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Schizophrenia Bulletin Advance Access published online on January 20, 2009
Schizophrenia Bulletin, doi:10.1093/schbul/sbn184
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© The Author 2009. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Stigmatization as an Environmental Risk in Schizophrenia: A User Perspective

Catherine van Zelst1,2
2 Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands

1 To whom correspondence should be addressed; tel: +31-43-3688666, fax: +31-43-3688689, e-mail: c.vanzelst{at}sp.unimaas.nl.

Stigmatization represents a chronic negative interaction with the environment that most people with a diagnosis of schizophrenia face on a regular basis. Different types of stigma—public stigma, self-stigma, and label avoidance—may each have detrimental effects. In the present article, the possible consequences of stigma on onset, course, and outcome of schizophrenia are reviewed. Stigmatization may be conceptualized as a modifiable environmental risk factor that exerts its influence along a variety of different pathways, not only after the illness has been formally diagnosed but also before, on the basis of subtle behavioral expressions of schizophrenia liability. Integrating stigma-coping strategies in treatment may represent a cost-effective way to reduce the risk of relapse and poor outcome occasioned by chronic exposure to stigma. In addition, significant gains in quality of life may result if all patients with schizophrenia routinely receive information about stigma and are taught to use simple strategies to increase resilience vis-à-vis adverse, stigmatizing environments.

Keywords: stigmatization / discrimination / schizophrenia / psychosis / environment / affective symptoms


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[Abstract] [Full Text] [PDF]


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