Interventions for reducing self-stigma in people with mental illnesses: a systematic review of randomized controlled trials

GMS German Medical Science

Messer, Melanie¹  Büchter, Roland Brian² 

[1] Faculty for Health Sciences, Health Services Research and Nursing Science, University of Bielefeld, Germany;Institute for Quality and Efficacy in Health Care (IQWiG), Cologne, Germany;

关键词: stigma;    mental illness;    systematic review;    anti-stigma interventions;    anti-stigma booklet;   

DOI  :  10.3205/000248

来源: DOAJ

【 摘 要 】

Background: Self-stigma occurs when people with mental illnesses internalize negative stereotypes and prejudices about their condition. It can reduce help-seeking behaviour and treatment adherence. The effectiveness of interventions aimed at reducing self-stigma in people with mental illness is systematically reviewed. Results are discussed in the context of a logic model of the broader social context of mental illness stigma. Methods: Medline, Embase, PsycINFO, ERIC, and CENTRAL were searched for randomized controlled trials in November 2013. Studies were assessed with the Cochrane risk of bias tool.Results: Five trials were eligible for inclusion, four of which provided data for statistical analyses. Four studies had a high risk of bias. The quality of evidence was very low for each set of interventions and outcomes. The interventions studied included various group based anti-stigma interventions and an anti-stigma booklet. The intensity and fidelity of most interventions was high. Two studies were considered to be sufficiently homogeneous to be pooled for the outcome self-stigma. The meta-analysis did not find a statistically significant effectat 3 months: –0.26 [–0.64, 0.12], I=0%, n=108). None of the individual studies found sustainable effects on other outcomes, including recovery, help-seeking behaviour and self-stigma.Conclusions: The effectiveness of interventions against self-stigma is uncertain. Previous studies lacked statistical power, used questionable outcome measures and had a high risk of bias. Future studies should be based on robust methods and consider practical implications regarding intervention development (relevance, implementability, and placement in routine services).

【 授权许可】

Unknown