bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTHbekhterev-93Research ArticleНАУЧНО-ИССЛЕДОВАТЕЛЬСКИЕ РАБОТЫRESEARCH PAPERSПсихиатрическая стигма - ее проявления и последствияStigma in patients with mental disorders- its manifestations and consequencesЛутоваНаталия БорисовнаLutovaN. B.lutova@mail.ruСорокинМихаил ЮрьевичSorokinM. Y.m.sorokin@list.ruВидВиктор ДавыдовичWiedV. D.wied@bekhterev.ruНациональный медицинский исследовательский центр психиатрии и неврологии им. В.М. БехтереваРоссияV.M. Bekhterev’ National medical research center of psychiatry and neurologyRussian Federation201719072018034145Copyright © Лутова Н.Б., Сорокин М.Ю., Вид В.Д., 20182018Лутова Н.Б., Сорокин М.Ю., Вид В.Д.Lutova N.B., Sorokin M.Y., Wied V.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/93

Несмотря на широкое обсуждение проблемы психиатрической стигмы, продолжаются попытки изучения путей и механизмов формирования самостигматизации, а также вовлечения в процесс лечения этой категории больных. Обследовано 66 больных, страдающих тяжелыми психическими расстройствами. Применялись опросники внешней стигмы, самостигматизации и шкала оценки мотивации к лечению. Обнаружены отдельные факторы, участвующие в формировании самостигматизации, влияние уровня имплицитной самостигматизации на развитие эксплицитной самостигматизации и ее негативное влияние на мотивацию больных к лечению.

Inspite of the problems of sigma being widely discussed, there still continue the attempts to understand the ways and factors producing the self-stigmatizing and mechanisms obtruding the involvement of self-stigmatized patients into the treatment process. In the present study there took part 66 in-patients with severe mental disorders. There were used the questionnaire of self-stigmatizing, devaluation/discrimination part of the experienced stigmatizing questionnaire and motivation for treatment rating scale. Detected some significant factors in producing the self-stigmatizing and influence of the implicit self-stigmatizing, the severeness of which results in the development of the explicit self-stigmatization, which destruct the motivation for treatment.

психиатрическая стигмасамостигматизацияпсихические расстройствамотивация к лечениюstigmaself-stigmatizationsevere mental disordersmotivation for treatmentReferencesСорокин М.Ю., Лутова Н.Б., Вид В.Д. Роль подсистемы мотивации к лечению в общей структуре комплаенса у больных при проведении психофармакотерапи // Журнал неврологии и психиатрии им. С.С. Корсакова. - 2016. - № 4, вып. 1. - С. 32-36.Сорокин М.Ю., Лутова Н.Б., Вид В.Д. Роль подсистемы мотивации к лечению в общей структуре комплаенса у больных при проведении психофармакотерапи // Журнал неврологии и психиатрии им. С.С. Корсакова. - 2016. - № 4, вып. 1. - С. 32-36.Сорокин М.Ю. Распространённость внешней стигматизации у психически больных и её взаимосвязь с мотивацией к лечению // Неврологический вестник. - 2016. - Т. XLVIII, вып. 2. - С. 73-77.Сорокин М.Ю. Распространённость внешней стигматизации у психически больных и её взаимосвязь с мотивацией к лечению // Неврологический вестник. - 2016. - Т. XLVIII, вып. 2. - С. 73-77.Aakre J.M., Klingman E.A., Docherty N.M. The relationship between stigma sentiments and self-identity of individuals with schizophrenia // Psychiatric Reabilitation J. - 2015. - Vol. 38. - Р. 125-131.Aakre J.M., Klingman E.A., Docherty N.M. The relationship between stigma sentiments and self-identity of individuals with schizophrenia // Psychiatric Reabilitation J. - 2015. - Vol. 38. - Р. 125-131.Butler A., Hokanson J., Flynn H. A comparision of self-esteem lability and low trait self-esteem as vulnerability factors for depression // J. of Personality and Social Psychology. - 1994. - Vol. 66. - Р. 166-177.Butler A., Hokanson J., Flynn H. A comparision of self-esteem lability and low trait self-esteem as vulnerability factors for depression // J. of Personality and Social Psychology. - 1994. - Vol. 66. - Р. 166-177.Corrigan P.W., Markowitz F.E., Watson A.C. Structural levels of mental illness stigma and discrimination // Schizophrenia Bull. - 2004. - Vol. 30 (3). - P. 481-491.Corrigan P.W., Markowitz F.E., Watson A.C. Structural levels of mental illness stigma and discrimination // Schizophrenia Bull. - 2004. - Vol. 30 (3). - P. 481-491.Corrigan P.W. Rao D. On the self-stigma of mental illness: stages, disclosure, and strategies for change // Can. J. Psychiatry. - 2012. - Vol. 57 (8). - P. 464-469.Corrigan P.W. Rao D. On the self-stigma of mental illness: stages, disclosure, and strategies for change // Can. J. Psychiatry. - 2012. - Vol. 57 (8). - P. 464-469.Corrigan P.W. On the stigma of mental illness: practical strategies for research and social change. - Washington: American Psychological Association. - 2005.Corrigan P.W. On the stigma of mental illness: practical strategies for research and social change. - Washington: American Psychological Association. - 2005.Corrigan P. W., Kleinlein P. The impact of mental illness stigma // On the stigma of mental illness: practical strategies for research and social change / ed. by Corrigan P.W. - Washington: American Psychological Association. - 2005. - P. 11-44.Corrigan P. W., Kleinlein P. The impact of mental illness stigma // On the stigma of mental illness: practical strategies for research and social change / ed. by Corrigan P.W. - Washington: American Psychological Association. - 2005. - P. 11-44.Crocker J., Major B., Steele C. Social stigma // The handbook of social psychology / ed. by Gilbert D.T., Fiske S.T. - Vol. 2 (4). - New York: McGraw-Hill - 1998. - P. 504-553.Crocker J., Major B., Steele C. Social stigma // The handbook of social psychology / ed. by Gilbert D.T., Fiske S.T. - Vol. 2 (4). - New York: McGraw-Hill - 1998. - P. 504-553.Devine P.G. Prejudice and out-group perception // Advanced social psychology / ed. by Tesser A. - New York: MCGraw-Hill. - 1995. - P. 467-524.Devine P.G. Prejudice and out-group perception // Advanced social psychology / ed. by Tesser A. - New York: MCGraw-Hill. - 1995. - P. 467-524.Flanagan E.H., Miller R., Davidson L. “Unfortunately, we treat the chart”: Sources of stigma in mental health setting // Psychiatrist Quarterly. - 2009. - Vol. 80 (1). - P. 55-64.Flanagan E.H., Miller R., Davidson L. “Unfortunately, we treat the chart”: Sources of stigma in mental health setting // Psychiatrist Quarterly. - 2009. - Vol. 80 (1). - P. 55-64.Fung K.M.T., Tsang H.W.H., Corrigan P., et al. Measuring self-stigma of mental illness in China and its implication for recovery // International J. Social Psychiatry. - 2007. - Vol. 53 (5). - P. 408-418.Fung K.M.T., Tsang H.W.H., Corrigan P., et al. Measuring self-stigma of mental illness in China and its implication for recovery // International J. Social Psychiatry. - 2007. - Vol. 53 (5). - P. 408-418.Gallo K.M. First person account: self-stigmatization // Schizophr. Bull. - 1994. - Vol. 20. - P. 407-408.Gallo K.M. First person account: self-stigmatization // Schizophr. Bull. - 1994. - Vol. 20. - P. 407-408.Goffman E. Stigma: Notes on the management of spoiled identity. - New York, NY: Simon & Schuster. - 1963.Goffman E. Stigma: Notes on the management of spoiled identity. - New York, NY: Simon & Schuster. - 1963.Goldin C.S. Stigma biomedical efficiency and institutional control // Soc. Sci. Med. - 1990. - Vol. 30. - P. 890-895.Goldin C.S. Stigma biomedical efficiency and institutional control // Soc. Sci. Med. - 1990. - Vol. 30. - P. 890-895.Hilton J.L., von Hippel W. Stereotypes // Ann. Rev. Psychol. - 1996. - Vol. 47. - P. 237-271.Hilton J.L., von Hippel W. Stereotypes // Ann. Rev. Psychol. - 1996. - Vol. 47. - P. 237-271.Huxley P., Thornicroft G. Social inclusion social quality and mental illness // Br. J. Psychiatry. - 2003. - Vol. 182. - P. 289-290.Huxley P., Thornicroft G. Social inclusion social quality and mental illness // Br. J. Psychiatry. - 2003. - Vol. 182. - P. 289-290.Karidi M.V., Stefanis C.N., Theleritis C., et al. Perceived social stigma, self-concept, and self-stigmatization of patients with schizophrenia // Comprehensive Psychiatry. - 2010. - Vol. 51. - P. 19-30.Karidi M.V., Stefanis C.N., Theleritis C., et al. Perceived social stigma, self-concept, and self-stigmatization of patients with schizophrenia // Comprehensive Psychiatry. - 2010. - Vol. 51. - P. 19-30.Lauber C., Norat C., Braunschweig C., Rossler W. Do mental health professionals stigmtise their patients? // Acta. Psychiatr. Scan. - 2006. - Vol. 113. - P. 51-59.Lauber C., Norat C., Braunschweig C., Rossler W. Do mental health professionals stigmtise their patients? // Acta. Psychiatr. Scan. - 2006. - Vol. 113. - P. 51-59.Link B. Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of the people with mental health disorders // Psychiatry Serv. - 2001. - Vol. 53. - P. 1621-1626.Link B. Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of the people with mental health disorders // Psychiatry Serv. - 2001. - Vol. 53. - P. 1621-1626.Link B.G., Cullen F.T., Struening E., et al. A modified labeling theory approach in the area of mental disorders: an empirical assessment // Am. Sociological Revirw. - 1989. - Vol. 54. - P. 100-123.Link B.G., Cullen F.T., Struening E., et al. A modified labeling theory approach in the area of mental disorders: an empirical assessment // Am. Sociological Revirw. - 1989. - Vol. 54. - P. 100-123.Lysaker P.H., Roe D., Yanos P.T. Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders // Shizo-phrenia Bulletin. - 2007. - Vol. 33. - P. 192-199.Lysaker P.H., Roe D., Yanos P.T. Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders // Shizo-phrenia Bulletin. - 2007. - Vol. 33. - P. 192-199.Lysaker P.H., Tsaj J., Yanos P.T., Roe D. Negative symptoms and concordant impairments in attention in schizophrenia: associations with social functioning, hope, self-esteem and internalized stigma // Schizophrenia Res. - 2009. - Vol. 110. - P. 165172.Lysaker P.H., Tsaj J., Yanos P.T., Roe D. Negative symptoms and concordant impairments in attention in schizophrenia: associations with social functioning, hope, self-esteem and internalized stigma // Schizophrenia Res. - 2009. - Vol. 110. - P. 165172.Major B., O’Brien L.T. The social psychology of stigma // Ann. Rev. Psychol. - 2005. Vol. 56. - P. 393-421.Major B., O’Brien L.T. The social psychology of stigma // Ann. Rev. Psychol. - 2005. Vol. 56. - P. 393-421.Quinn D.M., Williams M.K., Weiz B.M. From discrimination to internalized mental illness stigma: The mediating roles of anticipated discrimination and anticipated stigma // Psychiatric Rehabilitation. - 2015. - Vol. 38. - P. 103-108.Quinn D.M., Williams M.K., Weiz B.M. From discrimination to internalized mental illness stigma: The mediating roles of anticipated discrimination and anticipated stigma // Psychiatric Rehabilitation. - 2015. - Vol. 38. - P. 103-108.Ritsher J.B., Otilingam P.C., Grajales M. Internalized stigma of mental illness: psychometric properties of a new measure? // Psychiatry Res. - 2003. - Vol. 121. - P. 31-49.Ritsher J.B., Otilingam P.C., Grajales M. Internalized stigma of mental illness: psychometric properties of a new measure? // Psychiatry Res. - 2003. - Vol. 121. - P. 31-49.Ritsher J.B., Phelan J.C. Inernalized stigma predict erosion of morale among psychiatric outpatients // Psychiatey Res. - 2004. - Vol. 129. - P. 257-265.Ritsher J.B., Phelan J.C. Inernalized stigma predict erosion of morale among psychiatric outpatients // Psychiatey Res. - 2004. - Vol. 129. - P. 257-265.Rosenfield S. Labelling mental illness: the effects of received services and perceived stigma on life satisfaction // Am. Sociol. Rev. - 1997. - Vol. 62. - P. 660-672.Rosenfield S. Labelling mental illness: the effects of received services and perceived stigma on life satisfaction // Am. Sociol. Rev. - 1997. - Vol. 62. - P. 660-672.Rusch N., Angermeyer M.C., Corrigan P.W. Mentall illness stigma: concepts, consequences, and initiatives to reduce stigma // Eur. Psychiatry. - 2005. - Vol. 20. - P. 529-539.Rusch N., Angermeyer M.C., Corrigan P.W. Mentall illness stigma: concepts, consequences, and initiatives to reduce stigma // Eur. Psychiatry. - 2005. - Vol. 20. - P. 529-539.Vauth R., Kleim B., Wirtz M., Corrigan P. Selfefficacy and empowerment as outcomes of self-stigmatizing and coping schizophrenia // Psychiatry Res. - 2007. - Vol. 150. - 71-80.Vauth R., Kleim B., Wirtz M., Corrigan P. Selfefficacy and empowerment as outcomes of self-stigmatizing and coping schizophrenia // Psychiatry Res. - 2007. - Vol. 150. - 71-80.Vogel D.L., Wade N.G., Haake S. Measuring selfstigma associated with seeking psychological help // J. Counseling Psychology. - 2006. - Vol. 53. - P. 325-337.Vogel D.L., Wade N.G., Haake S. Measuring selfstigma associated with seeking psychological help // J. Counseling Psychology. - 2006. - Vol. 53. - P. 325-337.Watson A.C., Corrigan P., Larson J.E., Sells M. Selfstigma in people with mental illness // Schizophr. Bull. - 2007. - Vol. 33. - P. 1312-1318.Watson A.C., Corrigan P., Larson J.E., Sells M. Selfstigma in people with mental illness // Schizophr. Bull. - 2007. - Vol. 33. - P. 1312-1318.West M.L., Vayshenker B., Rotter M., Yanos P.T. The influence of mental illness and criminality selfstigmas and racial self-concept on outcomes in a forensic psychiatric sample // Psychiatric Rehabilitation J. - 2015. - Vol. 38(2). - P. 150-157.West M.L., Vayshenker B., Rotter M., Yanos P.T. The influence of mental illness and criminality selfstigmas and racial self-concept on outcomes in a forensic psychiatric sample // Psychiatric Rehabilitation J. - 2015. - Vol. 38(2). - P. 150-157.Yanos P.T., Roe D., Markus K., Lysaker P.H. Pathways between internalized stigma and outcomes related to recovery in schizophrenia spectrum disorders // Psychiatry Services - 2008. - Vol. 59(12). - P. 1437-1442.Yanos P.T., Roe D., Markus K., Lysaker P.H. Pathways between internalized stigma and outcomes related to recovery in schizophrenia spectrum disorders // Psychiatry Services - 2008. - Vol. 59(12). - P. 1437-1442.

The authors declare that there are no conflicts of interest present.