Effect of mental illness stigma upon the quality of life among families with schizophrenic patients in Mental Health Centre, Sulaimaniyah, Iraq: Mental illness stigma upon the quality of life among families with schizophrenic patients
Mental illness stigma upon the quality of life among families with schizophrenic patients
Copyright (c) 2025 Araz Mohammed Abdulkarim (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
- Articles
- Submited: November 16, 2024
-
Published: October 22, 2025
Abstract
Background and objective: Family caregivers of members with schizophrenia are subjected to stigmatization that significantly affects the quality of life. And causes delays in caregiving and treatment seeking for schizophrenic patients. The objective is to assess the stigma of mental illness and QoL levels and to determine its association among family caregivers of schizophrenic patients.
Methods: A quantitative cross-sectional study was performed on 100 family caregivers with schizophrenia in 100 patients selected at the Mental Health Center, General Teaching Hospital in Sulaimaniyah, Iraq, from December 2022 to February 2023. A questionnaire used for data collection by interviewing the caregivers was composed of three parts; socio-demographic characteristics of family caregivers and patients, the stigma of mental illness scale, and QoL-BREF.
Results: Most family caregivers of patients with schizophrenia were males (72%) and siblings (49%). Moderate prevalence of stigma (78%) and low level of life (91%) were observed among caregivers. The likelihood ratio test results indicated that stigma was significantly associated with QoL (LR=4.912, P <0.05). The multinomial logistic regression model analysis showed that family caregivers with a high level of stigma were significantly four times lower QoL (P <0.05, odds ratio=4.43).
Conclusion: Family caregivers experienced a moderate level of stigma and low QoL that reflects a failure to use practical approaches to prompt and satisfy their needs in the community.
Metrics
References
- He H, Liu Q, Li N, Guo L, Gao F, Bai L, et al. Trends in the incidence and DALYs of schizophrenia at the global, regional and national levels: results from the Global Burden of Disease Study 2017. Epidemiol Psychiatr Sci. 2020; 29:e91. https://doi.org/10.1017/S2045796020000167
- Sofi KQ. Assessment of the burden of care among family caregivers of patients with schizophrenia attending mental health treatment centre in Sulamani city. University of Sulaimani Sulaimani; 2016 .Master's thesis, P. 45.
- Al Mulhim AA, Al Dehneen HAY, Alabbad MRA. Mental Illnesses Stigma and Its Association with Quality of Life in Adult Saudi Patients. Egypt J Hosp Med. 2018; 70(5):766–70. https://doi.org/10.12816/0044330
- Girma E, Möller-Leimkühler AM, Müller N, Dehning S, Froeschl G, Tesfaye M, et al. Public stigma against family members of people with mental illness: Findings from the Gilgel Gibe Field Research Center (GGFRC), Southwest Ethiopia. BMC Int Health Hum Rights. 2014; 14(1):1–7. https://doi.org/10.1186/1472-698X-14-2
- Alyafei AH, Alqunaibet T, Mansour H, Ali A, Billings J, et al. The experiences of family caregivers of people with severe mental illness in the Middle East: A systematic review and meta-synthesis of qualitative data. PLoS One. 2021; 16(7):e0254351. https://doi.org/10.1371/journal.pone.0254351
- Corrigan PW, Druss BG, Perlick DA. The impact of mental illness stigma on seeking and participating in mental health care. PSPI. 2014; 15(2):37–70. https://doi.org/10.1177/1529100614531398
- Tu L, Wong YI, Zhou N. Family stigma and well-being among family members of persons with schizophrenia in China: The roles of affiliate stigma and psychosocial resources.Psychiatry Res 2019; 271:272–8. https://doi.org/10.1016/j.psychres.2018.11.056
- Karimi M, Brazier J. Health, health-related quality of life, and quality of life: what is the difference? Pharmacoeconomics. 2016; 34:645–9. https://doi.org/10.1007/s40273-016-0389-9
- Wang L, Chen Y, Hu C, Qin H. Influence of family dynamics on stigma experienced by patients with schizophrenia: Mediating effect of quality of life. Front Psychiatry. 2021; 12:1–8. https://doi.org/10.3389/fpsyt.2021.652410
- Lua PL, Bakar ZA. Health-related quality of life profiles among family caregivers of patients with schizophrenia. Fam Community Health2011;34(4):331–9. https://doi.org/10.1097/FCH.0b013e31822c1fe4
- Loukissa DA. Family burden in chronic mental illness: A review of research studies. Issues Ment Health Nurs. 2017; 28(3):259–71. doi: 10.1080/01612840601143173.
- Albikawi Z, Abuadas M. Quality of life and self-stigma of schizophrenia patient's caregiver tool: Development and validation using classical test theory and Rasch analysis. S Afr J Psychiatry. 2021; 27:1–8. https://doi.org/10.4102/sajpsychiatry.v27i0.1652
- Hussein H. Impact of social support upon schizophrenic patients' family. University of Baghdad; 2012. Master's thesis.
- Häfner H. From Onset and Prodromal Stage to a Life-Long Course of Schizophrenia and Its Symptom Dimensions: How Sex, Age, and Other Risk Factors Influence Incidence and Course of Illness Psychiatry. 201–15. https://doi.org/10.1155/2019/9804836
- Pongsaksri M. Time use for occupation and the expectations of people with schizophrenia and their relatives from the perspective of themselves and their relatives. Asian J Occup Ther. 2018; 14(1):1–7. doi: 10.11596/asiajot.14.1
- Mohammed QQ. Impact of mental illness stigma upon the quality of life of schizophrenic patients. University of Baghdad; 2014.
- Dagani J, Buizza C, Ferrari C, Ghilardi A. The role of psychological distress, stigma and coping strategies on help-seeking intentions in a sample of Italian college students. BMC Psychol. 2023; 11(1):177. doi: 10.1186/s40359-023-01171-w
- Deschenes S, McInerney A, Schmitz N. Exploring the factors that predict quality of life, and the relationship between recovery orientation and quality of life in adults with severe mental health difficulties. Curr. Psychol. 2023; 42(26):22419–28. https://doi.org/10.1007/s12144-022-03120-3
- Murru A, Carpiniello B. Duration of untreated illness as a key to early intervention in schizophrenia: a review. Neurosci Lett. 2018; 669:59–67. https://doi.org/10.1016/j.neulet.2016.11.034
- Ebrahim OS, Al-Attar GST, Gabra RH, Osman DMM. Stigma and burden of mental illness and their correlates among family caregivers of mentally ill patients. J Egypt Public Health Assoc. 2020; 95(1):1–8. https://doi.org/10.1186/s42506-020-00052-z
- Boyer L, Caqueo-Urízar A, Richieri R, Lancon C, Gutiérrez-Maldonado J, Auquier P, et al. Quality of life among caregivers of patients with schizophrenia: A cross-cultural comparison of Chilean and French families. BMC Fam Pract. 2012; 13(1):1–6. https://doi.org/10.1186/1471-2296-13-42
- Mehra A, Kumar A, Grover S, Chakrabarti S, Avasthi A. Relationship of stigma with burden and coping among caregivers of patients with severe mental disorders. Indian J Soc Psychiatry. 2020; 36(1):11. https://doi.org/10.4103/ijsp.ijsp_81_19
- Couture S, Penn D. Interpersonal contact and the stigma of mental illness: A review of the literature. J Ment Health. 2003; 12(3):291–305. https://doi.org/10.1080/09638231000118276
- Zhang Y, Subramaniam M, Lee SP, Abdin E, Sagayadevan V, Jeyagurunathan A, et al. Affiliate stigma and its association with quality of life among caregivers of relatives with mental illness in Singapore. Psychiatry Res. 2018; 265:55–61. https://doi.org/10.1016/j.psychres.2018.04.025
- Picco L, Pang S, Lau YW, Jeyagurunathan A, Satghare P, Abdin E, et al. Internalized stigma among psychiatric outpatients: Associations with quality of life, functioning, hope, and self-esteem. Psychiatry Res. 2016; 246:500–6. https://doi.org/10.1016/j.psychres.2016.10.041
- Mukherjee S, Mukhopadhyay DK. Stigma towards mental illness: a hospital-based cross-sectional study among caregivers in West Bengal. Indian J Public Health. 2018; 62(1):15. https://doi.org/10.4103/ijph.IJPH_337_17
- Von Kardorff E, Soltaninejad A, Kamali M, Eslami Shahrbabaki M. Family caregiver burden in mental illnesses: The case of affective disorders and schizophrenia–a qualitative exploratory study. Nord J Psychiatry. 2016; 70(4):248–54. https://doi.org/10.3109/08039488.2015.1109135