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. 2007 Jul;49(3):189-94.
doi: 10.4103/0019-5545.37320.

Stigmatization of severe mental illness in India: Against the simple industrialization hypothesis

Sushrut Jadhav  1 , Roland Littlewood, Andrew G Ryder, Ajita Chakraborty, Sumeet Jain, Maan Barua
Affiliations

Stigmatization of severe mental illness in India: Against the simple industrialization hypothesis

Sushrut Jadhav et al. Indian J Psychiatry. 2007 Jul.

Abstract

Background: Major international studies on course and outcome of schizophrenia suggest a better prognosis in the rural world and in low-income nations. Industrialization is thought to result in increased stigma for mental illness, which in turn is thought to worsen prognosis. The lack of an ethnographically derived and cross-culturally valid measure of stigma has hampered investigation. The present study deploys such a scale and examines stigmatizing attitudes towards the severely mentally ill among rural and urban community dwellers in India.

Aim: To test the hypothesis that there are fewer stigmatizing attitudes towards the mentally ill amongst rural compared to urban community dwellers in India.

Materials and methods: An ethnographically derived and vignette-based stigmatization scale was administered to a general community sample comprising two rural and one urban site in India. Responses were analyzed using univariate and multivariate statistical methods.

Result: Rural Indians showed significantly higher stigma scores, especially those with a manual occupation. The overall pattern of differences between rural and urban samples suggests that the former deploy a punitive model towards the severely mentally ill, while the urban group expressed a liberal view of severe mental illness. Urban Indians showed a strong link between stigma and not wishing to work with a mentally ill individual, whereas no such link existed for rural Indians.

Conclusion: This is the first study, using an ethnographically derived stigmatization scale, to report increased stigma amongst a rural Indian population. Findings from this study do not fully support the industrialization hypothesis to explain better outcome of severe mental illness in low-income nations. The lack of a link between stigma and work attitudes may partly explain this phenomenon.

Keywords: Ethnography; industrialization hypothesis; rural India; severe mental illness; stigma.

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Conflict of interest statement

Conflict of Interest: None declared

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