The mediation role of self-esteem for self-stigma on quality of life for people with schizophrenia: A retrospectively longitudinal study

Wen Yi Huang, Shu Ping Chen, Amir H. Pakpour, Chung Ying Lin (Corresponding Author)

Research output: Journal article publicationJournal articleAcademic researchpeer-review

20 Citations (Scopus)


Background: Among patients with schizophrenia, there is evidence of a negative association between self-stigma and subjective quality of life (SQoL), and self-esteem was an important mediator in the association. We attempted to use a longitudinal study to investigate the aforementioned mediation on a sample with schizophrenia. Methods: We used longitudinal data retrieved from medical records of a psychiatric centre between June 2014 and December 2015. In the data, we retrieved information of self-stigma using the Self-Stigma Scale — Short; SQoL, using the WHO questionnaire on the Quality of Life — Short Form; and self-esteem, using the Rosenberg Self-Esteem Scale. All the measures were evaluated five times. Linear mixed-effect models accompanied by Sobel tests were used to tackle the mediating effects. Results: Data from 74 patients (57 males) with schizophrenia were eligible for analysis; their mean (SD) age was 39.53 (10.67); mean age of onset was 22.95 (8.38). Self-esteem was a mediator for patients in physical (p = .039), psychological (p = .003), and social SQoL (p = .004), but not in environment SQoL (p = .051). Conclusion: Based on our findings, mental health professionals could tailor different programs to patients with schizophrenia, such as self-stigma reduction and self-esteem improvement programs. However, treatment as a whole should be sensitive to both self-stigma and self-esteem. Also, we should consider individuals’ health and wellbeing from social perspectives of disability rather than the medical model of disability emphasising symptoms and medications.

Original languageEnglish
Article numbere10
JournalJournal of Pacific Rim Psychology
Publication statusPublished - 1 Jan 2018


  • Linear mixed-effect model
  • Mediating effect
  • Serious mental illness

ASJC Scopus subject areas

  • Social Psychology

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