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Stigma of mental illness may increase depression, anxiety among those at high-risk for psychosis

Stigma related to risk-label and symptoms of psychosis was associated with increased depression and anxiety among individuals at clinical high-risk for psychosis, suggesting stigma-related shame should be addressed in early interventions.

“Early intervention for individuals at clinical high-risk for psychosis offers the possibility of forestalling the development of threshold psychosis, but simultaneously confers a label of risk with potentially stigmatizing consequences,” Lawrence H. Yang, PhD, of Mailman School of Public Health, Columbia University, New York, and colleagues wrote. “This issue is salient, as the label of risk is conferred upon all participants in a high-risk cohort, irrespective of whether they ever progress to full-blown psychosis. Capturing complex issues of labeling and stigma in this population is crucial to optimally assist youth at a possibly critical juncture.”

Lawrence H. Yang

To evaluate the effects of stigma among individuals with a clinical high-risk for psychosis, researchers assessed labeling-related measures including stereotype awareness or self-stigma and negative emotions (ie, shame) among 38 patients at clinical high-risk for psychosis.

Study participants endorsed awareness of mental illness stereotypes but did not largely agree with them, according to researchers. They described more stigma associated with symptoms than with the risk-label itself.

Shame related to stigma was associated with depression and shame related to risk-label was associated with anxiety.

“Our results indicate that [clinical high-risk] individuals may benefit from formal anti-stigma efforts to address labeling- and symptom-related stigma. Future studies might also address culture-specific aspects of stigma as this early identification is being adopted worldwide. Implementing procedures to avert stigma linked with the [clinical high-risk] status would ameliorate a major concern about its use to facilitate early identification worldwide,” Yang and colleagues concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.