Stigma Changes When It Crosses Borders

Think what it might be like to live in Siberia and endure the incredibly cold, dark winters. Now imagine what it must be like to live in Siberia and also have schizophrenia. It may sound like a gargantuan challenge, but Siberian residents with schizophrenia appear to have at least one thing going for them—they are not viewed by others as being dangerous.

This finding comes from a study conducted by M.C. Angermeyer, M.D., Ph.D., head of the clinic and outpatients' clinic of psychiatry the University of Leipzig in Germany. The results appeared in the June Acta Psychiatrica Scandinavica.

In spring 2001, Angermeyer and his colleagues conducted a survey of Germans' attitudes toward persons with schizophrenia and found that Germans tend to view such persons both as needy and dangerous. So Angermeyer and his team decided to conduct surveys in Russia and Mongolia to see how persons with the illness are viewed there as compared with in Germany.

In summer 2002 they conducted their Russian survey in the Siberian city of Novosibirsk. Novosibirsk is the principal industrial, administrative, and cultural center of western Siberia. A representative sample of residents of Novosibirsk aged 18 years and older—375 people—were interviewed for the survey. The survey was carried out by PreView, a Russian institute specializing in market research, although interviewers were trained and supervised by a member of the German research group.

Also in summer 2002, the researchers conducted their Mongolian survey in the city of Ulaanbaatar, which is the largest city in Mongolia. Once again, a representative sample of residents in the city 18 years of age or older was used, with 474 persons interviewed. The survey was carried out by the National Health Development Center in Ulaanbaatar and was supervised by a member of the German research group.

In both the Russian and Mongolian surveys, the same structured interview was used that had been employed in the German survey. However, the interview was translated into the Russian and Mongolian languages, and a panel, consisting of two psychiatrists, an ethnologist, a public health specialist, a sociologist, and a philologist, reviewed the translations, looking for any inconsistencies between the German and translated versions.

Each person interviewed in either Russia or in Mongolia was shown a vignette of a person with schizophrenia and asked how he or she would label that person. Interviewees in both Russia and Mongolia, as in Germany, tended to describe the schizophrenia person as being in need of help. But interviewees in Russia and Mongolia—unlike in Germany—did not describe the individual with schizophrenia as being dangerous.

Speculating why persons with schizophrenia might be perceived as threatening in Germany, yet not in Russia and Mongolia, the researchers wrote,“ Among the reasons might be that crimes committed by mentally ill people find a broader coverage in the media in Germany than in Russia and Mongolia. In Germany, the image that emerges from the press coverage of mental illness is dominated by information suggesting a strong association between mental disorder and crime, particularly violent crime. This selective reporting affects public attitudes, further reinforcing existing stereotypes.”

The investigators concluded, “Our findings suggest that the stigma attached to schizophrenia varies among different cultures, [and] therefore anti-stigma efforts need to be tailored to the specific conditions in a particular country.”

“We are planning to conduct similar population studies inquiring into attitudes toward, and beliefs about, people with bipolar disorder, obsessive-compulsive disorder, and borderline personality disorder,” Angermeyer told Psychiatric News. “In the meantime, we have also conducted a population survey in Bratislava, Czech Republic.”

The study was financed by the German Research Association.▪