Original article Extent and predictors of stigma experienced by patients with schizophrenia P. S ´ witaj a, * , J. Wciórka a , J. Smolarska-S ´ witaj b , P. Grygiel c a I Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland b Department of Cardiology, Public Central Teaching Hospital, Banacha 1a, 02-097 Warsaw, Poland c Institute of Sociology, University of Rzeszów, Rejtana 16c, 35-959 Rzeszów, Poland Received 3 May 2009; received in revised form 19 June 2009; accepted 24 June 2009 Available online 20 August 2009 Abstract Background: Schizophrenia is regarded as one of the most stigmatized mental illnesses. Relatively few studies have investigated actual stigma experiences among people with schizophrenia and the factors which may contribute to it. Aims: This cross-sectional study assesses the extent of stigma experienced by patients with schizophrenia and attempts to establish its clinical and sociodemographic predictors. Methods: A total of 153 subjects with schizophrenia (62 outpatients and 91 inpatients) were evaluated with the use of the Stigma section of the Consumer Experiences of Stigma Questionnaire (CESQ) and several instruments measuring their subjective quality of life, social functioning and severity of psychiatric symptoms. Results: Stigmatization experiences were common among respondents who most frequently reported having concealed their illness (86%), witnessed others saying offensive things about the mentally ill (69%), worried about being viewed unfavorably (63%) and been treated as less competent (59%). Higher levels of stigma were related to lower subjective quality of life and younger age of illness onset. No significant associations were found between stigma and symptoms or level of social functioning. Conclusion: Our findings point at the reduced life satisfaction as a key aspect of the subjective experience of the stigma of schizophrenia. # 2009 Elsevier Masson SAS. All rights reserved. Keywords: Stigma; Schizophrenia; Mental illness; Quality of life; Social functioning; Symptoms 1. Introduction Social stigma has been identified as a main barrier to recovery and to social inclusion of people receiving psychiatric treatment [29]. Its deleterious consequences sometimes may be even more severe than the difficulties arising from the symptoms of the disease itself [26]. One of the most highly stigmatized mental disorders is schizophrenia, not only because of the potentially chronic and disabling course of the illness but also due to a variety of negative stereotypes associated with its diagnosis such as poor prognosis, dangerousness, unpredict- ability or incompetence [3,6]. Research indicates unequivo- cally that the stigma of schizophrenia is a common, transcultural phenomenon, present in both western and non- western societies [12]. Although in recent years the issue of mental illness stigma has met with growing interest among researchers, not all aspects of this problem have received the same amount of attention. In comparison to public opinion surveys, studies conducted among people with mental illness until recently have been significantly less frequent. What is more, most previous research on stigma among psychiatric patients has focused on perceived or anticipated stigmatization. These studies have demonstrated that individuals who expect being devalued and discriminated against are more likely to be unemployed and earn less income [13], fail to adhere to treatment [30], have restricted social networks [14], reduced self-esteem [16], compromised quality of life [25] and higher levels of demoralization and depression [13,17]. Much less is known about factors associated with the actual stigmatization experiences reported by people with mental European Psychiatry 24 (2009) 513–520 * Corresponding author. Tel.: +48 22 8424034; fax: +48 22 4582818. E-mail address: switaj@ipin.edu.pl (P. S ´ witaj). 0924-9338/$ – see front matter # 2009 Elsevier Masson SAS. All rights reserved. doi:10.1016/j.eurpsy.2009.06.003