Matthias C. Angermeyer

Background: Spouses of people with mental disorder experience various forms of objective and subjective burden. This should negatively affect their quality of life. However, until now no single study has addressed this question. Aims: To investigate the quality of life of spouses of people with schizophrenia, depression or anxiety disorders. Method: Spouses of patients suffering from schizophrenia (n ¹/4 45), depression (n ¹/4 49) and anxiety disorders (n ¹/4 39) were consecutively recruited from out-patient services in the city of Leipzig. Quality of life was assessed by means of the WHOQOL-BREF, a self-administered questionnaire developed by the World Health Organisation. Results: Compared with the general population, the quality of life of the spouses of mentally ill people was lower in the domains ‘psychological well-being’ and ‘social relationships’. There was a significant association between the patient's functional level and the spouse's quality of life. Conclusions: Better treatment, professional support and participation in self-help and advocacy groups may help to improve the quality of life of spouses of mentally ill people.

Background Numerous studies have established proof of selective media reporting about the mentally ill, with the majority of the reports focusing almost exclusively on violence and dangerousness. A handful of studies found that there is an association between negative media portrayals and negative attitudes toward people with mental illness. However, empirical evidence of the impact of newspaper reports about mentally ill people on readers’ attitudes is very scarce. Aims To examine the impact of a newspaper article linking mentally ill persons with violent crime and the impact of an article providing factual information about schizophrenia on students’ attitudes toward people with mental illness. Method A total of 167 students aged 13–18 years were randomly assigned one of two articles. A period of 1 week before and 3 weeks after reading the newspaper article, they were asked to complete a self-administered questionnaire for the assessment of their attitudes toward mentally ill people. Results Respondents who read the article linking mentally ill persons with violent crime displayed an increased likelihood to describe a mentally ill person as dangerous and violent. Conversely, respondents who read the informative article used terms like ‘violent’ or ‘dangerous’ less frequently. The desire for social distance remained virtually unchanged at follow-up in both groups. Conclusion Two potential approaches to break the unwanted link between negative media reporting and negative attitudes are suggested. First, an appeal to media professionals to report accurate representations of mental illness. And second, an appeal to the adults living and working with adolescents to provide opportunities to discuss and reflect on media contents.

In order to examine whether there is a relationship between the state of mental health care and the acceptance of psychiatry, public attitudes toward psychiatric treatment in three countries where the reform of mental health care has progressed to a different degree will be compared.

Background: While there are some indications that the mental health literacy of the public has improved within recent years, the findings concerning its attitudes towards the mentally ill are quite inconsistent. Aims: The aim of this study is to examine whether any changes have taken place inGermany over the last decade regarding the stigmatisation ofmentally ill people. Method: In 2001, a representative population survey was carried out among the German adult population, using the same sampling procedure and the same measure for the assessment of perceived stigma as in a previous survey that had been conducted in 1990. Results: Our findings suggest that in 2001, the German public was somewhat less inclined to believe that former mental patients are exposed to stigmatisation than a decade ago. While this holds especially true for the devaluation of patients, the picture is more mixed for discrimination. The trend towards less perceived stigmatisation is particularly pronounced among people who are familiar with psychiatric treatment. Conclusions: Since a substantial amount of perceived stigma still persists, further efforts to reduce the stigma attached to mental illness are needed.

Fragestellung: Ziel der Studie ist zu erkunden, inwieweit das Laienpublikum mit einer bipolaren Störung eine psychische Erkrankung assoziiert. Methode: Im Januar 2005 wurde bei einer Zufallsstichprobe der deutschen Allgemeinbevölkerung (n = 1006) eine Telefonumfrage durchgeführt. Den Befragten wurden vier verschiedene Erklärungen für eine bipolare Störung angeboten unter denen sie eine auswählen sollten. Ergebnisse: Mit Abstand am häufigsten, von 61 % der Befragten, wurde unter einer bipolaren Störung die Eisschmelze am Nord- und Südpol verstanden. Nur 4,6 % brachten den Begriff mit einer psychischen Erkrankung in Zusammenhang. Diskussion: Es stellt sich die Frage, ob es sinnvoll ist für eine psychische Störung eine diagnostische Bezeichnung zu wählen, die das Laienpublikum an vieles andere aber nicht an eine psychische Erkrankung denken lässt. Da aber eine Rücknahme des Begriffs der bipolaren Störung nicht infrage kommt, erscheint es notwendig, sich vermehrt um dessen Propagierung im Laienpublikum zu bemühen. Aim: To explore to what extent the lay public knows that the term bipolar disorder denotes a mental disorder. Method: In January 2005, a telephone survey was conducted among a random sample of the German population (n = 1006). Out of four options given, respondents were asked to select the one they considered to be the correct explanation of what is meant by bipolar disorder. Results: Most of the respondents (61 %) believed that bipolar disorder is just another term for the melting of the polar ice caps, only 4.6 % associated it with mental illness. Discussion: The question arises as to whether it makes sense to use a diagnosis which the lay public associates with everything but a mental illness. Since it is impossible to erase the term bipolar disorder from the psychiatric terminology, it seems necessary to increasingly propagate this term among the lay public.

Anliegen: Angehörige von Menschen mit psychischen Störungen übernehmen als natürliches Hilfesystem vielfältige Aufgaben. Das Miterleben der Erkrankung im Alltag führt zu zahlreichen Belastungen und daraus hervorgehenden Beeinträchtigungen ihres Befindens. Die Unterstützung der Angehörigen erscheint deshalb dringend notwendig. Zwar gibt es bereits zahlreiche Ansätze der Angehörigenarbeit, es fehlen jedoch weitgehend spezifische Angebote für bestimmte Gruppen von Angehörigen wie Partner, Kinder oder Geschwister. Methode: Ausgehend von der Darstellung konzeptueller Ansätze der Angehörigenarbeit wird die Entwicklung eines Unterstützungsprogramms speziell für Partner von Menschen mit depressiven oder schizophrenen Störungen beschrieben. Ergebnisse: Das neu entwickelte Programm wird vorgestellt. Ergebnisse der Evaluation des Programms durch die Teilnehmer werden berichtet. Schlussfolgerung: Die bisherigen Erfahrungen mit dem Unterstützungsprogramm sind ermutigend. Eine endgültige Beurteilung seiner Effektivität wird die zz. noch laufende Evaluation im Rahmen einer Fall-Kontroll-Studie erlauben. Objective: Lifelong partners or close relatives of persons suffering from mental disorders will naturally step in to help by assuming a great variety of tasks. By witnessing their relative’s illness on a daily basis, they are exposed to many burdens with a negative impact on their own well-being. Hence, supporting the relatives of persons with mental disorders appears imperative. While there are various approaches to working with relatives, there are hardly any specific programmes for working with certain groups of relatives such as spouses, children or siblings. Methods: Basing on a discussion of the various approaches to looking after relatives, development of a programme is described aimed at specifically supporting spouses of persons suffering from depression or schizophrenia. Results: The concept of our programme is presented and results of its evaluation by participants are reported. Conclusion: The initial experiences with the support programme are quite promising. An evaluation of its effects, based on a case-control-design, is currently under way.

Aim Using Link and Phelan’s concept of the stigma process, public attitudes towards people with schizophrenia are examined. Method In the spring of 2001, a representative population survey was conducted in Germany (n=5025). A fully structured personal interview was carried out, beginning with the presentation of a case vignette. Results Labeling as mental illness increased the likelihood that someone suffering from schizophrenia was considered as being unpredictable and dangerous. This, in turn, led to an increase of the preference for social distance. Although much weaker, labeling also had a positive effect on public attitudes insofar as it was associated with a decrease of the tendency to attribute the responsibility for the occurrence of the disorder to the afflicted person. However, this had no significant impact on the desire for social distance. There was no significant association between labeling and the anticipation of poor prognosis. There were some differences between respondents who are familiar with mental illness and those who are not. Conclusion Our findings have some implications for the planning of interventions aimed at reducing stigma and discrimination because of schizophrenia. These interventions should primarily address the stereotypes of unpredictability and dangerousness since they are most likely to have a negative impact on the public’s willingness to engage in social relationships with those suffering from this disorder. The interventions should also be tailored according to whether the target population is familiar with mental illness or not.

There is ample evidence for a distorted presentation of the mentally ill in the media. However, only little is known about its impact on attitudes towards people with mental disorders. Therefore, we investigated the relationship between watching TV and reading the newspaper on the one hand, and the desire for social distance towards people with schizophrenia on the other. In 2001, a representative population survey was conducted in Germany, using a fully structured personal interview. We found that the desire for social distance towards people with schizophrenia increases almost continuously with the amount of TV consumption. The association between reading the newspaper and social distance is less pronounced and depends on the type of newspaper people read. Since, obviously, there is a relationship between media consumption and attitudes towards people with schizophrenia, inaccurate and one-sided messages about mental disorders should be replaced by accurate and more balanced messages.

Background: It is a widely shared belief that an increase in mental health literacy will result in an improvement of attitudes towards people with mental illness.Aims: To examine how the German public's causal attributions of schizophrenia and their desire for social distance from people with schizophrenia developed over the 1990s.Method: A trend analysis was carried out using data from two representative population surveys conducted in the Länder constituting the former Federal Republic of Germany in 1990 and 2001.Results: Parallel to an increase in the public's tendency to endorse biological causes, an increase in the desire for social distance from people with schizophrenia was found.Conclusions: The assumption underlying current anti-stigma programmes that there is a positive relationship between endorsing biological causes and the acceptance of people with mental illness appears to be problematic.