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

Psychiatrists' attitudes and knowledge about antipsychotic long-acting injections (LAIs) are important given the increasing emphasis on patient choice in treatment and the availability of second-generation antipsychotic (SGA) LAIs. A cross-sectional study of consultant psychiatrists' attitudes and knowledge in North West England was carried out. A pre-existing questionnaire on clinicians' attitudes and knowledge regarding LAIs was updated. Of 102 participants, 50% reported a decrease in their use of LAIs. LAI prescribing was evenly split between first-generation antipsychotic (FGA) and SGA-LAIs. Most regarded LAIs as associated with better adherence (89%) than tablets. A substantial proportion believed that LAIs could not be used in first-episode psychosis (38%) and that patients always preferred tablets (33%). Compared with a previous sample, the current participants scored more favourably on a patient-centred attitude subscale (60.4% vs 63.5%, P = 0.034) and significantly fewer regarded LAIs as being stigmatising and old-fashioned. Reported LAI prescribing rates have decreased in the last 5 years despite an SGA-LAI becoming available and most clinicians regarding LAIs as effective. Most attitudes and knowledge have remained stable although concerns about stigma with LAI use have decreased. Concerns about patient acceptance continue as do negative views about some aspects of LAI use; these may compromise medication choices offered to patients.
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PMID:Psychiatrists' use, knowledge and attitudes to first- and second-generation antipsychotic long-acting injections: comparisons over 5 years. 1947 83

This article investigates the subjective experience of stigma attached to schizophrenia-related disorders. We examine data from anthropological interviews from a community sample of 90 out-patients residing in a metropolitan area of the United States. Patients were under treatment with atypical antipsychotic medication, and their symptoms were for the most part relatively well controlled. Overall, 96% of participants reported an awareness of stigma that permeated their daily life. Based on an understanding of stigma as a product of interpersonal, reciprocal social processes, we identify 6 types of social relations and 5 identity domains in which social stigma is routinely encountered by participants. We describe the experience of stigma in each of these 11 subcategories, and suggest that taken together they constitute a framework of social and personal factors involved in the struggle to recover from psychotic illness. Among types of social relations, anonymous social interactions most commonly generated an awareness of stigma. Among identity domains, being a person who regularly takes medication was most commonly associated with an awareness of stigma. The finding that multiple forms of stigma are encountered irrespective of substantial symptomatic, functional, and subjectively perceived improvement creates a complex situation of stigma despite recovery.
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PMID:Awareness of stigma among persons with schizophrenia: marking the contexts of lived experience. 1959 60

This study builds on existing research investigating the stigma-reducing strategies specific to rehabilitation service providers by comparing differences in education levels and degree of contact among rehabilitation service providers. Rehabilitation service providers with master's level and bachelor level education showed significant differences in their stigmatizing tendencies on subscales of controllability and stability for different categories of disabilities. Specifically, service providers with a master's degree had more stigmatizing beliefs for psychosis and cocaine addiction, compared with service providers with a bachelor's degree. Service providers with either a bachelor's degree or master's degree reported lower levels of stigma overall for five of the six categories of disability compared with their community college student counterparts. No differences were found for length of time working with persons with psychiatric disabilities.
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PMID:Using attribution theory to examine community rehabilitation provider stigma. 1964 2

During the past several decades, neuropsychiatric agents have been one of the fastest growing classes of medicinal agents. This expansion is in part due to the increased recognition of the prevalence and burden of illness associated with disparate neuropsychiatric disorders, increased public awareness and possibly reduced stigma associated with mental illness, as well as extensive marketing of neuropsychiatric agents to healthcare providers. Most of the agents reviewed herein represent modifications and/or refinements of pre-existing agents and/or theoretical approaches (e.g., monoamine hypothesis). There remains a relative paucity of agents with genuinely novel mechanisms targeting effector systems implicated in contemporary models of disease pathophysiology in mood and psychotic disorders (e.g., glutamate, insulin, brain derived neurotrophic factor and other growth factors, immunoinflammatory systems and oxidative stress).
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PMID:Discontinued psychiatric drugs in 2008. 1971 45

Early intervention (EI) programs in schizophrenia and other psychoses are aimed at early detection (ED) of the disease; prevent conversion to manifested psychosis and phase-specific treatment to reduce development of chronic disabilities. EI strategies include targeting people at "high risk" for developing schizophrenia, intervening in prodromal phase of schizophrenia, and reducing the "duration of untreated psychosis" (DUP). Services are delivered by a specialized team and are usually resource intensive. Several strategies like treatment with antipsychotics, family interventions, and cognitive behavior therapy have been tried with modest success in prodromal patients. Significant ethical reservations exist regarding exposing prodromal patients to the stigma of labeling as "high risk for schizophrenia" and side effects of psychotropics in the absence of clear evidence of efficacy in favor of ED, intervention by specialist teams, and phase-specific interventions in prodrome of psychosis. More research is warranted to demonstrate the risk-benefit and cost-benefit of such interventions before these can be routinely recommended.
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PMID:Early intervention in schizophrenia. 1974 27

The symptoms and the individual experience of psychosis vary from patient to patient. Treatment, medication and cognitive psychotherapy are targeted mostly on positive and lately also on negative symptoms of psychosis. Deficits in metacognition found in patients with psychosis have a profound impact on the recovery process, their quality of life and experience of mental pain. Long term group psychotherapy helps patients to mourn their loss, improve their metacognition, and reduce the stigma and mental pain in patients with psychosis.
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PMID:Therapy and quality of life of patients with psychosis. 1978 2

Psychosis is the most traumatic mental illness influencing both sufferers and their families' quality of life, because of the symptoms and the social stigma. A delay in the recognition of fi rst episode psychosis is unfortunately common being often associated with social functioning decline and worse prognosis. Early detection and intervention could potentially alter the course of this serious illness. We reviewed evidence from the literature on the most recent examples of early intervention in psychosis and on its effectiveness in delaying transition to psychosis, reducing the duration of untreated psychosis, the admission rates, the suicide rates, the treatment costs, as well as preventing relapses and improving the short and long-term symptomatic and functional outcome. The morbidity and mortality associated with schizophrenia spectrum may be improved by a multidisciplinary approach, involving the School, the Primary care and the Information in order to detect as soon as possible the prodromal feelings associated with early psycho-sis. General practitioners are indeed ideally placed to identify mental and emotional changes in the emerging psychotic illnesses and could bridge the gap between specialist mental health services, patients and their families. These are the reasons why mental health should be demanding commitment for both psychiatrists and primary care.
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PMID:[Teaching how to ask for help: social sensitiveness and early intervention in psychosis]. 1979 88

Long-acting injections of antipsychotic medication (or depots) were developed specifically to promote treatment adherence and are a valuable option for maintenance medication in psychotic illnesses. Approximately 40-60% of patients with schizophrenia are partially or totally non-adherent to their antipsychotic regimen, but only 30% or less are prescribed a long-acting injection. The use of such injections has declined in recent years after the introduction of second-generation (atypical) oral antipsychotic drugs. Research shows that possible reasons for this decline include concerns that may be based on suboptimal knowledge, as well as an erroneous assumption that one's own patient group is more adherent than those of one's colleagues. Research on attitudes has also revealed that psychiatrists feel that long-acting injections have an ;image' problem. This editorial addresses the gaps in knowledge and behaviour associated with possible underutilisation of these formulations, highlighting the role of stigma and the need for more research.
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PMID:Antipsychotic long-acting injections: mind the gap. 1988 Sep 11

Around 0.7% of the population have schizophrenia. This serious psychotic disorder affects psychological and social functioning, and diagnosis can lead to stigma. Pharmacological interventions are a key element in management, but are sometimes ineffective and nearly half of patients do not adhere to drug treatment. Cognitive behavioural therapy (CBT) is now being used as adjunctive treatment in the management of patients with schizophrenia. Here we consider this approach.
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PMID:Cognitive behavioural therapy for schizophrenia. 2004 May 67

Romantic relationships are of particular importance to young people, and play a key role in the transition from adolescence to adulthood. Psychosis typically develops during late adolescence or early adulthood, a crucial period for gaining romantic experience. The significance of these relationships for young people with psychosis has never been explored. Eight participants were interviewed about their experiences and perceptions of romantic relationships using a semi-structured interview. The research was conducted using Interpretative Phenomenological Analysis (IPA). Five overarching themes emerged, suggesting that participants experienced conflict regarding romantic relationships, as they considered such relationships incompatible with psychosis, whilst they also associated them with normality and recovery. Relationships were perceived to be "risky", and participants were concerned with strategies for reducing these risks. Respondents typically perceived themselves to have a relative lack of experience and resources, making it more difficult for them to engage in romantic relationships. As romantic relationships are associated with a range of personal and social benefits, young people who have experienced psychosis may benefit from services supporting them in negotiating stigma and facilitating their involvement in romantic relationships.
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PMID:The personal meaning of romantic relationships for young people with psychosis. 2010 64


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