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Ritschel LA, Cassiello-Robbins C. Hope and depression and personality disorders. Curr Opin Psychol 2023; 49:101507. [PMID: 36459930 DOI: 10.1016/j.copsyc.2022.101507] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022]
Abstract
Hope is a positive psychology construct that comprises goals, agency thinking, and pathways thinking and has been associated with psychological and physical well-being. This paper summarizes recent findings regarding the relationship between hope and depressive symptoms as well as hope and personality disorders and traits. Studies have shown that hope is inversely associated with negative affect when examined cross-sectionally, although the relationship between hope and depression is more complex longitudinally. Little is known about hope as it pertains to personality disorders, though more recent studies have examined the relationship between hope and personality traits such as neuroticism and extraversion; results from those studies are mixed, leaving a wide gap in the literature for future exploration.
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Affiliation(s)
- Lorie A Ritschel
- Triangle Area Psychology Clinic, 5726 Fayetteville Road, Suite 101, Durham, NC 27713, USA; University of North Carolina School of Medicine, Department of Psychiatry, Campus Box 7160, Chapel Hill, NC 27599-7160, USA.
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2
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Pyszkowska A, Stojek MM. Early Maladaptive Schemas and Self-Stigma in People with Physical Disabilities: The Role of Self-Compassion and Psychological Flexibility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10854. [PMID: 36078568 PMCID: PMC9518149 DOI: 10.3390/ijerph191710854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
Self-stigmatizing thoughts may be rooted in one's core beliefs, and in turn be associated with early maladaptive schemas (EMS). Psychological flexibility, an ability to distance and accept one's thoughts, is reported to diminish EMS's effect on well-being, while self-compassion, a mindful attitude towards one's suffering, often reduces self-stigma. The objective of this study was to examine associations between EMS, self-stigma, psychological flexibility and self-compassion in individuals with disabilities, as they are at higher risk of experiencing self-stigma. Participants were 238 persons with disabilities. The Self-Stigma Scale, Young's Schemas Questionnaire, the Self-Compassion Scale Short and the Acceptance and Action-II Questionnaire were used. Hierarchical regression and mediation analysis were used to establish (1) predictors and (2) potential mediators of self-stigma in people with disabilities. Hierarchical regression showed that EMS alone accounted for 39% of the variance explained by self-stigma, and with the addition of psychological flexibility-an additional 2% was explained. Parallel mediation analyses indicated that psychological flexibility partially mediated the relationship between EMS domains and self-stigma. It appears that psychological rigidity is related to self-stigma and should be addressed in treatment through evidence-based approaches such as Schema Therapy and Acceptance and Commitment Therapy to enhance individuals' healthy life patterns, flexibility and self-compassion.
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Affiliation(s)
- Anna Pyszkowska
- Department of Social Sciences, University of Silesia in Katowice, 40-007 Katowice, Poland
| | - Monika M. Stojek
- Department of Social Sciences, University of Silesia in Katowice, 40-007 Katowice, Poland
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
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Ociskova M, Prasko J, Vanek J, Holubova M, Hodny F, Latalova K, Kantor K, Nesnidal V. Self-Stigma and Treatment Effectiveness in Patients with SSRI Non-Responsive Obsessive-Compulsive Disorder. Psychol Res Behav Manag 2021; 14:85-97. [PMID: 33574718 PMCID: PMC7873032 DOI: 10.2147/prbm.s287419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 01/04/2021] [Indexed: 12/16/2022] Open
Abstract
Purpose Obsessive compulsive disorder (OCD) is a debilitating mental disorder that often takes a chronic course. One of the factors influencing the treatment effectiveness in anxiety and depressive disorders is the self-stigma. This study focused on the relationship between the self-stigma, symptomatology, and therapeutic outcomes in patients with OCD. Patients and Methods Ninety-four inpatients with OCD, who did not sufficiently respond to at least one selective serotonin reuptake inhibitor trial, participated in the study. They attended a six-week therapeutic program consisting of exposure and response prevention, transdiagnostic group cognitive behavioral therapy, individual sessions, mental imagery, relaxation, sport, and ergotherapy. The participants completed several scales: the Internalized Stigma of Mental Illness Scale (ISMI), the self-report Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR), Beck Anxiety Scale (BAI), Beck Depression Scale-II (BDI-II), and Dissociative Experiences Scale (DES). A senior psychiatrist filled in the Clinical Global Impression (CGI-S). Results The average scales' scores considerably declined in all measurements except for DES. The self-stigma positively correlated with all psychopathology scales. It was also higher in patients with a comorbid personality disorder (PD). The higher self-stigma predicted a lower change in compulsion, anxiety, and depressive symptoms but not the change of obsessions or the overall psychopathology. Conclusion The self-stigma presents an important factor connected to higher severity of OCD. It is also a minor predictor of a lower change in symptomatology after combined treatment.
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Affiliation(s)
- Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic.,Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic.,Institute for Postgraduate Education in Health Care, Prague, The Czech Republic
| | - Jakub Vanek
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
| | - Michaela Holubova
- Department of Psychiatry, Hospital Liberec, Prague, The Czech Republic
| | - Frantisek Hodny
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
| | - Klara Latalova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
| | - Krystof Kantor
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
| | - Vlastimil Nesnidal
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic
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Feasibility of a Brief Online Psychoeducational Intervention for Women With Sexual Interest/Arousal Disorder. J Sex Med 2020; 17:2208-2219. [PMID: 32919927 PMCID: PMC7480645 DOI: 10.1016/j.jsxm.2020.07.086] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/14/2020] [Accepted: 07/31/2020] [Indexed: 01/07/2023]
Abstract
Background Low sexual desire and arousal are the most common sexual concerns in women, but most women lack access to effective treatment such as cognitive behavioral therapy. Web-based psychological interventions, which are economical, private, easily accessible, and potentially effective, may increase the reach of evidence-based treatment. Aim To determine the feasibility of translating cognitive behavioral therapy for the most common female sexual dysfunction, Female Sexual Interest/Arousal Disorder, into an online format. The present study examined the feasibility of an introductory psychoeducational module of eSense, an online program currently being developed that is based on existing empirically supported in-person treatments, which delivers content to the user in a visually appealing and interactive manner. Methods Sixteen cisgender women (M age = 31.9) with female sexual arousal/interest disorder worked through a pilot module of eSense inperson at a sexual health laboratory. Outcomes Qualitative semistructured interviews and online questionnaires were used to assess participants’ experiences of usability of the platform, clarity/relevance of the content, satisfaction with the experience, and any changes in clinical outcomes of sexual function and distress. Results Participants reported a high level of satisfaction with the website’s functionality and presentation. They reported greater knowledge, felt validated and more hopeful, and were eager to continue the remaining modules. Participants also reported notable prepost improvements in sexual desire, arousal, and satisfaction. Clinical Implications Initial user-experience assessment may represent a method of simultaneously improving online interventions and providing therapeutic education to participants. Strengths & Limitations This is one of the first studies, to our knowledge, to test a graphics-rich, interactive online intervention for sexual difficulties that does not require direct contact with expert providers or support groups. Limitations include the high level of education, motivation, and technical fluency of the sample and the potentially confounding effect of the researcher’s presence during interviews. Because this was a feasibility study, the sample size was small, and no control group was included, limiting conclusions about efficacy and generalizability. Conclusion The format of eSense appears to be feasible and usable, lending support to the growing evidence that it is possible to take in-person therapeutic interventions online. Zippan N, Stephenson KR, Brotto LA, Feasibility of a Brief Online Psychoeducational Intervention for Women With Sexual Interest/Arousal Disorder. J Sex Med 2020;17:2208–2219.
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Granero R, Valero-Solis S, Fernández-Aranda F, Gómez-Peña M, Moragas L, Mena-Moreno T, del Pino-Gutierrez A, Codina E, Martín-Romera V, Casalé G, Agüera Z, Baenas-Soto I, Valenciano-Mendoza E, Mora-Maltas B, Sánchez I, Lozano-Madrid M, Menchón JM, Murcia SJ. Response trajectories of gambling severity after cognitive behavioral therapy in young-adult pathological gamblers. J Behav Addict 2020; 9:140-152. [PMID: 32359237 PMCID: PMC8935189 DOI: 10.1556/2006.2020.00008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND AND AIMS The significant increase in the prevalence of gambling disorder (GD) among young adults in recent years has attracted interest in determining therapeutic efficiency in this sector of the population. The aim of this work was to estimate the response trajectories of gambling severity during the six-month follow-up after a cognitive behavioral therapy (CBT) program in young adult patients and to identify the main variables associated with each trajectory. METHODS The sample included n = 192 patients, aged 19-35 years old, seeking treatment for GD. Response trajectories were identified through latent class growth analysis. RESULTS Three trajectories emerged: T1 (n = 118, 61.5%), composed of patients with severe GD at pre-treatment and good evolution to recovery; T2 (n = 62, 32.3%), with patients with moderate-high GD affectation at baseline and good evolution to recovery; and T3 (n = 12, 6.3%), with participants with severe baseline GD severity and poor evolution after CBT (Abbott, 2019). The highest risk of poor therapeutic outcomes was related to lower social index positions, high emotional distress, high scores in harm avoidance and low scores in self-directedness. DISCUSSION AND CONCLUSIONS Differences in the response trajectories at short-term follow-up after CBT reveal heterogeneity in the samples including young and young-adult GD patients. Patients' phenotype at baseline should be considered when developing efficient, person-centered intervention programs, which should comprise strategies aimed at increasing emotional regulation capacities, self-esteem and self-efficacy, with the aim of avoiding relapses in the medium-long term after therapy.
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Affiliation(s)
- Roser Granero
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Departament de Psicobiologia i Metodologia, Autonomous University of Barcelona, Barcelona, Spain
| | - Susana Valero-Solis
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Amparo del Pino-Gutierrez
- Department of Public Health, Mental Health and Mother-Infant Nursing, University School of Nursing, University of Barcelona, Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Virginia Martín-Romera
- Departamento de Educación y Psicología, Centro Universitario Cardenal Cisneros, Universidad de Alcalá, Madrid, Spain
| | - Gemma Casalé
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Zaida Agüera
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Isabel Baenas-Soto
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | | | - Bernat Mora-Maltas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,CIBER Salud Mental (CIBERsam), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez Murcia
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Corresponding author. Department of Psychiatry, Bellvitge University Hospital-IDIBELL and CIBERObn, c/Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain. Tel.: +34 93 260 79 88; fax: +34 93 260 76 58. E-mail:
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Serra R, Kiekens G, Tarsitani L, Vrieze E, Bruffaerts R, Loriedo C, An A, Vanderlinden J. The effect of trauma and dissociation on the outcome of cognitive behavioural therapy for binge eating disorder: A 6-month prospective study. EUROPEAN EATING DISORDERS REVIEW 2020; 28:309-317. [PMID: 32080958 DOI: 10.1002/erv.2722] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 12/01/2019] [Accepted: 12/23/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND Binge eating disorder (BED) is commonly associated with a history of trauma. Yet, there is little insight into the potential effect that trauma, dissociation, and depressive symptoms may have on the outcome of treatment interventions. METHODS A total of 142 treatment-seeking patients admitted with a diagnosis of DSM-5 BED (88% female; mean age = 38.7; SD = 10.8) took part in a 6-month, protocolized, group cognitive behavioural therapy (CBT). Self-report questionnaires were administered to assess lifetime traumatic experiences, dissociation, and depression. Body mass index and the number of binges per week (BPW) were measured throughout treatment. The main outcomes were the percentage reduction in BPW and remission (i.e., less than one BPW; cf. DSM-5). RESULTS Most BED patients (91.5%) reported a history of trauma, with two in three patients reporting three or more traumatic experiences. Whereas the number of traumatic experiences was not significantly associated with a reduction in BPW or remission, a higher traumatic impact score significantly decreased the likelihood of obtaining remission at the end of treatment (OR = 0.96; 95% CI [0.92, 0.99]). Higher levels of dissociative symptoms partially mediated this prospective association. CONCLUSIONS The impact of traumatic experiences, as opposed to the number of traumatic experiences experienced, negatively predicts remission after 6 months of CBT. These findings highlight the importance of addressing trauma and dissociative features in the CBT treatment of BED.
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Affiliation(s)
- Riccardo Serra
- Department of Human Neurosciences and Mental Health, Sapienza University of Rome, Rome, Italy.,Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium
| | - Glenn Kiekens
- Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium.,Universitair Psychiatrisch Centrum, KU Leuven University, Leuven, Belgium
| | - Lorenzo Tarsitani
- Department of Human Neurosciences and Mental Health, Sapienza University of Rome, Rome, Italy
| | - Elske Vrieze
- Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium.,Universitair Psychiatrisch Centrum, KU Leuven University, Leuven, Belgium
| | - Ronny Bruffaerts
- Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium.,Universitair Psychiatrisch Centrum, KU Leuven University, Leuven, Belgium
| | - Camillo Loriedo
- Department of Human Neurosciences and Mental Health, Sapienza University of Rome, Rome, Italy
| | | | - Johan Vanderlinden
- Universitair Psychiatrisch Centrum, KU Leuven University, Leuven, Belgium.,Faculty of Psychology and Educational Sciences, KU Leuven University, Leuven, Belgium
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Psychometric Properties of the Korean Dispositional Hope Scale Using the Rasch Analysis in Stroke Patients. Occup Ther Int 2019; 2019:7058415. [PMID: 31819741 PMCID: PMC6885203 DOI: 10.1155/2019/7058415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 10/15/2019] [Indexed: 11/17/2022] Open
Abstract
Background It is reported that hopeful thinking plays a positive role in encouraging patients to achieve functional goals during the rehabilitation process. Hope is a key concept in evaluating stroke outcomes in research and rehabilitation practice. Aims The purpose of this study was to investigate the psychometric properties of the Korean Dispositional Hope Scale (K-DHS) using the Rasch analysis in patients with hemiplegic stroke. Methods The K-DHS was completed by 166 community-dwelling hemiplegic stroke patients in Korea. Data were analyzed according to item fit, item difficulty, and the appropriateness of the rating scale using the Rasch analysis. Results Item fit analysis showed that 8 items of the K-DHS are appropriate because the infit MSNQ was between 0.7 and 1.3. Item difficulty results revealed that there is a difference in distribution between personal attributes and item difficulty. It shows that the item fit statistics of the 4-point Likert scale of K-DHS are all good. The person separation index demonstrated that the K-DHS could differentiate two or three hope status strata in stroke patients. The item separation index indicated that the items were useful with high reliability. Conclusion The K-DHS comprises appropriate items for measuring the hope of stroke patients living in the community, and the rating scale of the K-DHS is also appropriate. This study is the first to conduct an analysis of the rating scale and its appropriateness, as well as the difficulty of items based on item response theory, and offers new insights for enhancing hope and improving well-being following stroke.
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Tomasi J, Lisoway AJ, Zai CC, Harripaul R, Müller DJ, Zai GCM, McCabe RE, Richter MA, Kennedy JL, Tiwari AK. Towards precision medicine in generalized anxiety disorder: Review of genetics and pharmaco(epi)genetics. J Psychiatr Res 2019; 119:33-47. [PMID: 31563039 DOI: 10.1016/j.jpsychires.2019.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/15/2019] [Accepted: 09/05/2019] [Indexed: 02/06/2023]
Abstract
Generalized anxiety disorder (GAD) is a prevalent and chronic mental disorder that elicits widespread functional impairment. Given the high degree of non-response/partial response among patients with GAD to available pharmacological treatments, there is a strong need for novel approaches that can optimize outcomes, and lead to medications that are safer and more effective. Although investigations have identified interesting targets predicting treatment response through pharmacogenetics (PGx), pharmaco-epigenetics, and neuroimaging methods, these studies are often solitary, not replicated, and carry several limitations. This review provides an overview of the current status of GAD genetics and PGx and presents potential strategies to improve treatment response by combining better phenotyping with PGx and improved analytical methods. These strategies carry the dual benefit of delivering data on biomarkers of treatment response as well as pointing to disease mechanisms through the biology of the markers associated with response. Overall, these efforts can serve to identify clinical, genetic, and epigenetic factors that can be incorporated into a pharmaco(epi)genetic test that may ultimately improve treatment response and reduce the socioeconomic burden of GAD.
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Affiliation(s)
- Julia Tomasi
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Amanda J Lisoway
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Clement C Zai
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ricardo Harripaul
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Molecular Neuropsychiatry & Development (MiND) Lab, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Daniel J Müller
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Gwyneth C M Zai
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; General Adult Psychiatry and Health Systems Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Randi E McCabe
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Margaret A Richter
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Frederick W. Thompson Anxiety Disorders Centre, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - James L Kennedy
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Arun K Tiwari
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Bokma WA, Wetzer GAAM, Gehrels JB, Penninx BWJH, Batelaan NM, van Balkom ALJM. Aligning the many definitions of treatment resistance in anxiety disorders: A systematic review. Depress Anxiety 2019; 36:801-812. [PMID: 31231925 PMCID: PMC6771798 DOI: 10.1002/da.22895] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/19/2019] [Accepted: 03/22/2019] [Indexed: 12/16/2022] Open
Abstract
Anxiety Disorders often show a chronic course, even when treated with one of the various effective treatments available. Lack of treatment effect could be due to Treatment Resistance (TR). Consensus on a definition for TR Anxiety Disorders (TR-AD) is highly needed as currently many different operationalizations are in use. Therefore, generalizability in current TR-AD research is suboptimal, hampering improvement of clinical care. The objective of this review is to evaluate the currently used definitions of TR-AD by performing a systematic review of available literature. Out of a total of n = 13 042, 62 studies that operationalized TR-AD were included. The current review confirms a lack of consensus on TR-AD criteria. In 62.9% of the definitions, TR was deemed present after the first treatment failure. Most studies (93.0%) required pharmacological treatment failures, whereas few (29.0%) required psychological treatment failures. However, criteria for what constitutes "treatment failure" were not provided in the majority of studies (58.1%). Definitions for minimal treatment duration ranged from at least 4 weeks to at least 6 months. Almost half of the TR-AD definitions (46.8%) required elevated anxiety severity levels in TR-AD. After synthesis of the results, the consensus definition considers TR-AD present after both at least one first-line pharmacological and one psychological treatment failure, provided for an adequate duration (at least 8 weeks) with anxiety severity remaining above a specified threshold. This definition could contribute to improving course prediction and identifying more targeted treatment options for the highly burdened subgroup of TR-AD patients.
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Affiliation(s)
- Wicher A. Bokma
- Department of Psychiatry, Amsterdam UMCVrije Universiteit, Psychiatry, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
| | - Guido A. A. M. Wetzer
- Department of Psychiatry, Amsterdam UMCVrije Universiteit, Psychiatry, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
| | - Jurriaan B. Gehrels
- Department of Psychiatry, Amsterdam UMCVrije Universiteit, Psychiatry, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam UMCVrije Universiteit, Psychiatry, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
| | - Neeltje M. Batelaan
- Department of Psychiatry, Amsterdam UMCVrije Universiteit, Psychiatry, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
| | - Anton L. J. M. van Balkom
- Department of Psychiatry, Amsterdam UMCVrije Universiteit, Psychiatry, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
- GGZ inGeest Specialized Mental Health CareAmsterdamThe Netherlands
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10
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Moore KE, Stein MD, Kurth ME, Stevens L, Hailemariam M, Schonbrun YC, Johnson JE. Risk Factors for Self-stigma among Incarcerated Women with Alcohol Use Disorder. STIGMA AND HEALTH 2019; 5:158-167. [PMID: 33102697 DOI: 10.1037/sah0000182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Alcohol use disorder (AUD) is a highly stigmatized condition, often associated with negative stereotypes such as being morally weak, incompetent, unpredictable, and aggressive. People with AUD are at risk of experiencing self-stigma, a social-cognitive experience in which people think others hold negative stereotypes about them, expect to be treated unfairly, and/or believe that negative stereotypes are personally accurate. Women in the criminal justice system with AUD in particular are at risk of experiencing self-stigma due to intersecting sources of disadvantage. Given that self-stigma can lead to treatment avoidance and dropout, it is important to understand risk factors for self-stigma to inform prevention and intervention efforts in the justice system. Incarcerated women with AUD (n=185) completed measures of alcohol self-stigma as well as a variety of theoretically relevant risk factors including sociodemographics, baseline levels of stress and depression, and alcohol-related factors (i.e., length of drinking history, frequency/amount of use, consequences of use, physician advice to stop, belief that legal involvement is related to alcohol use, alcohol-related charges, self-efficacy to quit, readiness for treatment, pressures to enter treatment, factors that influence treatment) and other stigmatized conditions (drug use, exchanging sex, and homelessness). Results showed that experiencing more consequences of alcohol use, pressures to enter treatment, and perceived stress were associated with internalized stigma and anticipated/enacted stigma. This study begins to identify which incarcerated women with AUD are most at risk of experiencing self-stigma that may interfere with alcohol treatment.
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Affiliation(s)
- Kelly E Moore
- East Tennessee State University, Department of Psychology, 420 Rogers-Stout Hall P.O. 70649, Johnson City, TN 37614
| | - Michael D Stein
- Butler Hospital, Behavioral Medicine and Addictions Research, 345 Blackstone Blvd. Providence, RI 02906
- Boston University School of Public Health, Department of Health Law, Policy & Management, 715 Albany Street, Boston, MA 02118
| | - Megan E Kurth
- Butler Hospital, Behavioral Medicine and Addictions Research, 345 Blackstone Blvd. Providence, RI 02906
| | - Lindsey Stevens
- Brown University Medical School, Department of Psychiatry and Human Behavior, 345 Blackstone Boulevard, Providence, RI 02906
| | - Maji Hailemariam
- Michigan State University, Division of Public Health, College of Human Medicine, 200 East 1st St., Flint, MI 48502
| | - Yael C Schonbrun
- Butler Hospital, Behavioral Medicine and Addictions Research, 345 Blackstone Blvd. Providence, RI 02906
- Brown University Medical School, Department of Psychiatry and Human Behavior, 345 Blackstone Boulevard, Providence, RI 02906
| | - Jennifer E Johnson
- Michigan State University, Division of Public Health, College of Human Medicine, 200 East 1st St., Flint, MI 48502
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Cawthorpe D, Marriott B, Paget J, Moulai I, Cheung S. Relationship Between Adverse Childhood Experience Survey Items and Psychiatric Disorders. Perm J 2019; 22:18-001. [PMID: 30296396 DOI: 10.7812/tpp/18-001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Developmental psychopathology theory suggests a relationship between early childhood adversity and mental disorder. OBJECTIVE To examine the relationship between the specific items on the Adverse Childhood Experiences (ACE) survey and the International Classification of Diseases, Tenth Revision (ICD-10) categories of psychiatric diagnoses in a pediatric sample. DESIGN The sample included patients enrolled in the Child and Adolescent Addiction Mental Health and Psychiatry Program with both a completed ACE survey and at least 1 diagnosis of record (per admission). These criteria yielded 2 samples for each sex (ACE survey item frequencies and values in collapsed and multiple-admission groups). Data were analyzed employing tetrachoric correlation, hierarchical regression, and polychoric factor analysis. RESULTS Hierarchical regression analysis identified that ICD-10 diagnostic categories, except for substance disorders, were not consistently related to ACE total score and tended to reduce the magnitude of the ACE total score in the multiple-admission group. Tetrachoric correlation revealed very low (< 0.4) positive and negative correlations between ICD-10 categories and ACE items in both multiple-admission and collapsed sample groups. Polychoric factor analysis indicated that the ACE survey items and the ICD-10 categories for both sexes were independent, with only the diagnostic ICD-10 category substance disorders being marginally associated with the ACE items factor for females. CONCLUSION The nominal relationship between ACE items and ICD-10 diagnostic categories indicates the need to include ACE assessment in advance of differential diagnosis and implementation of conventional mental health interventions for children and adolescents.
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Affiliation(s)
- David Cawthorpe
- Adjunct Professor in the Departments of Psychiatry and Community Health Sciences at the Institute for Child & Maternal Health at The University of Calgary in Canada
| | - Brian Marriott
- Evaluation Analyst in Addiction and Mental Health at Alberta Health Services in Calgary, Canada
| | - Jaime Paget
- Information Management Analyst in Addiction and Mental Health at Alberta Health Services in Calgary, Canada
| | - Iraj Moulai
- Information Management Analyst in Addiction and Mental Health at Alberta Health Services in Calgary, Canada
| | - Sandra Cheung
- Evaluation Assistant in Addiction and Mental Health at Alberta Health Services in Calgary, Canada
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12
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Holubova M, Prasko J, Ociskova M, Kantor K, Vanek J, Slepecky M, Vrbova K. Quality of life, self-stigma, and coping strategies in patients with neurotic spectrum disorders: a cross-sectional study. Psychol Res Behav Manag 2019; 12:81-95. [PMID: 30787642 PMCID: PMC6363490 DOI: 10.2147/prbm.s179838] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Modern psychiatry focuses on self-stigma, coping strategies, and quality of life (QoL). This study looked at relationships among severity of symptoms, self-stigma, demographics, coping strategies, and QoL in patients with neurotic spectrum disorders. Methods A total of 153 clinically stable participants who met criteria for generalized anxiety disorder, social phobia, panic disorder, agoraphobia, mixed anxiety-depressive disorder, adjustment disorders, somatoform disorders, or obsessive-compulsive disorder were included in a cross-sectional study. Psychiatrists examined patients during regular psychiatric checkups. Patients completed the Quality of Life Satisfaction and Enjoyment Questionnaire (Q-LES-Q), Internalized Stigma of Mental Illness Scale (ISMI), a sociodemographic questionnaire, the Stress Coping Style Questionnaire (Strategie Zvládání Stresu [SVF] 78), and the Clinical Global Impression (CGI) scale. Results The diagnostic subgroups differed significantly in age and use of negative coping strategies, but not in other measured clinical or psychological variables. The findings showed that neither sex nor partnership played a role in perceived QoL. All Q-LES-Q domains correlated negatively with all ISMI domains, except school/study. Unemployed and employed groups of patients differed in QoL. Each of the coping strategies, except the need for social support, was related to self-stigma. The findings showed that sex, partnership, education, and employment played no role in self-stigma. No differences between sexes in positive coping strategies, severity of disorder, self-stigma, or QoL were found. QoL correlated significantly with all coping strategies, except for guilt denial. Multiple regression showed the most important factors to be positive coping, employment, and overall self-stigma rating, explaining 32.9% of QoL. Mediation analysis showed self-stigma level and negative coping strategies to be the most influential. The most substantial factors associated with self-stigma, as indicated by regression analysis, were Q-LES-Q total, subjective CGI, and positive coping strategies, which clarified 44.5% of the ISMI. Conclusion The study confirmed associations among self-stigma, quality of life, disorder severity, and coping strategies of outpatients with neurotic spectrum disorders.
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Affiliation(s)
- Michaela Holubova
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic, .,Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic, .,Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic
| | - Jan Prasko
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic, .,Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic, .,Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovakia,
| | - Marie Ociskova
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic, .,Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic,
| | - Kryštof Kantor
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic, .,Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic,
| | - Jakub Vanek
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic, .,Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic,
| | - Milos Slepecky
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovakia,
| | - Kristyna Vrbova
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic, .,Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic,
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Lorona RT, Fergus TA, Valentiner DP, Miller LM, McGrath PB. Self-Stigma and Etiological Attributions About Symptoms Among Individuals Diagnosed With an Anxiety Disorder: Relations With Symptom Severity and Symptom Improvement Following CBT. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2018. [DOI: 10.1521/jscp.2018.37.7.536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nearly one-third of individuals in the U.S. will be diagnosed with an anxiety disorder during their lifetime. Receiving that label can evoke self-stigma, with self-stigma relating to greater symptom severity and negatively impacting treatment outcomes. A lesser-studied variable related to self-stigma is etiological attributions about symptoms, including biological and psychological attributions. The current study examined interrelations among self-stigma, etiological attributions, and symptom severity among 213 individuals diagnosed with an anxiety disorder who completed a cognitive-behavioral treatment (CBT) program. How self-stigma and etiological attributions related to symptom improvement following the program was examined in a subset of participants. Etiological attributions and self-stigma shared positive associations with symptom severity. Regression analyses indicated that, when controlling for overlap among self-stigma and etiological attributions, psychological attributions emerged as particularly relevant for understanding symptom severity. Changes in self-stigma and attributions were positively associated with changes in symptom severity following the CBT program. Study implications are discussed.
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Affiliation(s)
| | | | | | | | - Patrick B. McGrath
- OCD and Related Anxiety Disorders Program at Alexian Brothers Behavioral Health Hospital
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Ociskova M, Prasko J, Vrbova K, Kasalova P, Holubova M, Grambal A, Machu K. Self-stigma and treatment effectiveness in patients with anxiety disorders - a mediation analysis. Neuropsychiatr Dis Treat 2018; 14:383-392. [PMID: 29416340 PMCID: PMC5790087 DOI: 10.2147/ndt.s152208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
GOAL The goal of this study was to explore the impact of self-stigma on the treatment outcomes in patients with anxiety disorders and to find possible mediators of this relationship. METHOD Two hundred and nine patients with anxiety disorders, who were hospitalized in a psychotherapeutic department, attended the study. The average age was 39.2±12.4 years; two-thirds were women. Most of the patients used a long-term medication. The participants underwent either cognitive behavioral therapy (CBT) or short psychodynamic therapy. The selection to the psychotherapy was not randomized. All individuals completed several scales - Beck Depression Inventory, the second edition (BDI-II), Beck Anxiety Inventory (BAI), Dissociative Experience Scale (DES), Sheehan Disability Scale (SDS), subjective Clinical Global Impression (subjCGI), and The Internalized Stigma of Mental Illness Scale (ISMI). A senior psychiatrist filled out the objective CGI (objCGI). RESULTS The patients significantly improved in the severity of anxiety (BAI), depression (BDI-II), and overall severity of the mental disorder (objCGI). The self-stigma predicted a lower change of the objCGI, but not a change of the anxiety and depressive symptoms severity. Anxiety, depressive symptoms, dissociation, and disability were assessed as possible mediators of the relationship between the self-stigma and the treatment change. None of them were significant. CONCLUSION Self-stigma lowers the effectiveness of the combined treatment of anxiety disorders. Future research should explore other possible mediators influencing this relationship.
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Affiliation(s)
- Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University, University Hospital, Olomouc
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University, University Hospital, Olomouc
| | - Kristyna Vrbova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University, University Hospital, Olomouc
| | - Petra Kasalova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University, University Hospital, Olomouc
| | - Michaela Holubova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University, University Hospital, Olomouc
| | - Ales Grambal
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University, University Hospital, Olomouc
| | - Klara Machu
- Department of Psychology, Faculty of Arts, University of Ostrava, Ostrava, The Czech Republic
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Grambal A, Prasko J, Kamaradova D, Latalova K, Holubova M, Marackova M, Ociskova M, Slepecky M. Self-stigma in borderline personality disorder - cross-sectional comparison with schizophrenia spectrum disorder, major depressive disorder, and anxiety disorders. Neuropsychiatr Dis Treat 2016; 12:2439-2448. [PMID: 27703362 PMCID: PMC5036602 DOI: 10.2147/ndt.s114671] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Self-stigma arises from one's acceptance of societal prejudices and is common in psychiatric patients. This investigation compares the self-stigma of a sample of patients with borderline personality disorder (BPD), schizophrenia spectrum disorder (SCH), major depressive disorder (MDD), bipolar affective disorder (BAD), and anxiety disorders (AD) and explores of the self-stigma with the subjective and objective measures of the severity of the disorder and demographic factors. METHODS The total of 184 inpatients admitted to the psychotherapeutic department diagnosed with BPD, SCH, MDD, BAP, and AD were compared on the internalized stigma of mental illness (ISMI) scale. The ISMI-total score was correlated with the subjective and objective evaluation of the disorder severity (clinical global impression), and clinical and demographic factors. RESULTS The self-stigma levels were statistically significantly different among the diagnostic groups (BPD 71.15±14.74; SCH 63.2±13.27; MDD 64.09±12.2; BAD 62.0±14.21; AD 57.62±15.85; one-way analysis of variance: F=8.698, df=183; P<0.005). However after applying the Bonferroni's multiple comparison test, the only significant difference was between the BPD patients and the patients with AD (P<0.001). Stepwise regression analysis showed that the strongest factors connected with the higher level of self-stigma were being without partner, the number of hospitalization, and the severity of the disorder. CONCLUSION The BPD patients suffer from a higher level of self-stigma compared to patients with AD. In practice, it is necessary to address the reduction of self-stigma by using specific treatment strategies, such as cognitive therapy.
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Affiliation(s)
- Ales Grambal
- Faculty of Medicine and Dentistry, Department of Psychiatry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Jan Prasko
- Faculty of Medicine and Dentistry, Department of Psychiatry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Dana Kamaradova
- Faculty of Medicine and Dentistry, Department of Psychiatry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Klara Latalova
- Faculty of Medicine and Dentistry, Department of Psychiatry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Michaela Holubova
- Faculty of Medicine and Dentistry, Department of Psychiatry, Palacky University Olomouc, University Hospital Olomouc, Olomouc; Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic
| | - Marketa Marackova
- Faculty of Medicine and Dentistry, Department of Psychiatry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Marie Ociskova
- Faculty of Medicine and Dentistry, Department of Psychiatry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Milos Slepecky
- Faculty of Social Science and Health Care, Department of Psychology Sciences, Constantine the Philosopher University, Nitra, Slovak Republic
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Holubova M, Prasko J, Matousek S, Latalova K, Marackova M, Vrbova K, Grambal A, Slepecky M, Zatkova M. Comparison of self-stigma and quality of life in patients with depressive disorders and schizophrenia spectrum disorders - a cross-sectional study. Neuropsychiatr Dis Treat 2016; 12:3021-3030. [PMID: 27920539 PMCID: PMC5127433 DOI: 10.2147/ndt.s121556] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The views of one's self-stigma and quality of life (QoL) in patients with schizophrenia and depressive disorders are significant subjective notions, both being proven to affect patient's functioning in life. The objective of this study was to investigate the QoL and self-stigma in connection with demographic factors and compare the two groups of patients in terms of those variables. METHODS In a cross-sectional study, the outpatients with schizophrenia spectrum disorders and depressive disorders completed the Quality of Life Satisfaction and Enjoyment Questionnaire, the Internalized Stigma of Mental Illness Scale, and a demographic questionnaire during a routine psychiatric control. Furthermore, both patients and their psychiatrists evaluated the severity of the disorder by Clinical Global Impression-Severity scale. RESULTS The QoL of patients with depressive disorders or schizophrenia spectrum disorders did not significantly differ between the two groups. In both groups, unemployment was perceived to be a significant factor decreasing the QoL. Self-stigma was detected to be higher in patients with schizophrenia spectrum disorders than in patients with depressive disorders. A strong correlation was found between the two scales, meaning that those with higher levels of self-stigmatization were less prone to see their life as fulfilling and joyful. CONCLUSION This study shows that the degree of the internalized stigma can be an important aspect linked to the QoL irrespective of the diagnostic category.
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Affiliation(s)
- Michaela Holubova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc; Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Stanislav Matousek
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Klara Latalova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Marketa Marackova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Kristyna Vrbova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Aleš Grambal
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Milos Slepecky
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic
| | - Marta Zatkova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic
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Holubova M, Prasko J, Ociskova M, Marackova M, Grambal A, Slepecky M. Self-stigma and quality of life in patients with depressive disorder: a cross-sectional study. Neuropsychiatr Dis Treat 2016; 12:2677-2687. [PMID: 27799775 PMCID: PMC5077239 DOI: 10.2147/ndt.s118593] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Self-stigma is a maladaptive psychosocial phenomenon that can affect many areas of patients' lives and have a negative impact on their quality of life (QoL). This study explored the association between self-stigma, QoL, demographic data, and the severity of symptoms in patients with depressive disorder. PATIENTS AND METHODS Patients who met the International Classification of Diseases, 10th revision, research criteria for depressive disorder were enrolled in this cross-sectional study. All outpatients completed the following measurements: the Quality of Life Enjoyment and Satisfaction Questionnaire, the Internalized Stigma of Mental Illness Scale, demographic questionnaire, and the objective and subjective Clinical Global Impression-Severity scales that measure the severity of disorder. A total of 81 depressive disorder patients (with persistent affective disorder - dysthymia, major depressive disorder, or recurrent depressive disorder) and 43 healthy controls participated in this study. RESULTS Compared with the healthy control group, a lower QoL was observed in patients with depressive disorder. The level of self-stigma correlated positively with total symptom severity score and negatively with QoL. Multiple regression analysis revealed that the overall rating of objective symptom severity and score of self-stigma were significantly associated with QoL. CONCLUSION This study suggests a lower QoL in patients with depressive disorder in comparison with healthy controls and a negative impact of self-stigma level on QoL in patients suffering from depressive disorders.
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Affiliation(s)
- Michaela Holubova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc; Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Marketa Marackova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Ales Grambal
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Milos Slepecky
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University, Nitra, Slovak Republic
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