Anticipated and experienced discrimination amongst people with schizophrenia, bipolar disorder and major depressive disorder: a cross sectional study

Authors: Simone Farrelly, Sarah Clement, Jheanell Gabbidon, Debra Jeffery, Lisa Dockery, Francesca Lassman, Elaine Brohan, R Claire Henderson, Paul Williams, Louise M Howard, Graham Thornicroft, MIRIAD study group

Published in: BMC Psychiatry | Issue 1/2014

Login to get access

Abstract

Background

The unfair treatment of individuals with severe mental illness has been linked to poorer physical and mental health outcomes. Additionally, anticipation of discrimination may lead some individuals to avoid participation in particular life areas, leading to greater isolation and social marginalisation. This study aimed to establish the levels and clinical and socio-demographic associations of anticipated and experienced discrimination amongst those diagnosed with a schizophrenia and comparator severe mental illnesses (bipolar and major depressive disorders).

Methods

This study was a cross-sectional analysis of anticipated and experienced discrimination from 202 individuals in South London (47% with schizophrenia, 32% with depression and 20% with bipolar disorder).

Results

93% of the sample anticipated discrimination and 87% of participants had experienced discrimination in at least one area of life in the previous year. There was a significant association between the anticipation and the experience of discrimination. Higher levels of experienced discrimination were reported by those of a mixed ethnicity, and those with higher levels of education. Women anticipated more discrimination than men. Neither diagnosis nor levels of functioning were associated with the extent of discrimination. Clinical symptoms of anxiety, depression and suspiciousness were associated with more experienced and anticipated discrimination respectively.

Conclusions

The unfair treatment of individuals with severe mental illnesses remains unacceptably common. Population level interventions are needed to reduce levels of discrimination and to safeguard individuals. Interventions are also required to assist those with severe mental illness to reduce internalised stigma and social avoidance.
Appendix
Available only for authorised users
Literature
1.
go back to reference Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basáñez MG, Baxter A, Bell ML, Benjamin EJ, Bennett D: Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012, 380 (9859): 2163-2196. 10.1016/S0140-6736(12)61729-2.CrossRefPubMed Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basáñez MG, Baxter A, Bell ML, Benjamin EJ, Bennett D: Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012, 380 (9859): 2163-2196. 10.1016/S0140-6736(12)61729-2.CrossRefPubMed
2.
go back to reference Andrew A, Knapp M, McCrone P, Parsonage M, Trachtenberg M: Effective interventions in schizophrenia: the economic case. A report prepared for the Schizophrenia Commmission. 2012, London: Rethink Mental Illness Andrew A, Knapp M, McCrone P, Parsonage M, Trachtenberg M: Effective interventions in schizophrenia: the economic case. A report prepared for the Schizophrenia Commmission. 2012, London: Rethink Mental Illness
3.
go back to reference Thornicroft G: Shunned: Discrimination Against People With Mental Illness. 2006, Oxford: Oxford University Press Thornicroft G: Shunned: Discrimination Against People With Mental Illness. 2006, Oxford: Oxford University Press
4.
go back to reference Thornicroft G, Brohan E, Rose D, Sartorius N, Leese M: Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet. 2009, 373 (9661): 408-415. 10.1016/S0140-6736(08)61817-6.CrossRefPubMed Thornicroft G, Brohan E, Rose D, Sartorius N, Leese M: Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet. 2009, 373 (9661): 408-415. 10.1016/S0140-6736(08)61817-6.CrossRefPubMed
5.
go back to reference Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K, Bacle S, Van Audenhove C, Van Weeghel J, Reneses B, Germanavicius A, Economou M, Lanfredi M, Ando S, Sartorius N, Lopez-Ibor JJ, Thornicroft G, ASPEN/INDIGO Study Group: Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet. 2013, 381 (9860): 55-10.1016/S0140-6736(12)61379-8.CrossRefPubMed Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K, Bacle S, Van Audenhove C, Van Weeghel J, Reneses B, Germanavicius A, Economou M, Lanfredi M, Ando S, Sartorius N, Lopez-Ibor JJ, Thornicroft G, ASPEN/INDIGO Study Group: Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet. 2013, 381 (9860): 55-10.1016/S0140-6736(12)61379-8.CrossRefPubMed
6.
go back to reference Henderson C, Thornicroft G: Stigma and discrimination in mental illness: time to change. Lancet. 2009, 373 (9679): 1928-1930. 10.1016/S0140-6736(09)61046-1.CrossRefPubMed Henderson C, Thornicroft G: Stigma and discrimination in mental illness: time to change. Lancet. 2009, 373 (9679): 1928-1930. 10.1016/S0140-6736(09)61046-1.CrossRefPubMed
7.
go back to reference Corker E, Hamilton S, Henderson C, Weeks C, Pinfold V, Rose D, Williams P, Flach C, Gill V, Lewis-Holmes E, Thornicroft G: Experiences of discrimination among people using mental health services in England 2008–2011. Br J Psychiatry. 2013, 202 (s55): s58-s63. 10.1192/bjp.bp.112.112912.CrossRef Corker E, Hamilton S, Henderson C, Weeks C, Pinfold V, Rose D, Williams P, Flach C, Gill V, Lewis-Holmes E, Thornicroft G: Experiences of discrimination among people using mental health services in England 2008–2011. Br J Psychiatry. 2013, 202 (s55): s58-s63. 10.1192/bjp.bp.112.112912.CrossRef
8.
go back to reference Ucok A, Brohan E, Rose D, Sartorius N, Leese M, Yoon CK, Plooy A, Ertekin BA, Milev R, Thornicroft G, INDIGO Study Group: Anticipated discrimination among people with schizophrenia. Acta Psychiatr Scand. 2012, 125 (1): 77-83. 10.1111/j.1600-0447.2011.01772.x.CrossRefPubMed Ucok A, Brohan E, Rose D, Sartorius N, Leese M, Yoon CK, Plooy A, Ertekin BA, Milev R, Thornicroft G, INDIGO Study Group: Anticipated discrimination among people with schizophrenia. Acta Psychiatr Scand. 2012, 125 (1): 77-83. 10.1111/j.1600-0447.2011.01772.x.CrossRefPubMed
9.
go back to reference Rose D, Willis R, Brohan E, Sartorius N, Villares C, Wahlbeck K, Thornicroft G: Reported stigma and discrimination by people with a diagnosis of schizophrenia. Epidemiol Psychiatr Sci. 2011, 20 (2045–7960 (Print)): 193-204.CrossRefPubMed Rose D, Willis R, Brohan E, Sartorius N, Villares C, Wahlbeck K, Thornicroft G: Reported stigma and discrimination by people with a diagnosis of schizophrenia. Epidemiol Psychiatr Sci. 2011, 20 (2045–7960 (Print)): 193-204.CrossRefPubMed
10.
go back to reference Mak WW, Poon CY, Pun LY, Cheung SF: Meta-analysis of stigma and mental health. [Review] [33 refs]. Soc Sci Med. 2007, 65 (2): 245-261. 10.1016/j.socscimed.2007.03.015.CrossRefPubMed Mak WW, Poon CY, Pun LY, Cheung SF: Meta-analysis of stigma and mental health. [Review] [33 refs]. Soc Sci Med. 2007, 65 (2): 245-261. 10.1016/j.socscimed.2007.03.015.CrossRefPubMed
12.
go back to reference Jorm A, Reavley NJ: Depression and stigma: from attitudes to discrimination. Lancet. 2013, 381 (9860): 10-1. 10.1016/S0140-6736(12)61457-3.CrossRefPubMed Jorm A, Reavley NJ: Depression and stigma: from attitudes to discrimination. Lancet. 2013, 381 (9860): 10-1. 10.1016/S0140-6736(12)61457-3.CrossRefPubMed
13.
go back to reference Brohan E, Slade M, Clement S, Thornicroft G: Development and psychometric validation of the discrimination and stigma scale (DISC)). Psychiatr Res. 2013, 208 (1): 33-40. 10.1016/j.psychres.2013.03.007.CrossRef Brohan E, Slade M, Clement S, Thornicroft G: Development and psychometric validation of the discrimination and stigma scale (DISC)). Psychiatr Res. 2013, 208 (1): 33-40. 10.1016/j.psychres.2013.03.007.CrossRef
14.
go back to reference Gabbidon J, Brohan E, Clement S, Henderson RC, Thornicroft G, Group MS: The development and validation of the Questionnaire on Anticipated Discrimination (QUAD). BMC Psychiatry. 2013, 13: 297-10.1186/1471-244X-13-297.CrossRefPubMedPubMedCentral Gabbidon J, Brohan E, Clement S, Henderson RC, Thornicroft G, Group MS: The development and validation of the Questionnaire on Anticipated Discrimination (QUAD). BMC Psychiatry. 2013, 13: 297-10.1186/1471-244X-13-297.CrossRefPubMedPubMedCentral
15.
go back to reference Hafkenscheid A: Reliability of a standardized and expanded brief psychiatric rating scale: a replication study. Acta Psychiatr Scand. 1993, 88 (5): 305-310. 10.1111/j.1600-0447.1993.tb03464.x.CrossRefPubMed Hafkenscheid A: Reliability of a standardized and expanded brief psychiatric rating scale: a replication study. Acta Psychiatr Scand. 1993, 88 (5): 305-310. 10.1111/j.1600-0447.1993.tb03464.x.CrossRefPubMed
16.
go back to reference Hafkenscheid A: Psychometric evaluation of a standardized and expanded brief psychiatric rating scale. Acta Psychiatr Scand. 1991, 84 (3): 294-300. 10.1111/j.1600-0447.1991.tb03147.x.CrossRefPubMed Hafkenscheid A: Psychometric evaluation of a standardized and expanded brief psychiatric rating scale. Acta Psychiatr Scand. 1991, 84 (3): 294-300. 10.1111/j.1600-0447.1991.tb03147.x.CrossRefPubMed
17.
go back to reference Hall RC: Global assessment of functioning. A modified scale. Psychosomatics. 1995, 36 (3): 267-275. 10.1016/S0033-3182(95)71666-8.CrossRefPubMed Hall RC: Global assessment of functioning. A modified scale. Psychosomatics. 1995, 36 (3): 267-275. 10.1016/S0033-3182(95)71666-8.CrossRefPubMed
18.
go back to reference Burns T, Patrick D: Social functioning as an outcome measure in schizophrenia studies. Acta Psychiatr Scand. 2010, 116 (6): 403-418.CrossRef Burns T, Patrick D: Social functioning as an outcome measure in schizophrenia studies. Acta Psychiatr Scand. 2010, 116 (6): 403-418.CrossRef
19.
go back to reference Beck AT, Steer RA: Manual for the Beck Hopeless Scale. 1988, San Antonio, Texas: Psychological Corporation Beck AT, Steer RA: Manual for the Beck Hopeless Scale. 1988, San Antonio, Texas: Psychological Corporation
20.
go back to reference Ritsher JB, Otilingam P, Grajales M: Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Res. 2003, 121 (1): 31-49. 10.1016/j.psychres.2003.08.008.CrossRefPubMed Ritsher JB, Otilingam P, Grajales M: Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Res. 2003, 121 (1): 31-49. 10.1016/j.psychres.2003.08.008.CrossRefPubMed
21.
go back to reference Phinney JS: The multigroup ethnic identity measure: a new scale for use with adolescents and young adults from diverse groups. J Adolesc Res. 1992, 7: 156-176. 10.1177/074355489272003.CrossRef Phinney JS: The multigroup ethnic identity measure: a new scale for use with adolescents and young adults from diverse groups. J Adolesc Res. 1992, 7: 156-176. 10.1177/074355489272003.CrossRef
22.
go back to reference Angermeyer MC, Beck M, Dietrich S, Holzinger A: The stigma of mental illness: patients’ anticipations and experiences. Int J Soc Psychiatry. 2004, 50 (2): 153-162. 10.1177/0020764004043115.CrossRefPubMed Angermeyer MC, Beck M, Dietrich S, Holzinger A: The stigma of mental illness: patients’ anticipations and experiences. Int J Soc Psychiatry. 2004, 50 (2): 153-162. 10.1177/0020764004043115.CrossRefPubMed
23.
go back to reference Ilic L, Reinecke J, Bohner G, Rottgers HO, Beblo T, Driessen M, Frommberger U, Corrigan PW: Belittled, avoided, ignored, denied: assessing forms and consequences of stimga experiences of people with mental illness. Basic Appl Soc Psychol. 2013, 35: 31-40. 10.1080/01973533.2012.746619.CrossRef Ilic L, Reinecke J, Bohner G, Rottgers HO, Beblo T, Driessen M, Frommberger U, Corrigan PW: Belittled, avoided, ignored, denied: assessing forms and consequences of stimga experiences of people with mental illness. Basic Appl Soc Psychol. 2013, 35: 31-40. 10.1080/01973533.2012.746619.CrossRef
24.
go back to reference Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG: “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiatr. 2010, 167 (11): 1321-1330. 10.1176/appi.ajp.2010.09121743.CrossRefPubMedPubMedCentral Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG: “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiatr. 2010, 167 (11): 1321-1330. 10.1176/appi.ajp.2010.09121743.CrossRefPubMedPubMedCentral
25.
go back to reference Care Quality Commission: Count me in 2010: Results of the 2010 National Census of Inpatients and Patients on Supervised Community Treatment in Mental Health and Learning Disability Services in England and Wales. 2011, Newcastle Upon Tyne: Care Quality Commission and National Mental Health Development Unit Care Quality Commission: Count me in 2010: Results of the 2010 National Census of Inpatients and Patients on Supervised Community Treatment in Mental Health and Learning Disability Services in England and Wales. 2011, Newcastle Upon Tyne: Care Quality Commission and National Mental Health Development Unit
26.
go back to reference Bennewith O, Amos T, Lewis G, Katsakou C, Wykes T, Morriss R, Priebe S: Ethnicity and coercion among involuntarily detained psychiatric in-patients. Br J Psychiatry. 2010, 196 (1): 75-76. 10.1192/bjp.bp.109.068890.CrossRefPubMed Bennewith O, Amos T, Lewis G, Katsakou C, Wykes T, Morriss R, Priebe S: Ethnicity and coercion among involuntarily detained psychiatric in-patients. Br J Psychiatry. 2010, 196 (1): 75-76. 10.1192/bjp.bp.109.068890.CrossRefPubMed
27.
go back to reference Lockwood G, Henderson C, Thornicroft G: The Equality Act 2010 and mental health. Br J Psychiatry. 2012, 200: 182-183. 10.1192/bjp.bp.111.097790.CrossRefPubMed Lockwood G, Henderson C, Thornicroft G: The Equality Act 2010 and mental health. Br J Psychiatry. 2012, 200: 182-183. 10.1192/bjp.bp.111.097790.CrossRefPubMed
28.
go back to reference Strunk DR, Lopez H, DeRubeis RJ: Depressive symptoms are associated with unrealistic negative predictions of future life events. Behav Res Ther. 2006, 44 (6): 861-882. 10.1016/j.brat.2005.07.001.CrossRefPubMed Strunk DR, Lopez H, DeRubeis RJ: Depressive symptoms are associated with unrealistic negative predictions of future life events. Behav Res Ther. 2006, 44 (6): 861-882. 10.1016/j.brat.2005.07.001.CrossRefPubMed
29.
go back to reference Flynn J, Slovic P, Mertz CK: Gender, race and perception of environmental health risks. Risk Anal. 2006, 14 (6): 1101-1108.CrossRef Flynn J, Slovic P, Mertz CK: Gender, race and perception of environmental health risks. Risk Anal. 2006, 14 (6): 1101-1108.CrossRef
30.
go back to reference Gustafson PE: Gender differences in risk perception: theoretical and methodological perspectives. Risk Anal. 1998, 18 (6): 805-811.CrossRefPubMed Gustafson PE: Gender differences in risk perception: theoretical and methodological perspectives. Risk Anal. 1998, 18 (6): 805-811.CrossRefPubMed
31.
go back to reference Dolman C, Jones I, Howard LM: Pre-conception to parenting: a systematic review and meta-synthesis of the qualitative literature on motherhood for women with severe mental illness. Arch Womens Ment Health. 2013, 16 (3): 173-196. 10.1007/s00737-013-0336-0.CrossRefPubMed Dolman C, Jones I, Howard LM: Pre-conception to parenting: a systematic review and meta-synthesis of the qualitative literature on motherhood for women with severe mental illness. Arch Womens Ment Health. 2013, 16 (3): 173-196. 10.1007/s00737-013-0336-0.CrossRefPubMed
32.
go back to reference Jeffery D, Clement S, Corker E, Howard LM, Murray J, Thornicroft G: Discrimination in relation to parenthood reported by community psychiatric service users in the UK: a framework analysis. BMC Psychiatry. 2013, 13 (1): 120-10.1186/1471-244X-13-120.CrossRefPubMedPubMedCentral Jeffery D, Clement S, Corker E, Howard LM, Murray J, Thornicroft G: Discrimination in relation to parenthood reported by community psychiatric service users in the UK: a framework analysis. BMC Psychiatry. 2013, 13 (1): 120-10.1186/1471-244X-13-120.CrossRefPubMedPubMedCentral
Metadata
Title
Anticipated and experienced discrimination amongst people with schizophrenia, bipolar disorder and major depressive disorder: a cross sectional study
Authors
Simone Farrelly
Sarah Clement
Jheanell Gabbidon
Debra Jeffery
Lisa Dockery
Francesca Lassman
Elaine Brohan
R Claire Henderson
Paul Williams
Louise M Howard
Graham Thornicroft
MIRIAD study group
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2014
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-14-157

Other articles of this Issue 1/2014

BMC Psychiatry 1/2014 Go to the issue