| Objective: To identify the relationship between internalized stigma and quality of life in patients with schizophrenia, as well as the mediating role of self-esteem and severity of symptoms. Methods: The Internalized Stigma of Mental Illness Scale, Schizophrenia Quality of Life Scale, Self-Esteem Scale, and Positive and Negative Syndrome Scale were used to conduct a questionnaire survey among 309 inpatients with schizophrenia from 6 mental health centers in Xiangyang City, Siping City, and Changchun City from April 2023 to September 2023 by convenient sampling method. Results: The internalized stigma, self-esteem, and severity of symptoms in patients with schizophrenia could significantly effect their quality of life. Internalized stigma influenced quality of life through the following 3 pathways , namely, M1:“internalized stigma→self-esteem→quality of life” (effect value=-0.144, P<0.01, 95% CI [-0.271, -0.042], accounting for 18.8% of the total effect), M2: “internalized stigma→severity of symptoms→quality of life” (effect value=-0.175, P<0.01, 95%CI [-0.286, -0.079], accounting for 22.8% of the total effect], M3: “internalized stigma→self-esteem→severity of symptoms→quality of life”(effect value=-0.088, P<0.01, 95% CI [-0.171,-0.026], accounting for 11.5% of the total effect). The mediating effect accounts for 53.1% of the total effect, and there is no statistically significant difference among M1, M2, and M3 (P>0.05). Conclusion: The study revealed the relationship and mechanism between internalized stigma and quality of life in patients with schizophrenia. To improve their quality of life, mental health personnels should pay attention to the impact of patients’ internalized stigma on their quality of life, focus on improving their self-esteem and alleviating the severity of symptoms. |