Risk factors associated with experienced stigma among people diagnosed with mental ill-health: a cross-sectional study

Assessing the effectiveness of biofeedback therapy in the rehabilitation of limb motor dysfunction after stroke and the influencing factors of disease-related shame

OBJECTIVE

To evaluate the effectiveness of biofeedback therapy in the rehabilitation of limb motor dysfunction after stroke and the factors influencing disease-related shame.

METHODS

Medical records of 118 patients with limb motor dysfunction after stroke, treated in 521 Hospital of the Norinco Group from October 2019 to November 2022, were collected. The 56 patients in control group received conventional rehabilitation training, while the other 62 patients in observation group received electromyographic biofeedback therapy in addition to conventional treatment. The therapeutic effects of both groups were evaluated and compared after 4 weeks of treatment. Changes in FMA (Fugl-Meyer Motor Function Assessment Scale), mRS (Modified Rankin Scale), ADL (Activities of Daily Living Scale), and SSS (Stroke Stigma Scale) were compared before and after treatment. Multivariate logistic regression analysis was used to analyze the factors influencing disease-related shame after treatment. The effectiveness of risk factors in predicting disease-related shame was analyzed using receiver operating characteristic (ROC) curves.

RESULTS

Upon intervention, significant gains were noted in FMA and ADL scores, with reductions in mRS and SSS (P<0.0001). After 4 weeks, the observation group showed higher FMA and ADL scores and lower mRS and SSS (P<0.0001 for FMA and ADL; P<0.05 for mRS and SSS). Logistic regression identified age ≥60 (OR 8.045, P<0.001), income <4000 yuan (OR 0.187, P=0.002), and pretreatment ADL (OR 0.047, P<0.001) as predictors of disease-related shame. The AUC for age, household monthly income, and pretreatment ADL score were 0.595 (P=0.089), 0.608 (P=0.053), and 0.750 (P<0.001), respectively, demonstrating pretreatment ADL score as the most accurate predictor of disease-related shame.

CONCLUSIONS

Electromyographic biofeedback therapy has a significant effect on the rehabilitation of stroke patients, especially on motor recovery and activities of daily living. Age, monthly family income and pre-treatment ADL scores are key factors influencing disease-related shame.

Knowledge, attitudes, and behaviours towards schizophrenia, bipolar disorder, and autism: a pilot study

OBJECTIVES

Lack of knowledge and discriminatory attitudes and behaviours towards individuals with mental disorders is a worldwide problem but may be particularly damaging for young people. This pilot study examined knowledge, attitudes and behaviours towards schizophrenia, bipolar disorder and autism within a large sample of adults in Ireland, a country with the youngest population in Europe, in order to better understand public views on these groups.

METHODS

In a correlational, cross-sectional design, 307 adults in Ireland over the age of 18 completed a questionnaire over Google Forms examining knowledge, attitudes and behaviours towards schizophrenia, bipolar disorder and autism. Responses to questions specifically relating to each diagnosis were compared using trimmed mean ANOVA to examine whether responses to questions differed depending on diagnosis.

RESULTS

Results indicate varied knowledge, attitudes and behaviours towards these groups, but a majority believe it should be a research priority. ANOVA and post hoc tests revealed significant differences in knowledge, attitudes and behaviours towards each of schizophrenia, bipolar disorder, and autism (p < 0.005), and reported attitudes and behaviours towards schizophrenia were more negative than either bipolar disorder or autism. A majority of participants (54.8%) felt not informed enough about mental health by the media.

CONCLUSIONS

In our Irish sample, type and level of stigma varies according to mental health diagnosis. Our sample also report feeling inadequately informed about mental health by the media. Thus future policy and campaigns could consider targeting individual mental health diagnoses, with a focus on increasing familiarity and knowledge.

Physical and sexual victimization of persons with severe mental illness seeking care in central and southwestern Uganda

Purpose

This study established the prevalence of physical and sexual victimization, associated factors and psychosocial consequences of victimization among 1,201 out-patients with severe mental illness at Butabika and Masaka hospitals in Uganda.

Methods

Participants completed structured, standardized and locally translated instruments. Physical and sexual victimization was assessed using the modified adverse life events module of the European Para-suicide Interview Schedule. We used logistic regression to determine the association between victimization, the associated factors and psychosocial consequences.

Results

The prevalence of physical abuse was 34.1% and that of sexual victimization was 21.9%. The age group of > = 50 years (aOR 1.02;95% CI 0.62-1.66; p = 0.048) was more likely to have suffered physical victimization, while living in a rural area was protective against physical (aOR 0.59; 95% CI 0.46-0.76; p = <0.001) and sexual (aOR 0.48, 95% CI 0.35-0.65; p < 0.001) victimization. High socioeconomic status (SES) (aOR 0.56; 95% CI 0.34-0.92; p = <0.001) was protective against physical victimization. Females were more likely to have been sexually victimized (aOR 3.38; 95% CI 2.47-4.64; p = <0.001), while being a Muslim (aOR 0.60; 95% CI 0.39-0.90; p = 0.045) was protective against sexual victimization. Risky sexual behavior was a negative outcome associated with physical (aOR 2.19; 95% CI 1.66-2.90; p = <0.001) and sexual (aOR 3.09; 95% CI 2.25-4.23; p < 0.001) victimization. Mental health stigma was a negative outcome associated with physical (aOR 1.03; 95% CI 1.01-1.05; p < 0.001) and sexual (aOR 1.03; 95% CI 1.01-1.05; p = 0.002) victimization. Poor adherence to oral anti-psychotic medications was a negative outcome associated with physical (aOR 1.51; 95% CI 1.13-2.00; p = 0.006) and sexual (aOR 1.39; 95% CI 0.99-1.94; p = 0.044) victimization.

Conclusion

There is a high burden of physical and sexual victimization among people with SMI in central Uganda. There is need to put in place and evaluate complex interventions for improving detection and response to abusive experiences within mental health services. Public health practitioners, policymakers, and legislators should act to protect the health and rights of people with SMI in resource poor settings.

Stigma and its associated factors among patients with COVID-19 in Dhaka City: evidence from a cross-sectional investigation

Background

Coronavirus disease 2019 (COVID-19) has become a significant disease pandemic. Dhaka City alone has contributed about one-third to the total COVID-19 cases in Bangladesh. Globally, patients with infectious diseases, including COVID-19, experience stigma. There was no quantitative estimate of stigma experienced by patients with COVID-19 in the country. Therefore, this study aimed to assess the prevalence of stigma and its associated factors among patients with COVID-19 in Dhaka.

Methods

A cross-sectional study was conducted among 384 respondents aged 18 years or older who had been hospitalized or had stayed at home and were tested negative 15 days to 6 months before the day of data collection. Data collection was done through in-person and telephone interviews using a semi-structured survey questionnaire. A 15-item COVID-19-related stigma scale questionnaire was used to assess stigma. Binary logistic regression analysis was performed to identify the predictors of stigma.

Results

More than half (53.1%) of the respondents experienced stigma when they were COVID-19 positive. Females were at a 3.24 times higher risk of experiencing stigma than their male counterparts. Respondents from the 60+ age group and 40-59 age group were 63.0% and 48.0% less likely to experience stigma than those from the 18-39 age group. Non-hospitalised patients had 1.67 times higher odds of facing stigma than those hospitalised.

Conclusions

This study reported a high prevalence of stigma among the patients with COVID-19 in Dhaka City. The current evidence base of stigma experience among patients with COVID-19 offers a solid foundation for creating effective strategies and policies and designing appropriate interventions to counter stigma, which will improve the psychological well-being of patients with COVID-19 in Bangladesh.

At home or in hospital: Home treatment and mental health stigma

BACKGROUND

Stigmatized attitudes towards people with mental illness may influence treatment choice for oneself and others.

AIM

To gauge the attitudes of the UK general public towards treatment at home for mental illness and to assess the extent to which non-acceptability was related to stigmatized attitudes.

METHODS

Two hundred and two (101 female) people living in the UK completed an online (vignette) questionnaire in which we asked demographic details and personal experience of mental illness. To measure stigma, we used an adapted version of the Attitudes to Mental Illness Questionnaire (AMIQ) with vignettes asking about treatment at home and using scales for social distance and poor expectations; participants also filled in the Mental Health Knowledge Schedule (MAKS).

RESULTS

Participants did not evidence overall agreement with treatment at home for mental illness (i.e. >0; range = -16-to-+16, Mean (M) = 0.86, 95% confidence interval (CI) = -0.08, 1.80, p = .073), although they showed significant agreement with treatment at home should they experience mental illness themselves (range = -8-to-+8, M = 1.36, CI = 0.82, 1.89, p < .001). Acceptability for treatment at home differed according to specific mental illness considered (range = -4-to-+4); depression (M = 0.47, CI = 0.13, 0.81, p = .006) and alcohol abuse (M = 1.46, CI = 1.14,1.77, p < .001) were considered suitable for being treated at home but schizophrenia was not (M = -0.78, CI = -1.13,-0.43, p < .001). Multivariate analyses revealed that older age and attitudes indicating comfort with less social distance from people with mental illness were independently associated with treatment at home agreeability.

CONCLUSIONS

Public acceptability of home treatment for mental illness remains ambivalent in the UK, most obviously when considering treatment approaches for individuals other than themselves and for people with schizophrenia. Disagreement with home treatment is particularly evident in younger people and those who prefer less social contact with people with mental illness.

The Influence of Perfectionism, Self-Esteem and Resilience on Young People's Mental Health

The current study explored whether maladaptive perfectionism and low self-esteem constituted reliable risk factors of student mental illness, as well as determining whether resilience moderates these predictive relationships. 434 University undergraduate students were recruited. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Assessment (GAD-7). Perfectionism, self-esteem and resilience were analyzed in relation to the PHQ9 and GAD-7 scores via a regression analysis. Perfectionism discrepancy, self-esteem and resilience all significantly predicted depression and anxiety. Hierarchical regression analysis revealed a statistically significant amount of additional variance to be explained by resilience for depression and anxiety, than for perfectionism and self-esteem alone. Maladaptive perfectionism and low self-esteem predispose an individual to depression and anxiety, though resilience may act as a protective factor against development of mental illness.

Stigma and determinant factors among patients with mental disorders: Institution-based cross-sectional study

Objectives:

To assess prevalence and its associated factors of perceived stigma among patients with mental disorders who had appointment for treatment at Debre Markos, Finote Selam, and Felege Hiwot Hospitals, Ethiopia, 2019.

Methods:

At selected hospitals in the Amhara Region, an institution-based cross-sectional study was conducted from 1 February to 1 March 2019. Participants were selected using systematic random sampling technique and data were collected using a standardized questionnaire. The Internalized Stigma Scale was designed to examine the stigma associated with mental disorders. The data were coded and enter into Epi data version 4.4.2.1 before being exported to SPSS version 20 for analysis. Odds ratios and 95% confidence interval were used to show the strength of the association.

Results:

A total of 610 participants were participated, with a response rate of 98.6%, and 215 (35.2%) of them reported a high level of perceived stigma. Being single (adjusted odds ratio = 1.84, 95% confidence interval: 1.12, 3.02), accessing their medication freely (adjusted odds ratio = 1.70, 95% confidence interval: 1.08, 2.67), having suicidal thoughts (adjusted odds ratio = 1.95, 95% confidence interval: 1.25, 3.03), having low social support (adjusted odds ratio = 5.09, 95% confidence interval: 2.95, 8.76), age 25–34 years (adjusted odds ratio = 1.94, 95% confidence interval: 1.11, 3.40), age 35–44 years (adjusted odds ratio = 2.10, 95% confidence interval: 1.06–4.18), and age > 44 years (adjusted odds ratio = 3.48, 95% confidence interval: 1.67, 7.24) were revealed to be significantly associated with high perceived stigma after multivariable logistic regression analysis ( p < 0.05).

Conclusion:

The prevalence of high perceived stigma was 35.2%, which is found to be high among people who have mental disorders in this study. Being single, accessing their medication freely, having suicidal thoughts, having low social support, and being within the age of (25–34), (35–44), > 44 were all found to be significantly associated with high perceived stigma ( p < 0.05). But married, access medication by fee, have no suicidal thought, having moderate and strong social support, and young age were significantly associated with low perceived stigma.

Relationship between psychological factors and perceived stigma of addiction among women with substance use disorders, Thailand

BACKGROUND

Substance use disorders (SUDs) are one of the most stigmatized health conditions that impact drug user's treatment engagement. However, to date, little is known about perceived stigma and its correlates with psychological factors among high-risk groups such as people with SUDs in the criminal justice system. This study aimed to determine the association of psychological factors and perceived stigma of addiction among women with SUDs.

MATERIALS AND METHODS

This cross-sectional design was conducted on 652 women with SUDs who were treated in all 7 compulsory drug detention centers in Thailand with consecutive sampling technique. The data were collected by standardized interviewers with interviewing questionnaire. Multiple logistic regression was applied to examine the effect of psychological factors and perceived stigma.

RESULTS

More than half of SUD patients (57.2%) were methamphetamine abuse or dependence, approximately 69.9% reported high level of perceived stigma, 56.7% had mild depression, 34.8% had low level of perceived social support, and the average perceived stress score was 19.2 (standard deviation, 7.5). The perceived stigma was positively related to depressive symptom and perceived stress while was inversely related to perceived social support.

CONCLUSION

The psychological factors were strongly associated with perceived stigma of addiction. Thus, the detection of psychological problems among SUD patients may be benefit clinicians for identifying which patients are most at risk of perceived stigma and are the potential targets of intervention to reduce stigma in clinical practice.