Suchergebnisse

Background: While there are some indications that the mental health literacy of the public has improved within recent years, the findings concerning its attitudes towards the mentally ill are quite inconsistent. Aims: The aim of this study is to examine whether any changes have taken place inGermany over the last decade regarding the stigmatisation ofmentally ill people. Method: In 2001, a representative population survey was carried out among the German adult population, using the same sampling procedure and the same measure for the assessment of perceived stigma as in a previous survey that had been conducted in 1990. Results: Our findings suggest that in 2001, the German public was somewhat less inclined to believe that former mental patients are exposed to stigmatisation than a decade ago. While this holds especially true for the devaluation of patients, the picture is more mixed for discrimination. The trend towards less perceived stigmatisation is particularly pronounced among people who are familiar with psychiatric treatment. Conclusions: Since a substantial amount of perceived stigma still persists, further efforts to reduce the stigma attached to mental illness are needed.

<b><i>Background:</i></b> Alcohol dependence is among the most severely stigmatized mental disorders. We examine whether negative stereotypes and illness beliefs related to alcohol dependence have changed between 1990 and 2011. <b><i>Methods:</i></b> We used data from two population surveys with identical methodology that were conducted among German citizens aged ≥18 years, living in the 'old' German states. They were conducted in 1990 and 2011, respectively. In random subsamples (1990: n = 1,022, and 2011: n = 1,167), identical questions elicited agreement with statements regarding alcohol dependence, particularly with regard to the illness definition of alcohol dependence and blame. <b><i>Results:</i></b> Overall, agreement with negative stereotypes did not change in the course of 2 decades. About 55% of the respondents agreed that alcohol dependence is an illness like any other, >40% stated that it was a weakness of character and 30% endorsed that those affected are themselves to blame for their problems. <b><i>Conclusions:</i></b> It is apparent that promoting an illness concept of alcohol dependence has not been an easy solution to the problem of stigma. We discuss how the normative functions of alcohol dependence stigma might have prevented a reduction of negative stereotypes.

Aims: Several studies have found an inverse relationship between people's readiness to endorse biogenetic causal explanations of mental disorder and their desire for social distance from people with mental disorders. The aim of this study is to examine why this may be the case. Method: In the spring of 2001, a population survey was carried out among German citizens aged 18 years and older, living in private households. A total of 5025 interviews were conducted, reflecting a response rate of 65.1%. At the beginning of the personal, fully structured interview, respondents were presented with a vignette containing a diagnostically unlabelled psychiatric case history, either depicting a case of schizophrenia or major depressive disorder. Using five-point Likert scales, causal attributions as well as perceived dangerousness, fear and the desire for social distance were assessed. Results: The more respondents endorse a brain disease as a cause, the more dangerous they believe the person with schizophrenia or major depression to be. Respondents who perceive the individual in the vignette as being dangerous express a higher degree of fear and a greater preference for social distance from these individuals. As compared with brain disease, the relationships between heredity and perceived dangerousness are less pronounced for both disorders. Conclusions: Our analysis showed that endorsing biogenetic explanations decreases the likelihood of social acceptance of people with schizophrenia and major depression. Rejecting behavioural responses in the form of social distance desired from people with schizophrenia and major depression result from cognitive emotional processes in which biogenetic causal attributions are linked to lack of self-control, unpredictability and dangerousness, which, in turn, are associated with fear of these people.

Based on the observation that the course of schizophrenia appears to be more unfavourable in men than in women, we examined whether male sufferers are exposed to more negative and less positive emotional reactions and are met with a greater amount of rejection by their environment than their female counterparts. Data from a representative survey conducted in the 'old' Federal Republic of Germany during 1990 did not yield the expected gender difference with regard to emotional reactions. There were, however, some gender differences on the side of the respondents: Women expressed more feelings of anxiety and tended to show more prosocial reactions. Social distance tended to be slightly more pronounced towards men than towards women. This applied to both schizophrenia and alcoholism. The gender of the respondents, on the other hand, was of no importance for social distance.

Background and Aims: The purpose is to highlight the legal and ethical principles that inspired the reform of mental health care in Italy, the only country to have closed its psychiatric hospitals. The article will also try to verify some macro-indicators of the quality of care and discuss the crisis that the mental health care system in Italy is experiencing. Methods: Narrative review. Results: The principal changes in the legislation on mental health care in Italy assumed an important role in the evolution of morals and common sense of the civil society of that country. We describe three critical points: first, the differences in implementation in the different Italian regions; second, the progressive lack of resources that cannot be totally attributed to the economic crisis and which has compromised application of the law; and finally, the scarce attention given to measurement of change with scientific methods. Conclusion: Italy created a revolutionary approach to mental health care in a historical framework in which it produced impressive cultural expressions in many fields. At that time, people were accustomed to 'believing and doing' rather than questioning results and producing research, and this led to underestimating the importance of a scientific approach. With its economic and cultural crisis, Italy has lost creativity as well as interest in mental health, which has been guiltily neglected. Any future humanitarian approach to mental health must take the Italian experience into account, but must not forget that verification is the basis for any transformation in health care culture.

Background: There are studies that either deal with the stigmatization patients anticipate or with patients' concrete stigmatization experiences. Up until now, however, research is short of studies that investigate both aspects of subjective stigmatization simultaneously. Aims: This study aims at investigating to what extent patients with schizophrenia or depression anticipate and experience stigmatization and how this is influenced by the type of mental disorder and the social environment. Method: A total of 210 patients with schizophrenia or a depressive episode were interviewed, one half living in a city and the other in a small town. Results: Most of the patients expect negative reactions from the environment, particularly as concerns the access to work. Concrete stigmatization experiences were most frequently reported in the domain of interpersonal interaction. Even though schizophrenia patients and patients with depression anticipated stigmatization similarly frequently, the former reported concrete stigmatization experiences more frequently than the latter. Conversely, patients living in a small town anticipated stigmatization more frequently than patients from the city, even though both had actually experienced stigmatization at a similar rate. Conclusion: The results underline the necessity to differentiate between anticipated and experienced stigmatization. This is highly relevant for planning interventions aimed at reducing the stigma of mental disorder.

The aim of the study is to explore what schizophrenic patients understand by quality of life and what psychiatrists think quality of life may be like for schizophrenic patients. A survey was carried out among schizophrenic patients and psychiatrists from the whole of Germany. There are similarities and differences between the two: while both schizophrenic patients and psychiatrists recognised the importance of work, social relationships, family and independence for quality of life, patients thought about it more in terms of standard of living and lifestyle, whereas the psychiatrists' concept of quality of life was more illness-oriented encompassing the absence of handicaps and disabilities due to the illness and emphasising the importance of appropriate professional help and self-help. In order to facilitate the dialogue between psychiatrists and patients it is important to be aware of these differences.

Background: Spouses of people with mental disorder experience various forms of objective and subjective burden. This should negatively affect their quality of life. However, until now no single study has addressed this question. Aims: To investigate the quality of life of spouses of people with schizophrenia, depression or anxiety disorders. Method: Spouses of patients suffering from schizophrenia (n 1/4 45), depression (n 1/4 49) and anxiety disorders (n 1/4 39) were consecutively recruited from out-patient services in the city of Leipzig. Quality of life was assessed by means of the WHOQOL-BREF, a self-administered questionnaire developed by the World Health Organisation. Results: Compared with the general population, the quality of life of the spouses of mentally ill people was lower in the domains 'psychological well-being' and 'social relationships'. There was a significant association between the patient's functional level and the spouse's quality of life. Conclusions: Better treatment, professional support and participation in self-help and advocacy groups may help to improve the quality of life of spouses of mentally ill people.