PDF(Pubmed)
Abstract：
A significant proportion of individuals with psychiatric disorders face dual challenges such as managing the symptoms and disabilities of their conditions and enduring stigma arising from misconceptions about mental illness. This stigma denies them quality-of-life opportunities, such as access to satisfactory healthcare services, better employment, safer housing, and social affiliations. This systematic review aims to evaluate the effect of stigmatization on psychiatric illness outcomes, particularly its influence on treatment adherence, treatment-seeking behavior, and care outcomes. We conducted a systematic review of 39 studies published between 2010 and 2024, focusing on the effects of stigmatization on psychiatric illness outcomes. The review utilized robust methodology following Cochrane guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including studies from 2010 to 2024 obtained from databases such as PubMed, Embase, Google Scholar, Web of Science, and SCOPUS. The quality of the included studies was assessed using the Appraisal Tool for Cross-Sectional Studies, with most studies rated as moderate to high quality. The findings indicate that stigma in psychiatric illness is closely associated with several factors, including illness duration (mean effect size = 0.42, p < 0.05), frequency of clinic visits (mean reduction = 2.3 visits/year), and diagnosis of psychotic disorders (OR = 1.78, 95% CI: 1.20-2.65). Stigma manifests through misinformation, prejudice, and discrimination, leading to significant barriers to accessing and adhering to psychiatric treatment, thereby worsening health outcomes. It leads to delays in accessing healthcare, poor adherence to medication and follow-up, and negative psychiatric health outcomes, including disempowerment, reduced self-efficacy, increased psychiatric symptoms, and decreased quality of life. Also, stigma extends to caregivers and healthcare professionals, complicating care delivery. This review highlights the need for effective interventions and strategies to address stigma, emphasizing the importance of educational interventions to mitigate the adverse effects of public stigma. Understanding the multifaceted nature of stigma is crucial for developing targeted approaches to improve psychiatric care outcomes and ensure better mental health services for individuals with mental illnesses.
摘要：
很大一部分患有精神疾病的人面临着双重挑战，例如管理他们的症状和残疾，以及由于对精神疾病的误解而产生的持久耻辱。这种耻辱剥夺了他们生活质量的机会，例如获得令人满意的医疗保健服务，更好的就业,更安全的住房，和社会联系。本系统综述旨在评估污名化对精神疾病结局的影响。特别是它对治疗依从性的影响，寻求治疗的行为，和护理结果。我们对2010年至2024年间发表的39项研究进行了系统评价，重点关注污名化对精神疾病结局的影响。审查采用了遵循Cochrane指南和系统审查和荟萃分析指南的首选报告项目的稳健方法。包括从PubMed等数据库获得的2010年至2024年的研究，Embase,谷歌学者，WebofScience,和SCOPUS。纳入研究的质量使用横断面研究评估工具进行评估，大多数研究被评为中等质量到高质量。研究结果表明，精神疾病的污名与几个因素密切相关，包括疾病持续时间(平均效应大小=0.42，p<0.05)，就诊频率（平均减少=2.3次/年），和精神病性障碍的诊断（OR=1.78，95％CI：1.20-2.65）。耻辱通过错误信息表现出来，偏见,歧视,导致获得和坚持精神病治疗的重大障碍，从而恶化健康结果。这导致了获得医疗保健的延误，对药物和随访的依从性差，和负面的精神健康结果，包括剥夺权力，自我效能感降低,精神症状加重,生活质量下降。此外，耻辱延伸到护理人员和医疗保健专业人员，使护理交付复杂化。这篇综述强调了需要有效的干预措施和战略来解决污名，强调教育干预对减轻公众污名化的不利影响的重要性。了解污名的多面性对于制定有针对性的方法以改善精神病护理结果并确保为患有精神疾病的个人提供更好的心理健康服务至关重要。
