The Effect of Psychoeducation Focused on Reducing Internalized Stigma

The Effect of Psychoeducation Focused on Reducing Internalized Stigma in Individuals Diagnosed With Schizophrenia on Treatment Adherence and Internalized Stigma

In the fight against stigma, the focus should be on the education of individuals diagnosed with mental illness. Psychoeducation has an important place in the treatment and rehabilitation of mental health problems. Psychoeducation is necessary for early recognition of signs and symptoms of diseases, ensuring compliance with treatment, improving coping skills, as well as combating stigma, preventing internalized stigma, and counteracting social stigma. If individuals with mental disorders have adequate knowledge about the causes of stigma, they may be less prone to internalized stigma.

Study Overview

• Status: Not yet recruiting
• Conditions: Schizophrenia; Treatment Adherence; Stigma, Social
• Intervention / Treatment: Other: Psychoeducation Focused on Reducing Internalized Stigma

Detailed Description

The group most exposed to stigma among mental illnesses is individuals diagnosed with schizophrenia. These individuals avoid treatment due to fear of stigma, which creates a significant obstacle to ensuring their well-being. Internalization of stigma causes feelings of loneliness, anger, helplessness, deterioration in quality of life, and decrease in self-esteem, while at the same time creating a significant barrier to treatment compliance. Compliance problems with treatment: It causes impairments in functionality, relapses and exacerbations, repeated hospitalizations, adverse effects on quality of life and increased mortality rates. The fact that many patients who receive only medical treatment in the treatment of schizophrenia develop negative attitudes towards drug use due to drug side effects and recurrence of disease symptoms reveals that psychosocial approaches should also be given importance in addition to medical treatment. As a result, it is thought that internalized stigma is a significant obstacle to treatment compliance and practices implemented to reduce internalized stigma are effective in increasing treatment compliance.

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Kadriye ATAR, MSc; Phone Number: +90 5065595119; Email: kadriye.atar@ogr.iuc.edu.tr

Study Locations

• Turkey
  • Şişli
    • Istanbul, Şişli, Turkey
      • Istanbul University - Cerrahpasa (IUC)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Volunteer to participate in the research,
• Diagnosed with schizophrenia according to DSM-V TR diagnostic criteria,
• Over 18 years old,
• Being in remission for 2 months,
• At least primary school graduate,
• Residing in Edirne city center and its districts,
• Individuals without hearing or understanding problems.

Exclusion Criteria:

• Not meeting the inclusion criteria,
• Having a diagnosis of dementia or other organic mental disorder as an additional diagnosis,
• Individuals with a history of substance abuse (other than nicotine).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental; Psyhcoeducation Group (Experimental) Psychoeducation focused on reducing internalized stigma will be applied to the experimental group.	Other: Psychoeducation Focused on Reducing Internalized Stigma; Participants will be randomized and divided into experimental and control groups. Initial measurements will be collected through a face-to-face meeting. While the control group will continue to receive routine Community Mental Health Center service, the experimental group will receive a psychoeducation program focused on reducing internalized stigma in addition to the routine Community Mental Health Center service. After the program is completed, final measurements of the experimental and control groups will be collected. The program is planned to consist of 7 sessions, once a week, and approximately 60-90 minutes are expected to be allocated for each session. Sessions will be divided into two sessions: a 30-40 minute session and a 15 minute break.
No Intervention: No Intervention; Controls (Control Group) No intervention will be applied to the control group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Internalized Stigma of Mental Illness Scale	It is a self-report scale consisting of 29 items and assessing internal stigma. The scale includes: 1. Alienation (6 items), 2. Endorsement of Stereotypes (7 items), 3. Perceived Discrimination (5 items), 4. Social Withdrawal (6 items) and 5. Resistance to Stigma (5 items). It has five subscales. The items in the scale are on a four-point Likert-type scale as "I strongly disagree" (1 point), "I disagree" (2 points), "I agree" (3 points), "I strongly agree" (4 points). is answered. Items of the "Resistance to stigma" subscale are scored reversely. The total score obtained by summing the scores of the five subscales varies between 29 and 116 points. Higher scores from the scale mean that the person's internalized stigma is more severe in a negative way. While the internal consistency coefficient obtained for the entire scale was found to be 0.93, the split-half reliability of the scale was determined as 0.89.	4 Month
Medication Adherence Reporting Scale	It is a 5-point Likert type scale consisting of 5 questions. The scale is used to evaluate medication compliance in many diseases such as blood pressure, diabetes, rheumatoid arthritis, inflammatory bowel disease, hyperlipidemia, chronic pain, and bipolar mood disorder. The total test score is obtained by adding the scores obtained from the items. Scores from the scale vary between 5 and 25. An increase in the scores obtained indicates compatibility, and a decrease in the scores indicates non-compliance. It was found that the scale was evaluated with a single factor structure and had good levels of criterion and discriminant validity and reliability (Cronbach Alpha = 0.85).	4 Month

Collaborators and Investigators

• Sponsor: Istanbul University - Cerrahpasa (IUC)
• Investigators: Study Director: Ozge SUKUT, PhD, Istanbul University - Cerrahpasa (IUC)

Study record dates

Study Major Dates

• Study Start (Estimated): April 30, 2024
• Primary Completion (Estimated): May 1, 2024
• Study Completion (Estimated): September 1, 2024

Study Registration Dates

• First Submitted: March 30, 2024
• First Submitted That Met QC Criteria: March 30, 2024
• First Posted (Actual): April 4, 2024

Study Record Updates

• Last Update Posted (Actual): April 4, 2024
• Last Update Submitted That Met QC Criteria: March 30, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: Schizophrenia; Psychoeducation; Treatment Adherence; Internalized Stigma
• Additional Relevant MeSH Terms: Mental Disorders; Schizophrenia Spectrum and Other Psychotic Disorders; Schizophrenia
• Other Study ID Numbers: IstanbulUCKA

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No