Exploring attitudes and stigma toward using and not using antipsychotic medication. A multi-perspective cross-cultural study.

• Applicant: Professor Dr. Georg Schomerus
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: since 2025
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 561089496

Psychotic disorders significantly contribute to the global burden of disease. Although antipsychotic medication is effective in reducing symptoms, at least half of those who take such medication are dissatisfied, and less than 10% use it continuously during the first five years after a first psychotic episode. Considering the gap between antipsychotic prescriptions and actual usage, it is crucial to understand the attitudes, feelings, and possible stereotypes about antipsychotics and the dilemmas surrounding their use and non-use. Research has shown that beyond consideration of benefits and risks, fear of stigma influences individuals' decisions about antipsychotics use. Based on recent theoretical and empirical advances, in the proposed study we will offer a novel approach to gain a comprehensive understanding of attitudes and stigma toward antipsychotics use. We investigate a) individual differences, namely within-group effects; b) key stakeholders’ (service users’, close supporters’, psychiatrists’) differences, namely between-group effects; and c) possible cross-cultural differences, namely between-site effects, in attitudes and stigma toward antipsychotics use.Participants will be included from three independent samples: people who have experienced schizophrenia or psychosis (formal diagnosis or self-report) and have current or past experience of using or considering antipsychotics; informal close supporters (family or friends) of people meeting the criteria of the first sample; and formal close supporters (psychiatrists who prescribe antipsychotics). The proposed study will involve three working packages (WPs). In WP-I, we will explore stereotypes of using antipsychotics among the three groups of stakeholders using participatory and qualitative methodology via focus groups. On this basis, we will develop scales to assess public stigma and self-stigma toward antipsychotics use. In WP-II, after conducting a validity study, we will apply a cross-sectional design to assess attitudes and stigma toward antipsychotics use (including the use of scales developed in WP-I), investigating service users and their close supporters. Beyond differences in attitudes and stigma between stakeholder groups, we will investigate possible site differences (Germany and Israel) and individual differences that may be related to the assessed attitudes and stigma. In WP-III we will focus on data preparation and quantitative analysis, including further psychometric validation of scales as well as the investigation of main effects and interactions of individual differences, stakeholder differences, and site differences with respect to stigma, self-stigma and attitudes.

• DFG Programme: Research Grants
• International Connection: Israel
• Partner Organisation: The Israel Science Foundation
• Cooperation Partners: Professorin Ilanit Hasson-Ohayon, Ph.D.; Professor David Roe