DOI: 10.1097/jnr.0000000000000775 ISSN: 1948-965X

Influence of Sociodemographic Characteristics, Self-Esteem, and Quality of Life on Internalized Stigma in Patients With Schizophrenia: A Latent Profile Analysis

Hong LUO, Deng Ying BU, Yan Ling QIN, Yin Ling QIN, Jie CHEN
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Background:

The internalization of stigma in patients with schizophrenia is rising in prevalence and is associated with a worse prognosis. As tailored stigma-reduction interventions have been shown to improve outcomes in patients with this disorder, better understanding the profiles of internalized stigma and its associations may facilitate the development of targeted interventional programs for this patient population.

Purpose:

This study was developed to identify the profiles of internalized stigma and explore the influence of specific sociodemographic characteristics, self-esteem, and quality of life on this phenomenon in patients with schizophrenia in China.

Methods:

A hospital-based multicenter cross-sectional study was conducted involving 309 patients with schizophrenia from 6 psychiatric hospitals between April and September 2023. The participants voluntarily completed the Sociodemographic Questionnaire, Internalized Stigma of Mental Illness Scale, Schizophrenia Quality of Life Scale, and Rosenberg Self-Esteem Scale. Latent profile analysis was utilized to identify distinct internalized stigma profiles. Associations with the targeted variables were analyzed using univariate analysis and ordinal multicategorical logistic regression.

Results:

Three profiles were identified, including “low-internalized stigma” (profile 1, n =95, 30.7%), “medium-internalized stigma” (profile 2, n =183, 59.2%), and “high-internalized stigma” (profile 3, n =31, 10.0%). The results of the nonparametric Kruskal–Wallis H test showed significant differences in self-esteem and quality of life across the three profiles. Pairwise comparisons were further conducted using Dunn’s test with Holm adjustment, with significant intergroup differences observed for both self-esteem and quality of life. The results of ordinal multicategorical logistic regression analysis (using “low-internalized stigma” profile as the reference) revealed participants with lower levels of self-esteem ( B =−0.181, OR =0.834, 95% CI [.776, .897], p <.001) and quality of life ( B =−0.061, OR =0.941, 95% CI [.924, .958], p <.001) to be associated with a higher likelihood of “high-internalized stigma” profile classification.

Conclusions/Implications for Practice:

The results of this study support that internalized stigma in patients with schizophrenia exhibits significant intergroup heterogeneity, with self-esteem and quality of life serving as core differentiators and modifiable targets for practice. The three identified profiles provide a clear empirical basis for designing stratified, tailored stigma-reduction interventions.

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