Comparison of self-stigma and quality of life in patients with depressive disorders and schizophrenia spectrum disorders – a cross-sectional study

Figures & data

Table 1 Demographic and clinical characteristics of the patients with schizophrenia spectrum disorders and depressive disorders

Variable	All patients (n=183)	Schizoprenia spectrum disorders (n=103)	Depression (n=80)	Statistical comparison of schizophrenia spectrum disorders and depression
Age (years)	46.4±12.8	42.0±10.2	52.2±13.6	Unpaired t-test: t=5.77, df=180; P<0.0001
Gender (M:F)	62:121	41:62	21:59	Fisher’s exact test; ns
Age of disease onset (years)	33.1±13.5	26.1±9.0	42.4±12.9	Unpaired t-test: t=9.89, df=174; P<0.0001
Duration of the disorder (years)	13.3±10.0	15.4±9.5	10.5±10.1	Mann–Whitney test: U=2,469; P<0.0001
Number of hospitalizations	2.5±3.5	4.1±4.0	0.5±1.1	Mann–Whitney test: U=756; P<0.0001
Psychiatric heredity
Other disorder	53 (29)	39 (38)	14 (18)	Chi-square, df=10.4, 3; P<0.05
Same disorder	29 (16)	15 (15)	14 (18)
Without	94 (51)	47 (46)	47 (59)
Not completed	7 (4)	2 (2)	5 (6)
Education
Elementary	14 (8)	9 (9)	5	Chi-square, df=1.2, 3; ns
Vocational training	44 (24)	25 (24)	19
Secondary school	91 (50)	52 (51)	39
University	33 (18)	16 (16)	17
Not completed	1	1	–
Marital status
Single	71 (38.8)	61 (59.0)	11 (13.8)	Chi-square, df=39.2, 4; P<0.0001
Married	68 (37.2)	24 (23.1)	44 (56.0)
Divorced	35 (19.1)	15 (14.3)	20 (25.0)
Widowed	3 (1.6)	1 (0.9)	2 (2.5)
Not completed	6 (3.3)	3 (2.7)	3 (3.8)
Partner
No	89 (49)	66 (64)	23 (29)	Chi-square, df=22.8, 2; P<0.0001
Yes	88 (48)	34 (33)	54 (68)
Not completed	6 (3)	3 (3)	3 (4)
Employment
Yes	67 (37)	33 (32)	34 (42.5)	Chi-square, df=3.5, 1; ns (P=0.0599)
No	110 (60)	70 (68)	40 (50)
Not completed	6 (3)	–	6 (7.5)
objCGI severity	3.7±1.2	4.1±1.0	3.1±1.2	Mann–Whitney test: U=2,296; P<0.0001
subCGI severity	2.6±1.3	2.8±1.4	2.5±1.0	Mann–Whitney test: U=3,476; ns
objCGI–subCGI severity	1.1±1.3	1.4±1.4	0.7±1.0	Mann–Whitney test: U=2,572; P<0.0005
ISMI
Alienation	12.7±3.9	13.3±3.9	11.9±3.7	Unpaired t-test: t=2.5, df=179; P<0.05
Stereotype endorsement	13.1±3.3	14.0±3.4	12.0±2.7	Unpaired t-test: t=4.3, df=179; P<0.0001
Perceived discrimination	10.1±3.3	11.1±3.3	8.7±2.7	Mann–Whitney test: U=2,370; P<0.0001
Social withdrawal	12.4±3.9	13.0±3.8	11.6±3.8	Unpaired t-test: t=2.6, df=179; P<0.05
Stigma resistance	12.5±2.3	12.6±2.4	12.5±2.3	Unpaired t-test: t=0.4, df=179; ns
ISMI overall score	60.8±13.6	64.0±13.7	56.8±12.3	Unpaired t-test: t=3.7, df=179; P<0.0005
Q-LES-Q
Physical health (maximum 65p)	40.8±9.9	41.8±9.8	39.5±9.9	Unpaired t-test: t=1.6, df=181; ns
Feelings (maximum 70p)	47.1±10.6	46.3±10.6	48.0±10.6	Unpaired t-test: t=1.0, df=181; ns
Work (maximum 65p)	31.3±19.1	27.8±18.1	35.9±19.4	Mann–Whitney test: U=3,161; P<0.01
Household (maximum 50p)	35.8±9.5	35.0±9.0	36.8±10.0	Mann–Whitney test: U=3,486; ns
School/study (maximum 50p)	13.2±8.5	13.5±8.8	12.8±8.1	Mann–Whitney test: U=3,991; ns
Leisure (maximum 30p)	20.4±5.5	20.1±5.4	20.8±5.5	Unpaired t-test: t=0.8, df=181; ns
Social activities (maximum 55p)	36.0±9.2	35.7±9.2	36.5±9.1	Unpaired t-test: t=0.6, df=181; ns
General (max 80p)	51.2±11.9	51.5±12.1	50.8±11.8	Unpaired t-test: t=0.4, df=181; ns
Sum of Q-LES-Q (maximum 465p)	275.6±58.9	271.5±58.0	280.9±59.9	Unpaired t-test: t=1.1, df=181; ns
Sum of Q-LES-Q (%)	59.3±12.7	58.4±12.5	60.4±12.9	Unpaired t-test: t=1.1, df=181; ns

Note: Data presented as n (%) or mean ± standard deviation.

Abbreviations: F, female; ISMI, Internalized Stigma of Mental Illness Scale; M, male; ns, nonsignificant; objCGI, objective Clinical Global Impression; p, points; Q-LES-Q, Quality of Life Satisfaction and Enjoyment Questionnaire; subjCGI, subjective Clinical Global Impression.

Table 2 Partial correlations between demographic or clinical variables and quality of life in the whole sample after controlling for age

Domain	Age of onset of disorder	Duration of disorder	objCGI	subCGI	objCGI−subCGI	Number of hospitalizations
Physical health	0.14	−0.15	−0.32***	−0.54***	0.25**	0.06
Feelings	0.12	−0.13	−0.32***	−0.54***	0.25**	−0.06
Work	0.06	−0.40	−0.42***	−0.38***	−0.02	−0.24**
Household	0.07	−0.10	−0.36***	−0.48***	0.15	−0.16
School/study	−0.10	−0.01	−0.09	−0.08	−0.01	−0.05
Leisure	0.09	−0.11	−0.26**	−0.37***	0.13	−0.09
Social activities	0.10	−0.10	−0.28***	−0.37***	0.12	−0.09
General	0.13	−0.13	−0.37***	−0.52***	0.17*	−0.01
Sum of Q-LES-Q	0.12	−0.13	−0.48***	−0.60***	0.17*	−0.11

Notes: Statistically significant correlations (bold values), depending on the strength of correlation:

* P<0.05,

** P<0.01, or

*** P<0.001.

Abbreviations: objCGI, objective Clinical Global Impression; Q-LES-Q, Quality of Life Satisfaction and Enjoyment Questionnaire; subjCGI, subjective Clinical Global Impression.

Table 3 Average value of sum of Q-LES-Q (± standard deviation of each group/individual values) as a function of various demographic characteristics

Sex
Men (n=62)	263.9±58.1
Women (n=121)	281.6±58.6
	Unpaired t-test: t=1.9, df=181; ns (P=0.053)
Employment
No (n=108)	257.3±51.5
Yes (n=67)	307.4±57.6
	Unpaired t-test: t=6.1, df=181; P<0.0001
Having a partner
No (n=89)	270.2±57.7
Yes (n=94)	280.8±59.8
	Unpaired t-test: t=1.2, df=181; ns
Education
Elementary (n=14)	257.1±53.8
Vocational training (n=44)	273.3±52.7
Secondary school (n=91)	271.0±63.6
University (n=34)	298.7±50.5
	One-way ANOVA: F=2.5, df=182; ns (P=0.06)
Marital status
Single (n=71)	268.7±58.5
Married (n=68)	280.7±63.4
Divorced (n=35)	276.9±52.6
Widowed (n=3)	294.3±48.6
	One-way ANOVA: F=0.7, df=173; ns

Abbreviations: ANOVA, analysis of variance; ns, nonsignificant; Q-LES-Q, Quality of Life Satisfaction and Enjoyment Questionnaire.

Table 4 Partial correlations between self-stigma and its components measured by ISMI and demographic and clinical characteristics after controlling by the age

Demographic/clinical characteristics	Overall score	Alienation	Stereotype endorsement	Perceived discrimination	Social withdrawal	Stigma resistance
Onset of the disorder	−0.13	−0.13	−0.17*	−0.23**	−0.11	0.06
Duration of the disorder	0.16	0.16	0.20*	0.25**	0.13	−0.03
Number of hospitalizations	0.20*	0.18*	0.14	0.34***	0.20*	−0.09
objCGI-severity	0.32***	0.26**	0.25**	0.28***	0.30***	0.20*
subCGI-severity	0.50***	0.43***	0.42***	0.30***	0.48***	0.39***
objCGI−subCGI severity	−0.21*	−0.20*	−0.20*	−0.04	−0.21*	−0.22**

Notes: Statistically significant correlation (bold values):

* P<0.05;

** P<0.01;

*** P<0.001.

Abbreviations: ISMI, Internalized Stigma of Mental Illness Scale; objCGI, objective Clinical Global Impression; subjCGI, subjective Clinical Global Impression.

Table 5 Levels of self-stigma as measured by ISMI overall score in various demographic groups

	ISMI overall score
Sex
Men (n=62)	63.2±13.7
Women (n=119)	59.6±13.4
	Unpaired t-test: t=1.7, df=179; ns
Employment
No (n=108)	64.2±13.3
Yes (n=67)	56.2±12.7
	Unpaired t-test: t=3.9, df=173; P<0.001
Having a partner
No (n=87)	63.6±14.6
Yes (n=88)	59.0±12.0
	Unpaired t-test: t=2.3, df=173; P<0.05
Education
Elementary (n=14)	62.8±14.5
Vocational training (n=43)	61.1±13.9
Secondary school (n=90)	62.6±13.4
University (n=33)	55.0±12.3
	One-way ANOVA: F=2.7, df=179; P<0.05 Bonferroni’s multiple comparison test: secondary > university
Marital status
Single (n=71)	63.8±14.5
Married (n=68)	58.8±11.6
Divorced (n=33)	62.3±14.2
Widowed (n=3)	48.0±7.9
	One-way ANOVA: F=2.7, df=174; P<0.05 Bonferroni]s multiple comparison test: ns

Note: Data presented as mean ± standard deviation.

Abbreviations: ANOVA, analysis of variance; ISMI, Internalized Stigma of Mental Illness Scale; ns, nonsignificant.

Table 6 Partial correlations between Q-LES-Q subscales and components of ISMI in the whole sample after controlling by the age

Domain of Q-LES-Q	Overall score of ISMI	Alienation	Stereotype endorsement	Perceived discrimination	Social withdrawal	Stigma resistance
Physical health	−0.44***	−0.39***	−0.37***	−0.31***	−044***	−0.29***
Feelings	−0.56***	−0.50***	−0.48***	−0.37***	−0.50***	−0.37***
Work	−0.36***	−0.28***	−0.29***	−0.31***	−0.33***	−0.18*
Household	−0.41***	−0.34***	−0.35***	−0.28***	−0.35***	−0.30***
School/study	−0.11	−0.11	−0.06	−0.09	−0.08	−0.19*
Leisure	−0.30***	−0.30***	−0.23**	−0.20*	−0.29***	−0.20*
Social activities	−0.44***	−0.37***	−0.31***	−0.32***	−0.50***	−0.18*
General	−0.49***	−0.47***	−0.37***	−0.35***	−0.43***	−0.30***
Sum of Q-LES-Q	−0.56***	−0.49***	−0.45***	−0.41***	−0.52***	−0.35***

Notes: Statistically significant correlations (bold values):

* P<0.05.

** P<0.01.

*** P<0.001.

Abbreviations: ISMI, Internalized Stigma of Mental Illness Scale; Q-LES-Q, Quality of Life Satisfaction and Enjoyment Questionnaire.

Table 7 Multiple regression analysis with the sum of Q-LES-Q as a dependent variable weighted by age, and controlled for collinearity

Model	Regressors	B	SE	β	t	Significance
9	Employment	−31.179	7.794	−0.247	−4.001	0.000
	objCGI−subjCGI-severity score	−8.986	3.646	−0.176	−2.465	0.015
	Number of hospitalizations	1.765	1.034	0.107	1.707	0.090
	subjCGI-S	−21.938	3.779	−0.442	−5.806	0.000
	ISMI overall score	−1.695	0.302	−0.377	−5.618	0.000
	ANOVA: F=36.138, df=144; P<0.001; adjusted r^2=0.550

Abbreviations: ANOVA, analysis of variance; ISMI, Internalized Stigma of Mental Illness Scale; objCGI, objective Clinical Global Impression; Q-LES-Q, Quality of Life Satisfaction and Enjoyment Questionnaire; SE, standard error; subjCGI, subjective Clinical Global Impression; B, unstandardized regression coefficient; β, standardized regression coefficient; t, t statistic.