Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2013

Open Access 01-12-2013 | Research article

Stigma toward schizophrenia: do all psychiatrists behave the same? Latent profile analysis of a national sample of psychiatrists in Brazil

Authors: Alexandre Andrade Loch, Francisco Bevilacqua Guarniero, Fabio Lorea Lawson, Michael Pascal Hengartner, Wulf Rössler, Wagner Farid Gattaz, Yuan-Pang Wang

Published in: BMC Psychiatry | Issue 1/2013

Login to get access

Abstract

Background

An important issue concerning the worldwide fight against stigma is the evaluation of psychiatrists’ beliefs and attitudes toward schizophrenia and mental illness in general. However, there is as yet no consensus on this matter in the literature, and results vary according to the stigma dimension assessed and to the cultural background of the sample. The aim of this investigation was to search for profiles of stigmatizing beliefs related to schizophrenia in a national sample of psychiatrists in Brazil.

Methods

A sample of 1414 psychiatrists were recruited from among those attending the 2009 Brazilian Congress of Psychiatry. A questionnaire was applied in face-to-face interviews. The questionnaire addressed four stigma dimensions, all in reference to individuals with schizophrenia: stereotypes, restrictions, perceived prejudice and social distance. Stigma item scores were included in latent profile analyses; the resulting profiles were entered into multinomial logistic regression models with sociodemographics, in order to identify significant correlates.

Results

Three profiles were identified. The “no stigma” subjects (n = 337) characterized individuals with schizophrenia in a positive light, disagreed with restrictions, and displayed a low level of social distance. The “unobtrusive stigma” subjects (n = 471) were significantly younger and displayed the lowest level of social distance, although most of them agreed with involuntary admission and demonstrated a high level of perceived prejudice. The “great stigma” subjects (n = 606) negatively stereotyped individuals with schizophrenia, agreed with restrictions and scored the highest on the perceived prejudice and social distance dimensions. In comparison with the first two profiles, this last profile comprised a significantly larger number of individuals who were in frequent contact with a family member suffering from a psychiatric disorder, as well as comprising more individuals who had no such family member.

Conclusions

Our study not only provides additional data related to an under-researched area but also reveals that psychiatrists are a heterogeneous group regarding stigma toward schizophrenia. The presence of different stigma profiles should be evaluated in further studies; this could enable anti-stigma initiatives to be specifically designed to effectively target the stigmatizing group.
Literature
1.
Goffman E: Stigma: notes on the management of spoiled identity. 1963, Englewood Cliffs, NJ: Prentice-Hall
2.
Pilgrim D, Rogers AE: Psychiatrists as social engineers: a study of an anti-stigma campaign. Soc Sci Med. 2005, 61: 2546-2556. 10.1016/j.socscimed.2005.04.042.CrossRefPubMed
3.
Lauber C, Anthony M, Ajdacic-Gross V, Rössler W: What about psychiatrists’ attitude to mentally ill people?. European Psychiatry. 2004, 19: 423-427. 10.1016/j.eurpsy.2004.06.019.CrossRefPubMed
4.
Schulze B: Stigma and mental health professionals: a review of the evidence on an intricate relationship. Inter Rev Psychiatry. 2007, 19 (2): 137-155. 10.1080/09540260701278929.CrossRef
5.
Lauber C, Nordt C, Braunschweig C, Rössler W: Do mental health professionals stigmatize their patients?. Acta Psychiatrica Scandinavica Suppl. 2006, 429: 51-59.CrossRef
6.
Nordt C, Rössler W, Lauber C: Attitudes of mental health professionals toward people with schizophrenia and major depression. Schizophr Bull. 2006, 32 (4): 709-714.CrossRefPubMedPubMedCentral
7.
Magliano L, Fiorillo A, De Rosa C, Malangone C, Maj M: Beliefs about schizophrenia in Italy: a comparative nationwide survey of the general public, mental health professionals, and patients’ relatives. Canadian J Psychiatry. 2004, 49 (5): 322-330.
8.
Arvaniti A, Samakouri M, Kalamara E, Bochtsou V, Bikos C, Livaditis M: Health service staff’s attitudes towards patients with mental illness. Soc Psychiatry Psychiatric Epidemiol. 2009, 44 (8): 658-665. 10.1007/s00127-008-0481-3.CrossRef
9.
Jorm AF, Korten AE, Jacomb PA, Christensen H, Henderson S: Attitudes towards people with a mental disorder: a survey of the Australian public and health professionals. Australian New Zealand J Psychiatry. 1999, 33 (1): 77-83. 10.1046/j.1440-1614.1999.00513.x.CrossRef
10.
Lepping P, Steinert T, Gebhardt RP, Röttgers HR: Attitudes of mental health professionals and lay-people towards involuntary admission and treatment in England and Germany – a questionnaire analysis. European Psychiatry. 2004, 19 (2): 91-95. 10.1016/j.eurpsy.2003.11.001.CrossRefPubMed
11.
Hori H, Richards M, Kawamoto Y, Kunugi H: Attitudes towards schizophrenia in the general population, psychiatric staff, physicians, and psychiatists: A web-based survey in Japan. Psychiatry Res. 2011, 186 (2–3): 183-189.CrossRefPubMed
12.
Hengartner MP, Loch AA, Lawson FL, Guarniero FB, Wang YP, Rössler W, Gattaz WG: Attitudes of mental health professionals towards persons with schizophrenia: a transcultural comparison between Switzerland and Brazil. Revista de Psiquiatria Clin. 2012, 39 (4): 115-121. 10.1590/S0101-60832012000400001.CrossRef
13.
Crisp A, Cowan L, Hart D: The College’s anti-stigma campaign, 1998–2003. A shortened version of the concluding report. Psychiatr Bull. 2004, 28: 133-136. 10.1192/pb.28.4.133.CrossRef
14.
Warner R: Implementing local projects to reduce stigma of mental illness. Epidemiologia e Psichiatria Sociale. 2008, 17 (1): 20-25.PubMed
15.
Lyons C, Hopley P, Horrocks J: A decade of stigma and discrimination in mental health: plus ça change, plus c’est la meme chose (the more things change, the more they stay the same). J Psychiatr Ment Heal Nurs. 2009, 16 (6): 501-507. 10.1111/j.1365-2850.2009.01390.x.CrossRef
16.
17.
Rose D, Thornicroft G: Service user perspectives on the impact of a mental illness diagnosis. Epidemiologia e Psichiatria Sociale. 2010, 19 (2): 140-147.CrossRefPubMed
18.
Schulze B, Angermeyer MC: Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Soc Sci Med. 2003, 56 (2): 299-312. 10.1016/S0277-9536(02)00028-X.CrossRefPubMed
19.
Corrigan P, Thompson V, Lambert D, Sangster Y, Noel JG, Campbell J: Perceptions of discrimination among persons with serious mental illness. Psychiatr Serv. 2003, 54 (8): 1105-1110. 10.1176/appi.ps.54.8.1105.CrossRefPubMed
20.
Henderson C, Corker E, Lewis-Homes E, Hamilton S, Flach C, Rose D, Williams P, Pinfold V, Thornicroft G: England’s time to change antistigma campaign: one-year outcomes of service user-rated experiences of discrimination. Psychiatr Serv. 2012, 63 (5): 451-457. 10.1176/appi.ps.201100422.CrossRefPubMed
21.
Link BG, Yang LH, Phelan JC, Collins PY: Measuring mental illness stigma. Schizophr Bull. 2004, 30 (3): 511-541. 10.1093/oxfordjournals.schbul.a007098.CrossRefPubMed
22.
Stuart H: Fighting the stigma caused by mental disorders: past perspectives, present activities, and future directions. World Psychiatry. 2008, 7: 185-188.CrossRefPubMedPubMedCentral
23.
Lauber C, Nordt C, Sartorius N, Falcato L, Rössler W: Public acceptance of restrictions on mentally ill people. Acta Psychiatrica Scandinavica Suppl. 2000, 407: 26-32.CrossRef
24.
Lauber C, Nordt C, Rossler W: Recommendations of mental health professionals and the general population on how to treat mental disorders. Soc Psychiatry Psychiatric Epidemiol. 2005, 40 (10): 835-843. 10.1007/s00127-005-0953-7.CrossRef
25.
Des Courtis N, Lauber C, Costa CT, Cattapan-Ludewig K: Beliefs about the mentally ill: A comparative study between healthcare professionals in Brazil and in Switzerland. Int Rev Psychiatry. 2008, 20 (6): 503-509. 10.1080/09540260802565125.CrossRefPubMed
26.
Peluso ET, Blay SL: Public stigma and schizophrenia in São Paulo city. Rev Bras Psiquiatr. 2011, 33 (2): 130-136. 10.1590/S1516-44462011000200007.CrossRefPubMed
27.
Link BG, Moritznik J, Cullen FT: The effectiveness of stigma coping orientations: can negative consequences of mental illness labelling be avoided?. J Heal Soc Behav. 1991, 32 (3): 302-320. 10.2307/2136810.CrossRef
28.
Link BG, Cullen FT, Frank J, Wozniak JF: The social rejection of former mental patients: understanding why labels matter. Am J Sociol. 1987, 92: 1461-1500. 10.1086/228672.CrossRef
29.
Muthen B, Muthen LK: Integrating person-centered and variable-centered analyses: growth mixture modeling with latent trajectory classes. Alcohol Clin Exp Res. 2000, 24 (6): 882-891. 10.1111/j.1530-0277.2000.tb02070.x.CrossRefPubMed
30.
Lazarfeld PF, Henry NW: Latent structure analysis. 1968, Boston, Massachusetts: Houghton Mifflin Co
31.
Baillie D, McCabe R, Priebe S: Aetiology of depression and schizophrenia: current views of British psychiatrists. Psychiatr Bull. 2009, 33: 374-377. 10.1192/pb.bp.108.021899.CrossRef
32.
Loch AA, Hengartner MP, Guarniero FB, Lawson FL, Wang YP, Gattaz WF, Rössler WF: Psychiatrists’ stigma towards individuals with schizophrenia. Revista de Psiquiatria Clin. 2011, 38 (5): 173-177. 10.1590/S0101-60832011000500001.CrossRef
33.
Corrigan PW, Penn DL: Lessons from social psychology on discrediting psychiatric stigma. Am Psychol. 1999, 54 (9): 765-776.CrossRefPubMed
34.
Lewis G, Crof-Jeffreys C, David A: Are British psychiatrists racist?. Br J Psychiatry. 1990, 157: 410-415. 10.1192/bjp.157.3.410.CrossRefPubMed
35.
Dietz PE: Why the experts disagree: variations in the psychiatric evaluation of criminal insanity. Annals Am Acad Political Soc Sci. 1985, 477: 84-95. 10.1177/0002716285477001008.CrossRef
36.
Ghaemi SN, McHugh PR: The concepts of psychiatry: a pluralistic approach to the mind and mental illness. 2007, Baltimore, USA: The Johns Hopkins University Press
37.
Read J, Haslam N, Sayce L, Davies E: Prejudice and schizophrenia: a review of the ‘mental illness is an illness like any other’ approach. Acta Psychiatr Scand. 2006, 114: 303-318. 10.1111/j.1600-0447.2006.00824.x.CrossRefPubMed
38.
Harland R, Antonova E, Owen GS, Broome M, Landau S, Deeley Q, Murray R: A study of psychiatrists’ concepts of mental illness. Psychol Med. 2009, 39: 967-976. 10.1017/S0033291708004881.CrossRefPubMed
39.
Bennet L, Thrilaway K, Murray AJ: The stigmatizing implications of presenting schizophrenia as a genetic disease. J Genet Couns. 2008, 17: 550-559. 10.1007/s10897-008-9178-8.CrossRef
40.
Magliano L, Read J, Rega S, Oliviero N, Sagliocchi A, Patalano M, D’Ambrosio A: The influence of causal explanations and diagnostic labeling on medical students’ views of schizophrenia. Acad Med. 2011, 86: 1155-1162. 10.1097/ACM.0b013e318226708e.CrossRefPubMed
41.
Aromaa E, Tovanen A, Tuulari J, Wahlbeck K: Attitudes towards people with mental disorders: the psychometric characteristics of a finnish questionnaire. Soc Psychiatry Psychiatric Epidemiol. 2010, 45: 265-273. 10.1007/s00127-009-0064-y.CrossRef
42.
Fisher RJ: Social desirability bias and the validity of indirect questioning. J Consum Res. 1993, 20 (2): 303-315. 10.1086/209351.CrossRef
43.
Griffiths KM, Nakane Y, Christensen H, Yoshioka K, Jorm AF, Nakane H: Stigma in response to mental disorders: a comparison of Australia and Japan. BMC Psychiatry. 2006, 23: 6-21.
44.
Sakind NJ: Encyclopedia of research design. 2010, California, USA: SAGE PublicationsCrossRef
45.
Kahneman D, Sovic P, Tversky A: Judgment under uncertainty: heuristics and biases. 1982, Cambridge: Cambridge University PressCrossRef
46.
Zafar SN, Syed R, Tehseen S, Gowani SA, Zubair A, Yousaf W, Zubairi AJ, Naqvi H: Perceptions about the cause of schizophrenia and the subsequent help seeking behavior in Pakistani population – results of a cross-sectional survey. BMC Psychiatry. 2008, 8: 56-10.1186/1471-244X-8-56.CrossRefPubMedPubMedCentral
47.
Arboleda-Florez J, Stuart H: From Sin to science: fighting the stigmatization of mental illnesses. Canadian J Psychiatry. 2012, 57 (8): 457-463.
48.
Corrigan PW, Shapiro JR: Measuring the impact of programs that challenge the public stigma of mental illness. Clin Psychol Rev. 2010, 30 (8): 907-922. 10.1016/j.cpr.2010.06.004.CrossRefPubMedPubMedCentral
49.
Stuart H, Arboleda-Flôrez J: Community attitudes toward people with schizophrenia. Canadian J Psychiatry. 2001, 46: 245-252.
50.
Thompson AH, Stuart H, Bland RC, Arboleda-Florez J, Warner R, Dickson RA, Sartorius N, López-Ibor JJ, Stefanis CN, Wig NN, World Psychiatric Association: Attitudes about schizophrenia from the pilot site of the WPA worldwide campaign against the stigma of schizophrenia. Soc Psychiatry Psychiatric Epidemiol. 2002, 37: 475-482. 10.1007/s00127-002-0583-2.CrossRef
51.
Santos Junior A, Silva LFAL, Banzato CEM, Costa Pereira MC: A qualitative analysis on what Brazilian psychiatrists expect from current diagnostic classifications. European Psychiatry. 2009, 24 (S1): S733-CrossRef
52.
Durand-Zaleski I, Scott J, Rouillon F, Leboyer M: A first national survey of knowledge, attitudes and behaviours towards schizophrenia, bipolar disorders and autism in France. BMC Psychiatry. 2012, 12: 128-10.1186/1471-244X-12-128.CrossRefPubMedPubMedCentral
53.
Crisp A, Gelder M, Goddard E, Meltzer H: Stigmatization of people with mental illnesses: a follow-up study within the changing minds campaign of the royal college of psychiatrists. World Psychiatry. 2005, 4 (2): 106-113.PubMedPubMedCentral
54.
Chaplin R: Psychiatrists can cause stigma too. Br J Psychiatry. 2000, 177: 467-10.1192/bjp.177.5.467.CrossRefPubMed
Metadata
Title
Stigma toward schizophrenia: do all psychiatrists behave the same? Latent profile analysis of a national sample of psychiatrists in Brazil
Authors
Alexandre Andrade Loch
Francisco Bevilacqua Guarniero
Fabio Lorea Lawson
Michael Pascal Hengartner
Wulf Rössler
Wagner Farid Gattaz
Yuan-Pang Wang
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2013
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-13-92

Other articles of this Issue 1/2013

BMC Psychiatry 1/2013 Go to the issue

Study protocol

An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: the Combined Alcohol Social Phobia (CASP) trial protocol

Study protocol

Effectiveness and efficiency of assertive outreach for Schizophrenia in Germany: study protocol on a pragmatic quasi-experimental controlled trial

Research article

Typology of persons with severe mental disorders

Research article

The relationship between self-reported and registry-based data on use of psychoactive medications in postmenopausal women

Research article

TPH1A218C polymorphism and temperament in major depression

Research article

Perception of depressive symptoms by the Sardinian public: results of a population study