Skip to main content

The Influence of Stigma on the Course of Illness

  • Chapter
  • First Online:
The Stigma of Mental Illness - End of the Story?

Abstract

This chapter is about the impact of the stigma of mental illness on the illness course. Three different stages of the illness are examined: the time between illness onset and recognition, the first episode, and the long-term course. Generally, long-term panel studies are scarce. Best evidence is given for the long-term course of illness basing on several studies referring to Link’s modified labelling approach. These studies indicate that personal stigma (comprising perceived, experienced, and self stigma) is associated in the long run with impaired quality of life, decreased self esteem, and higher burden due to depression and further illness symptoms. Even though personal stigma is related to the illness course, it is not simply part of it, because the burden due to illness and symptoms usually improves over time while the burden due to stigma remains high.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Anderson KK, Fuhrer R, Malla AK (2013) “There are too many steps before you get to where you need to be”: help-seeking by patients with first-episode psychosis. J Ment Health 22:384–395

    Article  PubMed  Google Scholar 

  • Arria AM, Winick ER, Garnier-Dykstra LM et al (2011) Help seeking and mental health service utilization among college students with a history of suicide ideation. Psychiatr Serv 62:1510–1513

    Article  PubMed  PubMed Central  Google Scholar 

  • Bos AE, Kanner D, Muris P et al (2009) Mental illness stigma and disclosure: consequences of coming out of the closet. Issues Ment Health Nurs 30:509–513

    Article  PubMed  Google Scholar 

  • Brohan E, Slade M, Clement S, Thornicroft G (2010) Experiences of mental illness stigma, prejudice and discrimination: a review of measures. BMC Health Serv Res 10:80. doi:10.1186/1472-6963-10-80

    Article  PubMed  PubMed Central  Google Scholar 

  • Brunet K, Birchwood M, Lester H, Thornhill K (2007) Delays in mental health services and duration of untreated psychosis. Psychiatr Bull 31:408–410

    Article  Google Scholar 

  • Corker EA, Beldie A, Brain C et al (2014) Experience of stigma and discrimination reported by people experiencing the first episode of schizophrenia and those with a first episode of depression: the FEDORA project. Int J Soc Psychiatry. doi:10.1177/0020764014551941

    PubMed  Google Scholar 

  • Corrigan PW (2004) How stigma interferes with mental health care. Am Psychol 59:614–625

    Article  PubMed  Google Scholar 

  • Corrigan PW, Markowitz FE, Watson AC (2004) Structural levels of mental illness stigma and discrimination. Schizophr Bull 30:481–491

    Article  PubMed  Google Scholar 

  • Corrigan PW, Watson AC, Barr L (2006) The self-stigma of mental illness: implications for self-esteem and self-efficacy. J Soc Clin Psychol 25:875–884

    Article  Google Scholar 

  • Corrigan PW, Larson JE, Rüsch N (2009) Self-stigma and the “why try” effect: impact on life goals and evidence-based practices. World Psychiatry 8:75–81

    Article  PubMed  PubMed Central  Google Scholar 

  • Corrigan PW, Morris S, Larson J et al (2010) Self-stigma and coming out about one’s mental illness. J Community Psychol 38:259–275

    Article  PubMed  PubMed Central  Google Scholar 

  • Corrigan PW, Michaels PJ, Vega E et al (2012) Self-stigma of mental illness scale – short form: reliability and validity. Psychiatry Res 199:65–69

    Article  PubMed  PubMed Central  Google Scholar 

  • Crocker J (1999) Social stigma and self-esteem: situational construction of self-worth. J Exp Soc Psychol 35:89–107

    Article  Google Scholar 

  • Funk M, Drew N, Knapp M (2012) Mental health, poverty and development. J Pub Ment Health 11:166–185

    Article  Google Scholar 

  • Gerlinger G, Hauser M, De Hert M et al (2013) Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates, correlates, impact and interventions. World Psychiatry 12:155–164

    Article  PubMed  PubMed Central  Google Scholar 

  • Goffman E (1963) Stigma. Notes on the management of spoiled identity. Prentice-Hall, Englewood-Cliffs

    Google Scholar 

  • Graves RE, Cassisi JE, Penn DL (2005) Psychophysiological evaluation of stigma towards schizophrenia. Schizophr Res 76:317–327

    Article  PubMed  Google Scholar 

  • Hegelstad WT, Larsen TK, Auestad B et al (2012) Long-term follow-up of the TIPS early detection in psychosis study: effects on 10-year outcome. Am J Psychiatry 169:374–380

    Article  PubMed  Google Scholar 

  • Ienciu M, Romoşan F, Bredicean C, Romoşan R (2010) First episode psychosis and treatment delay – causes and consequences. Psychiatr Danub 22:540–543

    PubMed  Google Scholar 

  • Kisch J, Leino EV, Silverman MM (2005) Aspects of suicidal behavior, depression, and treatment in college students: results from the spring 2000 national college health assessment survey. Suicide Life Threat Behav 35:3–13

    Article  PubMed  Google Scholar 

  • Link BG, Cullen FT, Struening E et al (1989) A modified labeling theory approach to mental disorders: an empirical assessment. Am Sociol Rev 54:400–423

    Article  Google Scholar 

  • Link BG, Struening EL, Rahav M et al (1997) On stigma and its consequences: evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. J Health Soc Behav 38:177–190

    Article  CAS  PubMed  Google Scholar 

  • Link BG, Struening EL, Neese-Todd S et al (2001) Stigma as a barrier to recovery: the consequences of stigma for the self-esteem of people with mental illnesses. Psychiatr Serv 52:1621–1626

    Article  CAS  PubMed  Google Scholar 

  • Lloyd-Evans B, Crosby M, Stockton S et al (2011) Initiatives to shorten duration of untreated psychosis: systematic review. Br J Psychiatry 198:256–263

    Article  PubMed  Google Scholar 

  • Markowitz FE (1998) The effects of stigma on the psychological well-being and life satisfaction of persons with mental illness. J Health Soc Behav 39:335–347

    Article  CAS  PubMed  Google Scholar 

  • Markowitz FE (2001) Modeling processes in recovery from mental illness: relationships between symptoms, life satisfaction, and self-concept. J Health Soc Behav 42:64–79

    Article  CAS  PubMed  Google Scholar 

  • Marshall M, Lewis S, Lockwood A et al (2005) Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Arch Gen Psychiatry 62:975–983

    Article  PubMed  Google Scholar 

  • Mittal D, Sullivan G, Chekuri L et al (2012) Empirical studies of self-stigma reduction strategies: a critical review of the literature. Psychiatr Serv 63:974–981

    Article  PubMed  Google Scholar 

  • Mueller B, Nordt C, Lauber C et al (2006) Social support modifies perceived stigmatization in the first years of mental illness: a longitudinal approach. Soc Sci Med 62:39–49

    Article  PubMed  Google Scholar 

  • Patel V, Kleinman A (2003) Poverty and common mental disorders in developing countries. Bull World Health Organ 81:609–615

    PubMed  PubMed Central  Google Scholar 

  • Penn DL, Kohlmaier JR, Corrigan PW (2000) Interpersonal factors contributing to the stigma of schizophrenia: social skills, perceived attractiveness, and symptoms. Schizophr Res 45:37–45

    Article  CAS  PubMed  Google Scholar 

  • Perlick DA, Rosenheck RA, Clarkin JF et al (2001) Stigma as a barrier to recovery: adverse effects of perceived stigma on social adaptation of persons diagnosed with bipolar affective disorder. Psychiatr Serv 52:1627–1632

    Article  CAS  PubMed  Google Scholar 

  • Poyraz CA, Turan Ş, Sağlam NG et al (2015) Factors associated with the duration of untreated illness among patients with obsessive compulsive disorder. Compr Psychiatry 58:88–93

    Article  PubMed  Google Scholar 

  • Rüsch N, Heekeren K, Theodoridou A et al (2015) Stigma as a stressor and transition to schizophrenia after one year among young people at risk of psychosis. Schizophr Res. doi:10.1016/j.schres.2015.05.027 [Epub ahead of print]

    PubMed  Google Scholar 

  • Sibitz I, Provaznikova K, Lipp M et al (2013) The impact of recovery-oriented day clinic treatment on internalized stigma: preliminary report. Psychiatry Res 209:326–332

    Article  PubMed  Google Scholar 

  • Tanskanen S, Morant N, Hinton M et al (2011) Service user and carer experiences of seeking help for a first episode of psychosis: a UK qualitative study. BMC Psychiatry 11:157

    Article  PubMed  PubMed Central  Google Scholar 

  • Tarrier N, Khan S, Cater J, Picken A (2007) The subjective consequences of suffering a first episode psychosis: trauma and suicide behaviour. Soc Psychiatry Psychiatr Epidemiol 42:29–35

    Article  PubMed  Google Scholar 

  • World Health Organization (2013) Mental health action plan 2013–2020. WHO, Geneva

    Google Scholar 

  • Wright ER, Gronfein WP, Owens TJ (2000) Deinstitutionalization, social rejection, and the self-esteem of former mental patients. J Health Soc Behav 41:68–90

    Article  CAS  PubMed  Google Scholar 

  • Zäske H, Sauter S, Ohmann C, Icks A, Gaebel W (2013) Improving empowerment and stigma coping in people with mental illness [Poster in German]. Poster presented at the 12th German Conference for Healthcare Research, Berlin, 23–25 Oct 2013

    Google Scholar 

  • Zäske H, Freimüller L, Wölwer W, Gaebel W (2014) Anti-stigma competence for mental health professionals: results of a pilot study of a further education programme for people working in psychiatric and psychosocial settings [Article in German]. Fortschr Neurol Psychiatr 82:586–592

    Article  PubMed  Google Scholar 

  • Zäske H, Degner D, Jockers-Scherübl M et al (2016) Experiences of stigma and discrimination in patients with first-episode schizophrenia [Article in German]. Nervenarzt 87:82–87.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Harald Zäske .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Zäske, H. (2017). The Influence of Stigma on the Course of Illness. In: Gaebel, W., Rössler, W., Sartorius, N. (eds) The Stigma of Mental Illness - End of the Story?. Springer, Cham. https://doi.org/10.1007/978-3-319-27839-1_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27839-1_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27837-7

  • Online ISBN: 978-3-319-27839-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics