1
|
Singh A, Rejeb A. Illness perception: A bibliometric study. Heliyon 2024; 10:e31805. [PMID: 38845980 PMCID: PMC11153196 DOI: 10.1016/j.heliyon.2024.e31805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/09/2024] Open
Abstract
Illness perception is a crucial area of study that has seen significant growth and development over the years. This study conducts a comprehensive bibliometric and network analysis of illness perception research, capturing its evolution from 1975 to 2023. Utilizing 1813 publications from the Scopus database, authored by 5428 researchers, we identify key scholars and influential articles in the field. Our analysis includes various bibliometric networks such as citation, co-citation, collaboration, and keyword co-occurrence networks, along with the presentation of intellectual structure maps. Major research areas include the role of illness perception in mental health conditions like depression, coping mechanisms, quality of life, and chronic illnesses like diabetes, as well as the influence of lay beliefs on health behaviors, and the impact of illness beliefs on conditions like Myocardial Infarction and stroke. The results show a growing academic interest in understanding how illness perceptions shape healthcare outcomes and behaviors.
Collapse
Affiliation(s)
- Arti Singh
- Jindal School of Psychology and Counseling, O.P Jindal Global University, Sonipat, Haryana-131029, India
| | - Abderahman Rejeb
- Faculty of Business Economics, Széchenyi István University, 9026 Győr, Hungary
| |
Collapse
|
2
|
Billian J, Imfeld L, Roth CB, Moeller J, Lang UE, Huber CG. Patient-reported experience measures (PREMs) in outpatient psychiatry - is there an association to perceived discrimination and devaluation? Front Psychiatry 2024; 15:1378487. [PMID: 38699444 PMCID: PMC11064698 DOI: 10.3389/fpsyt.2024.1378487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/01/2024] [Indexed: 05/05/2024] Open
Abstract
Patient-Reported Experience Measures (PREMs) are gaining significance in the field of psychiatry, with patient satisfaction being a key measure. However, it is unclear if patient satisfaction in psychiatry is influenced by variables outside the treatment setting. This brief report thus examines the possible impact of perceived discrimination and devaluation (PDD) on patient satisfaction in the psychiatric outpatient setting. Data from 1,126 individuals who were undergoing or had recently completed treatment at 15 outpatient centers of the Psychiatric University Clinic in Basel, Switzerland, was analyzed. Patient satisfaction was assessed using the Münsterlingen Patient Satisfaction Questionnaire (MüPF), and perceived stigma was measured with the Perceived Discrimination Devaluation Scale. The results revealed a positive small effect size relationship between MüPF and PDD, suggesting that patients who perceived less stigma report higher treatment satisfaction. This relationship may affect most ratings, with the total MüPF score remaining relatively robust against this potential influence. Linear regression analysis indicated that a one-unit increase in PDD score could lead to a maximum change of 1.8 points on the 7-point Likert scale for the MüPF item correlating highest with PDD and 0.4 points on the total MüPF score. These findings highlight the importance of considering perceived stigma when evaluating patient satisfaction with psychiatric outpatient treatment. Future research should investigate associations between stigma, patient satisfaction, treatment outcome, as well as other external factors that may influence patient satisfaction in psychiatric settings.
Collapse
Affiliation(s)
- Janina Billian
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Lukas Imfeld
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
- Institute for Evaluation Research, Basel, Universitäre Psychiatrische Kliniken (UPK) Basel, University of Basel, Basel, Switzerland
| | - Carl B. Roth
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Julian Moeller
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
- Faculty of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Undine E. Lang
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| | - Christian G. Huber
- Universitäre Psychiatrische Kliniken (UPK) Basel, Klinik für Erwachsene, University of Basel, Basel, Switzerland
| |
Collapse
|
3
|
Sugisawa H, Shimizu Y, Kumagai T, Shishido K, Koda Y, Shinoda T. Influence of dialysis-related stigma on health-related indicators in Japanese patients undergoing hemodialysis. Ther Apher Dial 2023; 27:855-865. [PMID: 37052040 DOI: 10.1111/1744-9987.13992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/06/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION Focusing on impacts to health-related indicators in older Japanese patients, this study analyzed both the direct influence of dialysis-related stigma and influences of its intersectionality with other stigmatized characteristics. METHODS Data were collected through a cross-sectional survey of 7461 outpatients in dialysis facilities. Other stigmatized characteristics include lower income, lower education, disabled activities of daily living, and diabetic end-stage renal disease (ESRD) as a cause for starting dialysis treatment. RESULTS The average rate of an "agree" response on dialysis-related stigma items was 18.2%. Dialysis-related stigma significantly influenced all three health-related indicators, including suspected depression, informal networks, and compliance with dietary therapy. In addition, each interaction between dialysis-related stigma and educational attainment, gender, and diabetic ESRD significantly influence one health-related indicator. CONCLUSION These results suggest that dialysis-related stigma has both a significant direct and synergic influence with other stigmatized characteristics on health-related indicators.
Collapse
Affiliation(s)
- Hidehiro Sugisawa
- Gerontology Program, J. F. Oberlin University Graduate School of International Studies, Tokyo, Japan
| | | | - Tamaki Kumagai
- School of Health Sciences, International University of Health and Welfare, Odawara, Kanagawa, Japan
| | | | - Yutaka Koda
- Koda Medical and Dialysis Clinic, Niigata, Japan
| | - Toshio Shinoda
- Advanced Course for Clinical Engineering, Teikyo University Junior College, Tokyo, Japan
| |
Collapse
|
4
|
Nan D, Chong ESK, Dannuo W, Zewei L, Zexuan M, Shuyu D, Huang YT. Prevalence, risk, and protective factors of self-stigma for people living with depression: A systematic review and meta-analysis. J Affect Disord 2023; 332:327-340. [PMID: 37060952 DOI: 10.1016/j.jad.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/27/2023] [Accepted: 04/07/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND People living with depression are subjected to widespread stigmatization worldwide. Self-stigma may negatively affect patients' treatment, recovery, and psychological well-being. This review aims to summarize and synthesize the evidence on the prevalence, risk, and protective factors of depression self-stigma. METHODS Four online databases, PubMed, PsycINFO, Web of Science, and Embase, were searched to identify eligible studies. Fifty-six studies involving a total of 11,549 samples were included in the final analysis. Four reviewers independently screened the literature, extracted data, and assessed the risk of bias in eligible studies. Pearson's r was chosen as the effect size metric of risk and protective factors. RESULTS The results showed that the global prevalence of depression self-stigma was 29 %. Levels of self-stigma varied across regions, but this difference was not significant. Two demographic factors were identified: ethnicity (r = 0.10, p < 0.05) and having a partner/married (r = -0.22, p < 0.001). Five risk factors were identified: depression severity (r = 0.33, p < 0.01), public stigma (r = 0.44, p < 0.001), treatment stigma (r = 0.46, p < 0.001), perceived stigma (r = 0.37, p < 0.001), and enacted stigma (r = 0.71, p < 0.001). Five protective factors were identified: quality of life (r = -0.38, p < 0.001), social relationship (r = -0.26, p < 0.05), self-esteem (r = -0.46, p < 0.001), extroversion (r = -0.32, p < 0.001), and social functioning (r = -0.49, p < 0.001). LIMITATIONS Heterogeneity was observed in some of the results. Causality cannot be inferred due to the predominance of cross-sectional designs among the included literature. CONCLUSIONS Risk and protective factors of depression self-stigma exist across many dimensions. Future research should examine the inner mechanisms and effectiveness of interventions to reduce stigma.
Collapse
Affiliation(s)
- Du Nan
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
| | - Eddie S K Chong
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
| | - Wei Dannuo
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
| | - Liu Zewei
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Mu Zexuan
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
| | - Deng Shuyu
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
| | - Yu-Te Huang
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China.
| |
Collapse
|
5
|
Luo G, Li Y, Yao C, Li M, Li J, Zhang X. Duration of untreated illness and clinical correlates in first-episode and drug-naïve patients with major depressive disorder. Psychiatry Res 2023; 320:115056. [PMID: 36680911 DOI: 10.1016/j.psychres.2023.115056] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/28/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUNDS The notion that a prolonged duration of untreated illness (DUI) leads to poorer outcomes has contributed to extensive changes in mental health services worldwide. However, most studies on DUI have focused on schizophrenia and related psychosis. This study aimed to assess the possible relationship between DUI and certain clinical correlates in first-episode and drug-naïve patients with major depressive disorder (MDD). METHODS This cross-sectional study recruited 1718 first-episode and drug-naïve MDD outpatients. All participants were scored on the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Positive and Negative Syndrome Scale, and thyroid hormone and metabolic parameters were measured. We used the Structure Clinical Interview for DSM-IV for clinical diagnosis and investigated suicide attempts through face-to-face interviews. RESULTS A total of 171 (10%) of MDD patients had co-morbid psychiatric symptoms. Participants who were older, with lower education level, and married were less likely to seek a timely treatment compared to the counterparts. One-month longer untreated duration was associated with 2% to 9% higher odds of being with most of the investigated clinical conditions. For those with the longest DUI, the risk was increased for most of the investigated clinical conditions, with absolute risk differences ranging from 5.19% to 29.48%. CONCLUSIONS These findings suggest that longer DUI may be negatively associated with clinical correlates in MDD. Further long-term follow-up studies are warranted to confirm these preliminary results.
Collapse
Affiliation(s)
- Guoshuai Luo
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin 300222, China
| | - Yaxi Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 3210 Humin Rd, Shanghai 201108, China
| | - Cong Yao
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin 300222, China
| | - Meijuan Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin 300222, China
| | - Jie Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin 300222, China.
| | - Xiangyang Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing 100101, China.
| |
Collapse
|
6
|
Stigma towards depression in a community-based sample in China. Compr Psychiatry 2020; 97:152152. [PMID: 31838297 DOI: 10.1016/j.comppsych.2019.152152] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 11/12/2019] [Accepted: 11/29/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE Understanding the general public's beliefs about depression is essential if public education and anti-stigma interventions are to be effective. This study aimed to examine Chinese respondents' personal attitudes towards depression and their perceptions about the attitudes of others regarding depression and to identify the correlates of personal stigma and perceived stigma towards depression. METHODS A community survey was conducted among 1697 residents aged between 16 and 89 years of a large city in central China using the Depression Stigma Scale. Participants completed questionnaires assessing experiences of depression and family functioning. RESULTS Participants reported high levels of stigma towards depression, with greater perceived stigma than personal stigma. Increasing age was correlated with greater personal stigma and perceived stigma. Higher personal stigma was also significantly correlated with being male, unemployed and good family function. CONCLUSION Concerningly high levels of stigmatizing beliefs towards depression were prevalent among the public. This may be a reason why people with mental disorders do not seek assistance. This highlights the importance of the need for health education and promotion activities. Findings from this study suggest that targeted, culturally appropriate education programs are needed to improve knowledge about depression in the broader community.
Collapse
|
7
|
Akıncı E, Buzrul Sönmez S. Psikiyatri polikliniğine başvuran hastaların ruhsal bozukluk ve antidepresanlara yönelik inanç ve tutumları. FAMILY PRACTICE AND PALLIATIVE CARE 2019. [DOI: 10.22391/fppc.613150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
8
|
Zhu L, Yao J, Wu L, Wang J, Qiu M, Zhang C, Zhang H, Xie J, Liu A, Ranchor A, Schroevers M. Psychometric properties of the Depression Stigma Scale (DSS) in Chinese cancer patients: a cross-sectional study. BMJ Open 2019; 9:e028429. [PMID: 31340966 PMCID: PMC6661685 DOI: 10.1136/bmjopen-2018-028429] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES The Depression Stigma Scale (DSS) is commonly used to assess depression stigma in the general population and in people with depression. The DSS includes two 9-item subscales assumed to measure personal depression stigma (ie, personal perceptions of depression) and perceived depression stigma (ie, perceptions of how others perceive depression). The aim of the present study was to examine its psychometric properties in terms of validity and reliability in Chinese cancer patients. DESIGN A cross-sectional study design. PARTICIPANTS AND SETTINGS This study focused on 301 Chinese cancer patients recruited from two hospitals in Xi'an, China. METHODS Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the factor structure. Internal consistency was assessed using Cronbach's alpha. To examine concurrent validity, symptoms of depression were used as the criterion. RESULTS For each subscale of the DSS (ie, personal and perceived depression stigma), the EFA and CFA confirmed a two-factor structure: weak-not-sick (ie, perceiving that depression is not a real illness, but rather a sign of weakness) and discrimination (ie, perceiving that depressed people are discriminated against). The Cronbach's alphas were adequate, ranging from 0.70 to 0.80. Symptoms of depression were positively but weakly correlated to personal and perceived depression stigma. CONCLUSIONS The DSS appeared to show satisfactory psychometric properties in our sample of cancer patients. Both personal depression stigma and perceived depression stigma subscales consisted of two underlying aspects.
Collapse
Affiliation(s)
- Lei Zhu
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Juntao Yao
- Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Liyang Wu
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Jun Wang
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Mengting Qiu
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Chunyu Zhang
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Hongmei Zhang
- Department of Oncology, Xijing Hospital attached to the Medical University of the Air Force, Xi'an, China
| | - Juan Xie
- Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Ailan Liu
- Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Adelita Ranchor
- Department of Health Psychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Maya Schroevers
- Department of Health Psychology, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
9
|
Fox AB, Earnshaw VA, Taverna EC, Vogt D. Conceptualizing and Measuring Mental Illness Stigma: The Mental Illness Stigma Framework and Critical Review of Measures. STIGMA AND HEALTH 2018; 3:348-376. [PMID: 30505939 PMCID: PMC6261312 DOI: 10.1037/sah0000104] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Although the last decade has seen a proliferation of research on mental illness stigma, lack of consistency and clarity in both the conceptualization and measurement of mental illness stigma has limited the accumulation of scientific knowledge about mental illness stigma and its consequences. In the present article, we bring together the different foci of mental illness stigma research with the Mental Illness Stigma Framework (MISF). The MISF provides a common framework and set of terminology for understanding mechanisms of mental illness stigma that are relevant to the study of both the stigmatized and the stigmatizer. We then apply this framework to systematically review and classify stigma measures used in the past decade according to their corresponding stigma mechanisms. We identified more than 400 measures of mental illness stigma, two thirds of which had not undergone any systematic psychometric evaluation. Stereotypes and discrimination received the most research attention, while mechanisms that focus on the perspective of individuals with mental illness (e.g., experienced, anticipated, or internalized stigma) have been the least studied. Finally, we use the MISF to discuss the strengths and weaknesses of mental illness stigma measurement, identify gaps in the literature, and provide recommendations for future research.
Collapse
Affiliation(s)
- Annie B Fox
- Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System
| | - Valerie A Earnshaw
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital
- Department of Pediatrics, Harvard Medical School
| | - Emily C Taverna
- Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System
| | - Dawne Vogt
- Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System
- Department of Psychiatry, Boston University School of Medicine
| |
Collapse
|
10
|
Yoshimura Y, Bakolis I, Henderson C. Psychiatric diagnosis and other predictors of experienced and anticipated workplace discrimination and concealment of mental illness among mental health service users in England. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1099-1109. [PMID: 29987387 DOI: 10.1007/s00127-018-1561-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 07/02/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE This study aims to examine whether psychiatric diagnosis is associated with likelihoods of experienced and anticipated workplace discrimination and the concealment of psychiatric diagnoses. METHODS 5924 mental health service users in England were interviewed as part of the Viewpoint survey between 2009 and 2014 using the Discrimination and Stigma Scale. Associations of psychiatric diagnosis with experienced and anticipated work-related discrimination or the concealment of mental illness were examined with the use of logistic regression models. RESULTS 25.6% of the participants reported experiencing discrimination in at least one work-related domain, contrasting with the 53.7% who anticipated workplace discrimination and the 72.9% who had concealed their mental illness. There was strong evidence that patients with schizophrenia and schizoaffective disorder had a decreased risk of experienced discrimination in keeping a job compared to those with depression, anxiety disorder, bipolar disorder or personality disorder. Furthermore, patients with depression were more likely to report anticipated discrimination in applying for education or training compared to those with schizophrenia and schizoaffective disorder. In addition, patients with depression were more likely to conceal their mental illness compared to those with schizophrenia and schizoaffective disorder and bipolar disorder. CONCLUSION This study suggests that psychiatric diagnosis is a predictor of experienced and anticipated workplace discrimination and the concealment of mental illness and that more support is needed for employees with common mental disorders and their employers to enable better workplace outcomes for this group.
Collapse
Affiliation(s)
- Yusaku Yoshimura
- Department of Psychiatry, Zikei Hospital/Zikei Institute of Psychiatry, Okayama, Japan. .,Department of Psychiatry, Kawasaki Medical Graduate School, Kurashiki, Japan.
| | - Ioannis Bakolis
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.,Biostatistics and Health Informatics Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Claire Henderson
- Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| |
Collapse
|
11
|
Rayan A, Mahroum MH, Khasawneh A. The correlates of stigma toward mental illness among Jordanian patients with major depressive disorder. Perspect Psychiatr Care 2018; 54:192-197. [PMID: 28543049 DOI: 10.1111/ppc.12222] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/12/2017] [Accepted: 04/17/2017] [Indexed: 11/30/2022] Open
Abstract
AIM This study aims to assess the correlates of stigma toward mental illness among patients diagnosed with major depressive disorder (MDD). METHODS One hundred and sixty one Jordanian outpatients suffering from MDD completed the study. Participants completed the demographic questionnaire, the Center for Epidemiological Studies for the intensity of depression, and the Devaluation-Discrimination Scale to assess stigma. RESULTS Participants reported a moderate level of perceived stigma toward mental illness. Age, perceived pain, the number of relapses, and severity of depressive symptoms were significantly correlated with stigma toward mental illness among the study sample. The severity of depressive symptoms was the strongest correlate of stigma toward mental illness. CONCLUSIONS Factors associated with stigma toward mental illness should be carefully considered when implementing anti-stigma programs for patients.
Collapse
Affiliation(s)
- Ahmad Rayan
- Department of Psychiatric and Mental Health Nursing, Zarqa University, Zarqa, Jordan
| | - Maryam Husnee Mahroum
- The Acute Inpatient Psychiatric Unit at King Abdullah University Hospital, Ramtha, Jordan
| | - Aws Khasawneh
- Department of Neuro Sciences, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
12
|
|
13
|
Dell'Osso B, Glick ID, Baldwin DS, Altamura AC. Can long-term outcomes be improved by shortening the duration of untreated illness in psychiatric disorders? A conceptual framework. Psychopathology 2013; 46:14-21. [PMID: 22890286 DOI: 10.1159/000338608] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 03/18/2012] [Indexed: 01/22/2023]
Abstract
The duration of untreated illness (DUI), meaning the latency to the pharmacological treatment, has been increasingly investigated in the last decade as a predictor of outcome across different psychiatric conditions, particularly in psychotic disorders. DUI is essentially computed by subtracting the age of onset of a specific disorder from the age at which the first adequate pharmacological treatment is administered. Assessment of the latency to treatment represents one of the first steps in planning early interventions. This review examines the role of the DUI in psychotic and affective disorders, focusing on neuropathological, epidemiologic, clinical and prognostic factors related to a longer latency to treatment. Through a Medline and Cochrane Library search, relevant studies up to June 2011 and other pertinent articles including meta-analyses, randomized controlled trials, naturalistic studies and clinical reviews were identified. Converging evidence indicates that a prolonged DUI negatively influences the outcome of first-episode psychosis and schizophrenia in different ways, and increasing data point toward a similar conclusion in affective disorders. Even though methodological limitations related to investigation of the DUI need to be considered, research and interventions aimed to reduce latency to treatments are object of increasing implementation worldwide. The assessment of the DUI represents one of the most important parameters to consider in this perspective, in order to quantify different latency to treatment in specific disorders and to plan related, targeted interventions.
Collapse
Affiliation(s)
- Bernardo Dell'Osso
- Department of Neurological Sciences, Università degli Studi di Milano, Milano, Italy.
| | | | | | | |
Collapse
|
14
|
Failure to diagnose herniated discs in a depressed 43-year-old woman. Gen Hosp Psychiatry 2012; 34:103.e11-2. [PMID: 22018771 DOI: 10.1016/j.genhosppsych.2011.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2011] [Revised: 09/11/2011] [Accepted: 09/13/2011] [Indexed: 11/20/2022]
Abstract
A high comorbidity is known to exist between psychiatric illness and chronic pain (I. Elman, J.K. Zubieta, D. Borsook. The missing p in psychiatric training: why it is important to teach pain to psychiatrists. Arch Gen Psychiatry 2011;1:12-20). We report on the case of a middle-aged woman for whom preexisting psychiatric illness with a concurrent affective episode may have contributed to the failure by an array of clinicians across specialties to recognize an evolving surgical emergency.
Collapse
|
15
|
Frischknecht U, Beckmann B, Heinrich M, Kniest A, Nakovics H, Kiefer F, Mann K, Hermann D. The vicious circle of perceived stigmatization, depressiveness, anxiety, and low quality of life in substituted heroin addicts. Eur Addict Res 2011; 17:241-9. [PMID: 21654177 DOI: 10.1159/000328637] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Accepted: 04/16/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Perceived stigmatization of drug addicts may interact with negative mood states and thus may contribute to the maintenance of addictive behavior. METHODS Opiate maintenance patients (n = 106) and an unselected comparison group (n = 144) rated self-report questionnaires about perceived stigmatization, quality of life (QoL), depressiveness, anxiety, self-esteem, addiction characteristics, and social support. RESULTS 63% of opiate maintenance patients felt discriminated in contrast to 16% of the comparison group. Perceived stigmatization was rated higher by opiate maintenance patients, and all domains of QoL were rated lower, even when statistically controlling depressiveness, anxiety and social factors. Perceived stigmatization was correlated to depressiveness, anxiety, low self-esteem and low QoL, but not addiction characteristics and social support. Structural equation models revealed anxiety and the pathway depressiveness enhancing feelings of being stigmatized resulting in low self-esteem to explain 74% of variance in mental QoL, whereas anxiety and a pathway stigmatization inducing depressiveness leading to low self-esteem explained 49% of variance in physical QoL. CONCLUSIONS A vicious circle of stigmatization, negative affective states and low QoL was confirmed. In addition to societal antistigma campaigns, antidepressive and anxiolytic therapy might have the potential to diminish feelings of being stigmatized and to improve QoL.
Collapse
Affiliation(s)
- Ulrich Frischknecht
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med 2010; 71:2150-61. [PMID: 21051128 DOI: 10.1016/j.socscimed.2010.09.030] [Citation(s) in RCA: 838] [Impact Index Per Article: 59.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 07/12/2010] [Accepted: 09/21/2010] [Indexed: 12/13/2022]
Abstract
An expansive body of research has investigated the experiences and adverse consequences of internalized stigma for people with mental illness. This article provides a systematic review and meta-analysis of the extant research regarding the empirical relationship between internalized stigma and a range of sociodemographic, psychosocial, and psychiatric variables for people who live with mental illness. An exhaustive review of the research literature was performed on all articles published in English that assessed a statistical relationship between internalized stigma and at least one other variable for adults who live with mental illness. In total, 127 articles met the inclusion criteria for systematic review, of which, data from 45 articles were extracted for meta-analyses. None of the sociodemographic variables that were included in the study were consistently or strongly correlated with levels of internalized stigma. The review uncovered a striking and robust negative relationship between internalized stigma and a range of psychosocial variables (e.g., hope, self-esteem, and empowerment). Regarding psychiatric variables, internalized stigma was positively associated with psychiatric symptom severity and negatively associated with treatment adherence. The review draws attention to the lack of longitudinal research in this area of study which has inhibited the clinical relevance of findings related to internalized stigma. The study also highlights the need for greater attention on disentangling the true nature of the relationship between internalized stigma and other psychosocial variables.
Collapse
Affiliation(s)
- James D Livingston
- Forensic Psychiatric Services Commission, BC Mental Health & Addiction Services, British Columbia, Canada.
| | | |
Collapse
|
17
|
Age at onset and latency to treatment (duration of untreated illness) in patients with mood and anxiety disorders: a naturalistic study. Int Clin Psychopharmacol 2010; 25:172-9. [PMID: 20305566 DOI: 10.1097/yic.0b013e3283384c74] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study was designed to investigate and compare demographic and clinical features with specific emphasis on age at onset, age at first treatment and, in particular, on duration of untreated illness (DUI), in patients with different mood and anxiety disorders. Study sample included 729 outpatients with the following diagnoses: major depressive disorder (n=181), bipolar disorder type I (BD I, n=115) and II (BD II, n=186), generalized anxiety disorder (n=100), panic disorder (n=96), and obsessive-compulsive disorder (n=51). Main demographic and clinical variables of the sample were compared among the diagnostic groups using one-way analysis of variance or chi tests. The diagnostic groups showed significant differences in relation to age at onset and age at first pharmacological treatment and in relation to latency to treatment. In particular, patients with major depressive disorder showed the shortest DUI (39.08 months), whereas patient with BD II showed the longest DUI (97.2 months) in comparison with the other groups. Within the group with anxiety disorders (F=7.512, P<0.001), patients with panic disorder showed the shortest DUI (44.35 months), whereas patients with obsessive-compulsive disorder showed the longest DUI (90.57 months). The present findings suggest that patients with different mood and anxiety disorders show significant differences in terms of age at onset, age at first treatment and, consequently, DUI, which potentially reflect different reasons influencing treatment delay.
Collapse
|
18
|
Abstract
The duration of untreated illness (DUI), defined as the interval between the onset of a psychiatric disorder and the administration of the first pharmacological treatment, has been increasingly investigated in the last decade as a predictor of outcome across different psychiatric conditions including schizophrenia and psychotic disorders (duration of untreated psychosis), and mood and anxiety disorders. Converging evidence indicates that a prolonged DUI may be viewed as a negative prognostic factor in schizophrenia and increasing data point toward a similar conclusion in mood and anxiety disorders. Through a Medline search, the present article highlights the role of the DUI in this group of psychiatric disorders, focusing on social and psychopathological determinants of the DUI, as well as the clinical consequences related to a longer DUI in terms of outcome. Hypotheses on neurobiological mechanisms underpinning outcome differences in relation to a prolonged DUI are provided and methodological limitations related to the assessment of the DUI in published studies and clinical practice discussed. Finally, given that DUI is supposed to be a potentially modifiable prognostic factor, intervention programs aimed to reduce this variable are briefly considered and discussed.
Collapse
|
19
|
Brohan E, Slade M, Clement S, Thornicroft G. Experiences of mental illness stigma, prejudice and discrimination: a review of measures. BMC Health Serv Res 2010; 10:80. [PMID: 20338040 PMCID: PMC2851715 DOI: 10.1186/1472-6963-10-80] [Citation(s) in RCA: 235] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Accepted: 03/25/2010] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties. METHOD A narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. RESULTS 57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. CONCLUSIONS The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose.
Collapse
Affiliation(s)
- Elaine Brohan
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Mike Slade
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Sarah Clement
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Graham Thornicroft
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
| |
Collapse
|