Evidence for the Effectiveness of Psychological Interventions for Internalized Stigma among Adults with Schizophrenia Spectrum Disorders: A Systematic Review and Meta-Analyses

Shankar Jagan, Tuti Iryani Mohd Daud (), Lip Choy Chia, Suriati Mohamed Saini, Marhani Midin, Ng Eng-Teng and Selvasingam Ratnasingam
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Shankar Jagan: Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
Tuti Iryani Mohd Daud: Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
Lip Choy Chia: Department of Psychiatry and Mental Health, Hospital Keningau, Peti Surat 11 Jalan Apin-Apin, Keningau 89007, Malaysia
Suriati Mohamed Saini: Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
Marhani Midin: Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
Ng Eng-Teng: Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
Selvasingam Ratnasingam: Department of Psychiatry & Mental Health, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak 93586, Malaysia

IJERPH, 2023, vol. 20, issue 8, 1-24

Abstract: In recent years, psychological interventions have been used to alleviate internalized stigma in people with schizophrenia spectrum disorders, but outcomes have been inconsistent. The aim of this review was to examine the existing evidence regarding this matter. Four electronic databases (EMBASE, MEDLINE, PsycINFO, and the Cochrane Central Register of Controlled Trials) were searched from inception until 8 September 2022, using appropriate strategies. The eligibility, quality, and strength of evidence of each study were all evaluated against the predetermined standards. Further quantitative analyses were performed using the RevMan software. A total of 27 studies were included in the systematic review. Eighteen studies with extractable data for meta-analysis yielded a statistically significant overall effect (Z = 3.00; p = 0.003; 95% CI: −0.69 [−1.15, −0.24]; n = 1633), although there was considerable heterogeneity (Tau 2 = 0.89; Chi 2 = 303.62, df = 17; p < 0.00001; I 2 = 94%). Subgroup analyses for Narrative Enhancement and Cognitive Therapy (NECT) produced a statistically significant and highly homogenous effect (Z = 3.40; p = 0.0007; 95% CI: −0.44 [−0.70, −0.19]; n = 241; Tau 2 = 0.00; Chi 2 = 0.14, df = 2 ( p = 0.93); I 2 = 0%). In conclusion, the majority of the psychological interventions are successful in lowering levels of internalized stigma, especially NECT, and interventions that integrate multiple therapies may be more beneficial.

Keywords: internalized stigma; internalised stigma; psychological interventions; therapies; schizophrenia spectrum disorders; NECT; systematic review; meta-analyses (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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