الفهرس 
AbstractOnly 14 pages are availabe for public view
 |  | from | 125 |  |  |
| | | from | 125 | | |
Abstract
Paradoxically, insight is associated with positive outcomes, such as better treatment adherence, recovery, and negative outcomes, such as depression, hopelessness, low self-esteem, and quality of life. Self-stigma as a moderating variable can be decisive whether more insight leads to better or worse outcome. On the other hand, self-stigma can act as a mediator between insight and outcomes (saostowo, 2011).Therefore, the relationship between insight and internalized stigma in psychiatric patients is important for both theoretical and practical reasons because of its close association with patients’ willingness to seek or accept care for their mental illness. .
The present study aimed:
1- To assess the levels of insight and internalized stigma in psychiatric patients
2- To determine the relationship between insight and internalized stigma in psychiatric patients.
Material and method:
The total study sample was 250 psychiatric patients who attended at Bani-Ahmed psychiatric hospital in El-Minia governorate during ten months started from the first of March to the end of December 2013.
Data were collected through the following four tools:
1- Structured interview questionnaire:
An interview questionnaire was developed by the researcher and covered the patient’s age, gender, residence, education, job, diagnosis and duration of illness.
2- The Arabic version of Brief Psychiatric Rating Scale (BPRS)
Brief Psychiatric rating scale was developed by Overall et al., 1963 and modified by Ventura et al., 1993. This scale includes 24 symptoms to assess the severity of psychiatric symptoms. It is rated on a 7-point scale of severity ranging from “not present” (1) to “extremely severe” (7), higher score indicates greater severity.
3- Insight scale (IS):
Developed by Birchwood and colleagues in 1994. It consists of 8 items divided into 3 subscales to assess awareness of illness (2 items number 2&7) maximum total 4, relabel of experiences (2 items number 1&8) maximum total 4 and need for treatment (4 items number 3,4,5&6) divide score by 2 to give total score. Scored on a 3- point likert scale (0= disagree, 1= unsure & 2= agree) with higher scores indicating higher level of insight.
4-Internalized Stigma of mental illness (ISMI) inventory:
Developed by Ritsher and colleagues (2003). It contains 29 items scored on a 4-point Likert scales (1=‘strongly disagree’ to 4=‘strongly agree’) high scores indicate that internalized stigmatization is more severe in the individual except in stigma resistance subscale.
The main results yielded by this study were:
1- The studied sample consisted of 250 psychiatric patients. Male patients represent (73.6%) while Females were (26.4%) patients. 50 % of the sample resided in rural area, 47.2 % were graduated from secondary school, 46% were single and 36 % of them were married. More than one third of the studied sample (35.6 %) were didn’t work and (54.4%) of patients were schizophrenics.
2 -The severity of symptoms increased in females than males, in patients reside rural than urban areas. Widow and divorced patients respectively had highest severity of symptoms than those who were married or single. Also, the severity of symptoms increased among schizophrenic, depressed and manic patients respectively while decreased in schizoaffective and other diagnosis patients respectively
3- More than half of the studied sample have a lack of insight (68.8% were agree that they are mentally well, 61.6% were disagree that, if someone said they have a nervous or mental illness they would be right and 45.6% agree that they don’t need medication.
4- There were no statistical differences between insight and sociodemograghic characteristics as gender, residence, marital status and occupation. While there is a highly statistical difference between level of education and insight. Insight increased among preparatory and secondary educated patients while was decreased in illiterate and primary educated patients.
5- There was a highly statistical difference among insight and patient’s diagnosis. Insight increased among depressed and schizoaffective patients. While it decreased among schizophrenic, other diagnosis and manic patients respectively.
6- About half of the studied sample suffers from feeling of alienation, stereotypes endorsement, discrimination experiences and social withdrawal.
7- There were no significant differences between gender, residence, level of education, occupation and marital status and internalized stigma subscales.
8- There was a highly statistical significant difference between diagnosis and all subscales of (ISMI) scale. The internalized stigma increased in depressed patients then schizoaffective patients except in stigma resistance which increased in patients with other diagnosis and mania. While the internalized stigma decreased in patients with mania and other diagnosis except in stigma resistance which decreased in depressed and schizoaffective patients.
9- There was negative weak significant correlation between insight and symptoms severity. While insight was significantly and positively correlated with internalized stigma of mental illness scale.