Other Titles

Depressive Symptoms as a Mediator of Self-Stigma and Recovery in Patients with Schizophrenia: A Cross-Sectional Study [Title Slide]

Abstract

Background: Self-stigma has consistently been identified as a significant factor that hinders recovery in people with schizophrenia. When feel internalize stigma, it can intensify depressive symptoms, which may reduce sense of recovery. The mechanism that connects self-stigma, depression, and perceived recovery is not yet well understood.

Aims: investigate the mediating effects of depressive symptoms on self-stigma and perceived recovery among people with schizophrenia.

Methods: Involved 200 participants , recruited from community of a medical center. Examined demographic data, self-stigma (measured using the Internalized Stigma of Mental Illness scale), which served as the independent variable, and depressive symptoms (assessed using the Beck Depression Inventory II), which acted as the mediator. Perceived recovery was measured using the Perceived Recovery Inventory, serving as the dependent variable. Mediation analysis was conducted using the PROCESS macro (Model 4) for SPSS. Bootstrapping with 5,000 resamples was performed to test the indirect effect, with 95% confidence intervals that exclude zero considered statistically significant.

Results: Self-stigma significantly predicted higher levels of depressive symptoms (β = .528, t = 8.748, p < .001). Depressive symptoms were negatively associated with perceived recovery (β = –.269, t = –3.331, p = .001). The direct effect of self-stigma on perceived recovery was non-significant (β = .000, p = .996), whereas the total effect was negative and significant (β = –.142, p = .044). The indirect effect of self-stigma on perceived recovery through depressive symptoms was significant (B = –.108, SE = .035, 95% CI = –.176 to –.037), with a completely standardized indirect effect of –.142 (SE = .045, 95% = –.228 to –.050). The mediation analysis indicated a significant indirect effect, supported by a significant Sobel test value (z = 3.124; p = 0.002). The findings indicate a full mediation effect.

Conclusion: Depressive symptoms fully mediate the relationship between self-stigma and perceived recovery. This indicates that self-stigma primarily affects recovery through depressive symptoms.It is essential to integrate interventions aimed at reducing self-stigma and managing depressive symptoms into nursing care. By enhancing emotional strength and addressing internalized stigma, we may promote a sense of recovery among people living with mental illness.

Notes

Extensive reference list included in attached file.

Description

This study examined depression as a mediator between self-stigma and recovery in 200 individuals with schizophrenia. Results showed that self-stigma increased depression, which negatively impacted recovery. The direct effect of self-stigma on recovery was nonsignificant, indicating that depression fully mediates this relationship. The findings highlight the need for interventions addressing both stigma and depression to enhance recovery.

Author Details

Po Chun Fu, MSN RN/HN and Chiu-Yueh Yang, PhD

Sigma Membership

Lambda Beta at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Quantitative Research

Keywords:

Schizophrenia, Self-Stigma, Self Concept, Stigma, Perceived Recovery, Recovery, Recovery--Psychosocial Factors, Depressive Symptoms, Depression

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-07-30

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Additional Files

References.pdf (122 kB)

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Depressive Symptoms as a Mediator of Self-Stigma and Recovery in Patients with Schizophrenia

Toronto, Ontario, Canada

Background: Self-stigma has consistently been identified as a significant factor that hinders recovery in people with schizophrenia. When feel internalize stigma, it can intensify depressive symptoms, which may reduce sense of recovery. The mechanism that connects self-stigma, depression, and perceived recovery is not yet well understood.

Aims: investigate the mediating effects of depressive symptoms on self-stigma and perceived recovery among people with schizophrenia.

Methods: Involved 200 participants , recruited from community of a medical center. Examined demographic data, self-stigma (measured using the Internalized Stigma of Mental Illness scale), which served as the independent variable, and depressive symptoms (assessed using the Beck Depression Inventory II), which acted as the mediator. Perceived recovery was measured using the Perceived Recovery Inventory, serving as the dependent variable. Mediation analysis was conducted using the PROCESS macro (Model 4) for SPSS. Bootstrapping with 5,000 resamples was performed to test the indirect effect, with 95% confidence intervals that exclude zero considered statistically significant.

Results: Self-stigma significantly predicted higher levels of depressive symptoms (β = .528, t = 8.748, p < .001). Depressive symptoms were negatively associated with perceived recovery (β = –.269, t = –3.331, p = .001). The direct effect of self-stigma on perceived recovery was non-significant (β = .000, p = .996), whereas the total effect was negative and significant (β = –.142, p = .044). The indirect effect of self-stigma on perceived recovery through depressive symptoms was significant (B = –.108, SE = .035, 95% CI = –.176 to –.037), with a completely standardized indirect effect of –.142 (SE = .045, 95% = –.228 to –.050). The mediation analysis indicated a significant indirect effect, supported by a significant Sobel test value (z = 3.124; p = 0.002). The findings indicate a full mediation effect.

Conclusion: Depressive symptoms fully mediate the relationship between self-stigma and perceived recovery. This indicates that self-stigma primarily affects recovery through depressive symptoms.It is essential to integrate interventions aimed at reducing self-stigma and managing depressive symptoms into nursing care. By enhancing emotional strength and addressing internalized stigma, we may promote a sense of recovery among people living with mental illness.