The Effect of Psychosocial Rehabilitation on Perceived Stigma among Patients with Schizophrenia in Kelantan, Malaysia

Background: Schizophrenia is a chronic mental illness which is highly related with stigma and discrimination. Sociodemographic and clinical factors are among the predictive factors of perceived stigma. Psychosocial rehabilitation plays a role in reducing the perceived stigma among patients with schizophrenia. Objectives: This study is aimed to compare the perceived stigma level in patients with schizophrenia who attended psychosocial rehabilitation with patients who did not attend psychosocial rehabilitation in Kelantan and its predictive factors. Designs: A comparative cross-sectional study was conducted between two groups of schizophrenia patients who received psychosocial rehabilitation and those who did not. Materials and Methods: The Devaluation-Discrimination Scale (DDS) Malay Version self-report questionnaire was completed by 70 participants in each group. All participants (n = 140) also were rated by interviewer with the Brief Psychiatric Rating Scale-Extended version (BPRS-E). Results: The mean score of perceived stigma in schizophrenia patients who attended psychosocial rehabilitation was 2.40 (SD = 0.39) and in those who did not attend was 2.73 (SD = 0.39). The mean difference score of perceived stigma between the two groups was .335 (95% CI .204, .465) with p-value < 0.001. Simple linear regression was used to explore the predictive factors for stigma in patients with schizophrenia. The variables with p-value < 0.25 or clinically important were selected for multivariable analysis. Multiple linear regression was proceeded and revealed that the significant predictive factors were ethnic (p < .005), somatic concern (p < .05) and depression (p < .001). Conclusions: Ethnic, somatic concern and depression were the significant predictive factors for stigma in schizophrenia patients. Psychosocial rehabilitation significantly reduced the perceived stigma among patients with schizophrenia. Thus, patients with schizophrenia should receive psychosocial rehabilitation and the predictive factors should be considered as part of the holistic management of schizophrenia towards recovery