title: Self-stigma, quality of life and schizophrenia: An outpatient clinic survey in Nigeria.
abstract: BACKGROUND
  Stigma is a major obstacle to the treatment and recovery of people with mental illness. In Nigeria, there is a dearth of information on internalization of stigma and its effect on treatment outcome measures such as quality of life.
  
  
  OBJECTIVE
  The aim of the study was to assess self-stigma among patients with schizophrenia attending a psychiatric hospital outpatient clinic, and the relationship of self-stigma to the socio-demographic, clinical characteristics and quality of life of the patients.
  
  
  METHODS
  Two hundred and fifty-six consecutive outpatient attendees of the Neuropsychiatric Hospital, Aro, Abeokuta in Nigeria with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnosis of schizophrenia were recruited for the study. The diagnosis of schizophrenia was established with the Structured Clinical Interview Schedule for DSM-IV Axis I disorder (SCID), while item 17 of the Present State Examination was used to ascertain the presence of insight into the illness. The subjects were interviewed with a socio-demographic questionnaire, the Internalized Stigma of Mental Illness (ISMI) scale, the Brief Psychiatric Rating Scale (BPRS) and the World Health Organization's Quality of Life (WHOQOL-Bref) questionnaire.
  
  
  RESULTS
  The mean age of the subjects was 39.5 (SD = 10.6) years with males constituting 52.0% of the sample. High self-stigma was found in 18.8% of the subjects. The socio-demographic and clinical correlates of high self-stigma found using univariate analysis were low educational level (χ(2) = 22.69, p < .001), unemployment (χ(2) = 15.9, p < .001), low income (χ(2) = 25.03, p < .001), source of income (χ(2) = 12.52, p = .007) and severity of psychopathology (t = 8.245, p < .001). High self-stigma was associated with poor quality of life in all the domains of WHOQOL-Bref.
  
  
  CONCLUSIONS
  This study revealed that self-stigma was common among subjects with schizophrenia. It is associated with poor treatment outcome, highlighting the need to incorporate stigma intervention strategies into mental health care delivery.
authors.affiliation: Department of Psychiatry, Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria temdad2@yahoo.com.
authors.forename: Temilola J
authors.initials: TJ
authors.lastname: Mosanya
authors.affiliation: Department of Psychiatry, Ladoke Akintola University Teaching Hospital, Ogbomoso, Nigeria.
authors.forename: Adegoke O
authors.initials: AO
authors.lastname: Adelufosi
authors.affiliation: Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria.
authors.forename: Olaolu T
authors.initials: OT
authors.lastname: Adebowale
authors.affiliation: Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria.
authors.forename: Adegboyega
authors.initials: A
authors.lastname: Ogunwale
authors.affiliation: Department of Psychiatry, Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria.
authors.forename: Olaide K
authors.initials: OK
authors.lastname: Adebayo
mesh_terms: D000293:Adolescent; D000328:Adult; D010054:Brief Psychiatric Rating Scale; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D010044:Outpatient Clinics, Hospital; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D012649:Self Concept; D057545:Social Stigma; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Self-stigma; quality of life; schizophrenia