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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this paper the similarities between normal and abnormal behaviour are emphasized and selected aspects of communication, normal and aberrant, between persons are explored. Communication in a social system may be verbal or non-verbal: one person's actions cause a response in another person. This response may be cognitive, behavioural or physiological. Communication may be approached through the individual, the social situation or social interaction. Psychoanalysis approaches the individual in terms of the coded communications of psychoneurotic symptoms or psychotic behaviour; the humanist-existential approach is concerned more with emotional expression. Both approaches emphasize the development of individual identity. The interaction between persons and their social background is stressed. Relevant are sociological concepts such as illness behaviour, stigma, labelling, institutionalization and compliance. Two approaches to social interactions are considered: the gamesplaying metaphor, e.g. back pain as a psychosocial manipulation--the 'pain game'; and the 'spiral of reciprocal perspectives' which emphasizes the interactional complexities of social perceptions. Communicatory aspects of psychological treatments are noted: learning a particular metaphor such as 'resolution' of the problem (psychotherapy), learning more 'rewarding' behaviour (learning theory) or learning authenticity or self-actualization (humanist-existential).
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PMID:Communication and abnormal behaviour. 26 53

From the present study several important observations may be made. It has been observed that illiterate and poor people with agricultural background are increasingly becoming more aware of the availability of psychiatric treatment facilities. Acceptance of treatment offered by mental hospital is greater in spite of prejudice and stigma against mental diseases. Chances of availing treatment facilities for mental diseases were better in cases of educated, economically independent and non-agricultural workers than the illiterate, economically dependant and agricultural workers. Women are not having equal opportunity for treatment facilities though they suffer from psychotic disorders equally as men; this reflects the present socio-cultural attitudes. Age pattern of patients suffering from mental diseases in this country was different from western countries. Duration of stay in the hospital and rate of improvement were comparable to other centres.
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PMID:A review of 5153 treated psychiatric patients--a five year retrospective study. 61 82

Primary care physicians in the tri-state area of Nebraska, Iowa and South Dakota were surveyed concerning their baseline practices in requesting psychiatric consultations, and their recommendations for improvement in psychiatric consultation. A two-page questionnaire was used to collect data. The information obtained was analyzed by tetrachoric correlations. Our results indicate that most primary care physicians refer patients to psychiatrists and prescribe psychotropic medications. It was generally noted that the respondents do not do psychotherapy themselves. In contrast to studies from other areas, our research showed that the symptoms which prompted psychiatric referral the most are psychosis and depression. Suggestions for improvement in psychiatric consultations included that psychiatrists need to be more available to the primary care practitioner. It was also indicated that financial constraints, social stigma and psychiatric shortage were problems in referral of patients to psychiatrists.
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PMID:Use of adult psychiatric services by primary care physicians in midwestern cities. 231 13

Extremes in mood, thought and behavior--including psychosis--have been linked with artistic creativity for as long as man has observed and written about those who write, paint, sculpt or compose. The history of this long and fascinating association, as well as speculations about its reasons for being, have been discussed by several modern authors and investigators, including Koestler (1975), Storr (1976), Andreasen (1978), Becker (1978), Rothenberg (1979), Richards (1981), Jamison (in press) and Prentky (in press). The association between extreme states of emotion and mind and creativity not only is fascinating but also has significant theoretical, clinical, literary and societal-ethical implications. These issues, more thoroughly reviewed elsewhere (Jamison et al. 1980; Richards 1981; Jamison, in press), include the understanding of cognitive, perceptual, mood and behavioral changes common to manic, depressive and creative states; the potential ability to lessen the stigma of mental illness; effects of psychiatric treatment (for example, lithium) on creativity; and concerns raised about genetic research on mood disorders. The current study was designed to ascertain rates of treatment for affective illness in a sample of eminent British writers and artists; to study differences in subgroups (poets, novelists, playwrights, biographers, artists); to examine seasonal patterns of moods and productivity; and to inquire into the perceived role of very intense moods in the writers' and artists' work. One of the major purposes of this investigation was to look at possible similarities and dissimilarities between periods of intense creative activity and hypomania. Hypothesized similarities were based on the overlapping nature of mood, cognitive and behavioral changes associated with both; the episodic nature of both; and possible links between the durational, frequency and seasonal patterns of both experiences.
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PMID:Mood disorders and patterns of creativity in British writers and artists. 273 15

National admission statistics by diagnosis since 1970, were available from seven WHO member countries. All had officially introduced the ICD 8, but only two countries strictly adhered to the ICD categories in practice. The new 3-digit category 298 (Other psychosis) has met with no success, nor did the new subgroups of schizophrenia with a favourable outcome (295.4, 295.5 and 295.7) gain much acceptance. The discrepancy in diagnostic distribution is virtually unchanged from that before 1970 with a persistent wide concept of schizophrenia in U.S.A. and of depressive illness in England. A new feature is the striking increase in non-psychotic admissions at a time when there is a marked decline in the hospital population. This is taken to indicate that the social stigma attached to the term psychosis persists, and is met with evasion. A preference for unspecified terms (fourth digit 9) is evident, as is the use of terms which leave open whether the patient is psychotic or not (311 in ICD 9). Evidently, instruction in the use of the WHO glossary is called for. In the U.S.A. the replacement of the ICD by the local classification DSM-III is likely to accelerate the reluctance to accept international standards. Moreover, the development of local diagnostic systems for research purposes in England and U.S.A. is not without problems, as there is a disturbing lack of consensus in diagnosis between these two national systems. Obviously, we need the ICD with its clear concepts, and above all the ICD is valuable for securing continuity in diagnostic classification.
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PMID:Persistent discrepancy in international diagnostic practice since 1970. 666 46

Successful outpatient treatment of schizophrenic disorders largely depends on the patient's ability to form a treatment alliance with mental health professionals. However, even in the context of competent pharmacotherapy, symptoms of schizophrenia often persist under this alliance. The authors review five common syndromes occurring during the course of treatment of patients with schizophrenia that interfere with the therapeutic alliance: paranoia, denial of illness, stigma, demoralization, and terror from awareness of having psychotic symptoms. Mental health clinicians can use specific psychotherapeutic management techniques for these symptoms. Examples of these techniques include "sharing mistrust" for paranoid patients, providing patients who deny their illness with alternate points of view, making admiring and approving statements to demoralized patients, and normalizing experiences of stigmatized patients. The techniques do not require advanced psychotherapy training and can be used, with ongoing supervision, by bachelor's-level mental health workers.
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PMID:Psychotherapeutic management techniques in the treatment of outpatients with schizophrenia. 798 32

Recent literature on insight has paid little attention to patients' social backgrounds and cultures. Discharge summaries from 357 patients with a psychotic illness were examined to investigate factors associated with insight. A highly significant association was found between British white ethnic origin and being thought by the admitting psychiatrist to have some insight. Possible explanations include: different ways of understanding mental illness in different cultures, greater stigma leading to greater denial of illness in some cultures, greater illness severity at admission in some ethnic groups and racial bias in psychiatrists' ratings.
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PMID:Insight, psychosis and ethnicity: a case-note study. 887 40

Building on modified labeling theory, I examine the relationships between stigma, psychological well-being, and life satisfaction among persons with mental illness. The study uses longitudinal data from 610 individuals in self-help groups and outpatient treatment. Results from cross-sectional and lagged regression models show adverse effects of stigma on the outcomes considered. However, much of the effects of anticipated rejection are due to discriminatory experiences. The results also indicate that stigma is related to depressive-anxiety types of symptoms but not psychotic symptoms. Although the findings show that the negative effect of stigma on life satisfaction is partly mediated by self-concept, reciprocal effects models indicate that the relationship between self-concept and life satisfaction is bi-directional. The study suggests ways in which stigma processes need to be explored in greater detail.
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PMID:The effects of stigma on the psychological well-being and life satisfaction of persons with mental illness. 991 55

Schizophrenia is one of the most researched, yet still one of the least understood, of the mental disorders. One key area that remains comparatively neglected is the fact that schizophrenia typically develops at late adolescence. In common with people with psychotic disorders, around 25% of normal teenagers also report finding adolescence very distressing, and a substantial empirical literature shows that certain characteristics typical of adolescence such as conflicted family relationships, grandiosity, egocentrism, and magical ideation bear a distinct resemblance to phenomena seen in psychotic disorders. Indeed, such phenomena, as might be judged prodromal or symptomatic in first-onset schizophrenia, have been shown to be remarkably common in normal adolescents, generally in about 50% of samples. Furthermore, prodromal-like signs in normal adolescents appear to be functionally linked to psychological development. For most adolescents, such phenomena pass with successful psychological development. It is proposed that psychosis in late adolescence is a consequence of severe disruption in this normally difficult psychological maturational process in vulnerable individuals, and explanations are offered as to why and how this comes about. It is suggested that problems either in reaching psychological maturity with regard to parents or in bonding to peers or both, may lead to crucial self-construction difficulties, and that psychosis emerges out of such "blocked adolescence." This approach proposes therapeutic interventions that enable professional services to side with both parents and clients simultaneously, and is normalizing and stigma-free.
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PMID:Why does schizophrenia develop at late adolescence? 1129 67

Suicide and suicide attempts occur at a significantly greater rate in schizophrenia than in the general population. Common estimates are that 10% of people with schizophrenia will eventually have a completed suicide, and that attempts are made at two to five times that rate. Demographically associated with suicidality in schizophrenia are being young, being early in the course of the illness, being male, coming from a high socioeconomic family background, having high intelligence, having high expectations, not being married, lacking social supports, having awareness of symptoms, and being recently discharged from the hospital. Also associated are reduced self-esteem, stigma, recent loss or stress, hopelessness, isolation, treatment non-compliance and substance abuse. Clinically, the most common correlates of suicidality in schizophrenia are depressive symptoms and the depressive syndrome, although severe psychotic and panic-like symptoms may contribute as well. This review specifically explores the issue of depression in schizophrenia, in relation to suicide, by organizing the differential diagnosis of this state and highlighting their potentially treatable or correctable causes. This differential diagnosis includes both acute and chronic disappointment reactions, the prodrome of an acute psychotic episode, neuroleptic induced akinesia and akathisia, the possibility of direct neuroleptic-induced depression, negative symptoms of schizophrenia, and the possible co-occurrence of an independent depressive diathesis. The potential beneficial roles of 'atypical' antipsychotic agents, including both clozapine and more novel agents, and adjunctive treatment with other psychopharmacological medications are considered, and the important roles of psychosocial factors and interventions are recognized.
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PMID:Suicide and schizophrenia. 1144 86


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