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Psychiatry Res. 2016 Jun 30;240:253-259. doi: 10.1016/j.psychres.2016.04.035. Epub 2016 Apr 29.

Internalized stigma of mental illness and depressive and psychotic symptoms in homeless veterans over 6 months.

Author information

1
Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA; Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA. Electronic address: jennifer.boyd@va.gov.
2
Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA; Department of Clinical Psychology, California School of Professional Psychology, Alliant International University, San Francisco, CA, USA.
3
Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA.
4
Departments of Psychiatry and Epidemiology, VA North East Program Evaluation Center and Yale School of Medicine, New Haven, CT, USA.

Abstract

We investigated the relationship between internalized stigma of mental illness at baseline and depressive and psychotic symptoms 3 and 6 months later, controlling for baseline symptoms. Data on homeless veterans with severe mental illness (SMI) were provided by the Northeast Program Evaluation Center (NEPEC) Special Needs-Chronic Mental Illness (SN-CMI) study (Kasprow and Rosenheck, 2008). The study used the Internalized Stigma of Mental Illness (ISMI) scale to measure internalized stigma at baseline and the Symptom Checklist-90-R (SCL-90-R) to measure depressive and psychotic symptoms at baseline and 3 and 6 month follow-ups. Higher levels of internalized stigma were associated with greater levels of depressive and psychotic symptoms 3 and 6 months later, even controlling for symptoms at baseline. Alienation and Discrimination Experience were the subscales most strongly associated with symptoms. Exploratory analyses of individual items yielded further insight into characteristics of potentially successful interventions that could be studied. Overall, our findings show that homeless veterans with SMI experiencing higher levels of internalized stigma are likely to experience more depression and psychosis over time. This quasi-experimental study replicates and extends findings of other studies and has implications for future controlled research into the potential long-term effects of anti-stigma interventions on mental health recovery.

KEYWORDS:

Depression; Internalized stigma of mental illness; Psychosis; Veterans

PMID:
27138814
DOI:
10.1016/j.psychres.2016.04.035
[Indexed for MEDLINE]

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