四川精神卫生2025，Vol.38Issue(2)：172-177,6.DOI:10.11886/scjsws20240729002
精神分裂症患者内在病耻感与生活质量的关系:自尊及阴性症状严重程度的链式作用路径
Relationship between internalized stigma and quality of life in patients with schizophrenia::the chain mediating role of self-esteem and severity of negative symptoms
摘要
Abstract
Background Patients with schizophrenia experience low quality of life,and internalized stigma is considered an important indicator for quality of life,while the mediating role of self-esteem and severity of negative symptoms in the relationship between internalized stigma and quality of life remains underexplored.Objective To examine the mediating role of self-esteem and severity of negative symptoms in the relationship between internalized stigma and quality of life,so as to provide references for improving their quality of life.Methods A total of 342 patients with schizophrenia who were hospitalized in 6 hospitals in Xiangyang City,Siping City and Changchun City from April to September 2023 were included,and all of whom met the diagnostic criteria for schizophrenia according to the International Classification of Diseases,tenth edition(ICD-10).Internalized Stigma of Mental Illness Scale(ISMI),Schizophrenia Quality of Life Scale(SQLS),Self-Esteem Scale(SES)and negative symptom subscale of Positive and Negative Symptom Scale(PANSS)were administered to all patients.Spearman correlation analysis was adopted to determine correlations between the different scales.A structural equation modeling was constructed using Amos 28.0,and Bootstrap method was employed to verify the mediating effect of self-esteem and negative symptom severity in the association between internalized stigma and quality of life.Results A total of 309 patients(90.35%)completed questionnaires in this study.The ISMI score of schizophrenia patients was positively correlated with both SQLS score and the PANSS negative symptom subscale score(r=0.612,0.492,P<0.01),while was negatively correlated with SES score(r=-0.513,P<0.01).The SQLS score was negatively associated with the SES score(r=-0.555,P<0.01)and positively associated with PANSS negative symptom subscale score(r=0.672,P<0.01).The SES score was negatively correlated with PANSS negative symptom subscale score(r=-0.433,P<0.01).The total effect value of internalized stigma on quality of life was 0.746(95%CI:0.680～0.806).Self-esteem and severity of negative symptoms independently mediated the relationship between internalized stigma and quality of life,and the indirect effect values were 0.151(95%CI:0.062～0.254)and 0.126(95%CI:0.047～0.205),accounting for 20.24%and 16.89%of the total effect,respectively.In addition,a chained mediation effect of self-esteem and quality of life was also demonstrated,the indirect effect value was 0.102(95%CI:0.049～0.165),accounting for 13.67%of the total effect).Conclusion Internalized stigma in patients with schizophrenia patients can not only directly affect the quality of life,but also indirectly affect the quality of life of patients through either separate or chained mediation of self-esteem and the severity of negative symptoms.[Funded by Hubei Provincial Undergraduate Innovation and Entrepreneurship Project(number,S202410519027)]关键词
精神分裂症/生活质量/病耻感/自尊/阴性症状Key words
Schizophrenia/Quality of life/Stigma/Self-esteem/Negative symptoms分类
医药卫生引用本文复制引用
艾桂局,金铭,邵全明,刘燕妮,王仙珍,罗红..精神分裂症患者内在病耻感与生活质量的关系:自尊及阴性症状严重程度的链式作用路径[J].四川精神卫生,2025,38(2):172-177,6.基金项目
湖北省大学生创新创业项目(项目名称:精神分裂症患者症状体验的同期症状网络研究,项目编号:S202410519027) （项目名称:精神分裂症患者症状体验的同期症状网络研究,项目编号:S202410519027）
