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Alqahtani R, Pringle A. The general impact of self-stigma of mental illness on adult patients with depressive disorders: a systematic review. BMC Nurs 2024; 23:432. [PMID: 38918754 PMCID: PMC11200989 DOI: 10.1186/s12912-024-02047-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Mental illness stigma is often common among mentally ill patients. This stigma can come from others or the patients themselves, which is called 'self-stigma'. The present study explored the widespread impacts of self-stigma on adult patients with depression. Additionally, this review compared the severity of self-stigma levels among psychiatric disorders and to review and update thoughts about self-stigma of depression. METHODS An etiology and risk systematic review was conducted using the Joanna Briggs Institute (JBI) approach as a guideline. The search process was performed via research databases including MEDLINE, EMBASE and CINAHL. The inclusion criteria are studies include participants diagnosed with depressive disorders, both genders, participants' exposure to mental illness self-stigma, participants' experience of self-stigma consequences and any geographical site or clinical settings are included, the type of the included studies must be observational studies. The included studies were limited to the English language studies that were published from 2016 and onwards. Patients with depression under the age of eighteen and patients diagnosed with multiple mental illnesses were excluded. The JBI critical appraisal checklist were adopted to assess the risk of bias. RESULTS In December 2022, a comprehensive search yielded eight cross-sectional studies that were included in this systematic review, involving a total of 783 patients diagnosed with depression, and 28 studies were excluded for not fulfilling the inclusion criteria of the review. The findings were extracted and synthesized through textual narrative synthesis into three main categories negatively affected by self-stigma of depression. These are: (1) the impact on the quality of life, (2) the impact on self-esteem and (3) the impact on self-worth. Moreover, in regard to the comparison of self-stigma levels among psychiatric disorders, self-stigma for people with schizophrenia was higher than self-stigma of depression. CONCLUSION Self-stigma of depression has negatively impacted multiple aspects of the patient's life. Thus, the review brings the following recommendations: increase community awareness, educate the healthcare providers, include the topic of mental illness stigma in academic curriculums. The main limitation of the review is the limited number of included studies. TRIAL REGISTRATION The research proposal for this review has been registered to Prospero (ID number: CRD42022366555).
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Affiliation(s)
- Refah Alqahtani
- Faculty of Nursing and Applied Medical Sciences, College of Applied Medical Science in Jubail, Imam Abdulrahman Bin Faisal University (IAU), Jubail Industrial City, Saudi Arabia.
| | - Alan Pringle
- Faculty of Medicine & Health Sciences, School of Health Sciences, Nottingham University, Nottingham City, UK
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Watts G, Crompton C, Grainger C, Long J, Botha M, Somerville M, Cage E. 'A certain magic' - autistic adults' experiences of interacting with other autistic people and its relation to Quality of Life: A systematic review and thematic meta-synthesis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241255811. [PMID: 38829019 DOI: 10.1177/13623613241255811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
LAY ABSTRACT Research has suggested that autistic people enjoy spending time with other autistic people and find them easier to talk to. We wanted to find out what autistic people say about spending time with other autistic people and whether this makes their life better. We found 52 papers which described this and reviewed what they found. We found that many autistic people had positive experiences of spending time with other autistic people and these experiences had positive impact on their lives in a range of different ways. The papers did not tell us whether this also happens for autistic people with a learning disability. More research is needed to find out more about why spending time with other autistic people helps some autistic people.
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Kayaoğlu K, Ay E. Examination of internalized stigma, quality of life, and happiness in patients with schizophrenia. J Ment Health 2024; 33:101-109. [PMID: 37975570 DOI: 10.1080/09638237.2023.2278096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 08/25/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Happiness in patients with schizophrenia is a neglected concept that needs to be developed. Determining the relationship between internalized stigma, quality of life, and happiness, which is important for the prognosis of schizophrenia, will reveal why it is necessary to focus on activities that will increase happiness in patients with schizophrenia. AIM This study aimed to compare the levels of internalized stigma, quality of life, and happiness in patients with schizophrenia. METHODS A descriptive and correlational research design was used. The research population consisted of patients who applied to the psychiatry outpatient clinic of a hospital in eastern Turkey during the research period and were diagnosed with schizophrenia according to the DSM-5 diagnostic criteria; 87 voluntary patients who agreed to participate in the study constituted the research sample. A personal information form, the Internalized Stigma of Mental Illness Scale (ISMI), the World Health Organization Quality-of-Life Scale (WHOQOL-BREF), and the Subjective Happiness Scale (SHS) were used for data collection. RESULTS According to the patients' ISMI, WHOQOL-BREF-TR, and SHS scores, patients perceived internalized stigma above the moderate level in all sub-dimensions. In general, their quality of life was moderate (the highest mean score was on the national environment domain and the lowest mean score was on the social domain); the mean SHS score was 13.02 ± 5.53. There was a strong and negative correlation between the mean SHS score and the total ISMI score and a strong and positive correlation between SHS and the physical, mental, social, and national environment domains of WHOQOL-BREF-TR. CONCLUSIONS It was determined that the mean internal stigma score of the patients decreased and their mean quality of life score increased as their mean subjective happiness score increased. It is recommended clinical studies be carried out to increase happiness in patients with schizophrenia.
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Affiliation(s)
- Kübra Kayaoğlu
- Department of Psychiatric Nursing, Faculty of Health Sciences, Malatya Turgut Ozal University, Malatya, Turkey
| | - Eda Ay
- Department of Psychiatric Nursing, Faculty of Nursing, Atatürk University, Erzurum, Turkey
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Attepe Özden S, Tekindal M, Tekindal MA. Quality of Life of people with Schizophrenia: A meta-analysis. Int J Soc Psychiatry 2023; 69:1444-1452. [PMID: 37029492 DOI: 10.1177/00207640231164019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
BACKGROUND Schizophrenia is a severe, chronic mental disorder that causes many psychosocial problems. In order to reveal these problems, it is necessary to measure the quality of life of people with schizophrenia. AIM The aim of this meta-analysis is to compare the quality of life of people with schizophrenia and healthy subjects. METHODS Literature search was conducted in the Web of Science Core Collection database including the dates of January 2000 and March 2021. The systematic search provided 464 potentially relevant studies. The final sample consisted of 18 studies. RESULTS The results of using a random effects model for analysis indicated that schizophrenia subjects showed considerably lower quality of life scores compared to healthy controls. CONCLUSION Determining the quality of people with schizophrenia will help us to create effective psychosocial intervention programs.
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Affiliation(s)
| | - Melike Tekindal
- Department of Social Work, İzmir Katip Çelebi University, İzmir, Turkey
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Garg R, Singla A, Raj R. Health-related quality of life and stigma in opioid dependence: Comparison between buprenorphine users and non-users. J Neurosci Rural Pract 2023; 14:453-458. [PMID: 37692831 PMCID: PMC10483188 DOI: 10.25259/jnrp_109_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/15/2023] [Indexed: 09/12/2023] Open
Abstract
Objectives Opioid dependence leads to reduced quality of life (QOL) and stigma. There is scarcity of literature on impact of buprenorphine on QOL of patients with opioid dependence from India. This study reports QOL and stigma in patients taking buprenorphine and compare it with those who were not on any treatment. Materials and Methods A cross-sectional, descriptive, comparative study was conducted among three groups (n = 100 each). Group 3 comprised patients who were already taking buprenorphine for at least 3 months from a government outpatient opioid-assisted treatment center. Group 2 comprised patients who were not on any treatment but had come to enrol in buprenorphine treatment and Group 1 comprised patients who had come to get some other treatment and were not willing for buprenorphine. After fulfilling inclusion and exclusion criteria, sociodemographic pro forma, Hindi self-stigma scale, and World Health Organization QOL-BREF Hindi were applied. Appropriate statistical analyses were done. Results Patients already taking buprenorphine had significantly better QOL and it improved as the duration of treatment increased. Patients on buprenorphine treatment had significantly lesser stigma than patients not already on treatment. Stigma negatively impacted QOL in the three groups. Conclusion QOL and factors affecting it should be an integral part of management of opioid dependence. Efforts should be made to enrol maximum number of patients in treatment to enhance their quality of life and reduce stigma.
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Affiliation(s)
- Rohit Garg
- Department of Psychiatry, Government Medical College, Patiala, Punjab, India
| | - Aditi Singla
- Department of Psychiatry, Government Medical College, Patiala, Punjab, India
| | - Rajnish Raj
- Department of Psychiatry, Government Medical College, Patiala, Punjab, India
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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.
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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.
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Luo R, Ji Y, Liu Y, Sun H, Tang S, Li X. Relationships among social support, coping style, self-stigma, and quality of life in patients with diabetic foot ulcer: A multicentre, cross-sectional study. Int Wound J 2023; 20:716-724. [PMID: 36787266 PMCID: PMC9927899 DOI: 10.1111/iwj.13914] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/23/2022] [Indexed: 11/27/2022] Open
Abstract
Patients with diabetic foot ulcer have a significantly lower quality of life. Quality of life could be connected to other psychological or social processes. The purpose of this study was to examine the relationships between social support, decision regret, self-stigma, and quality of life in patients with diabetic foot ulcers. The sample of the study consisted of 229 diabetic foot ulcer patients. Data were collected from September 2019 to March 2020. The demographic and clinical information, the Stigma Scale for Chronic Illness, Medical Coping Scale, Social Support Scale, and Quality of Life scale were used to assess the quality life for diabetic foot ulcer. Pearson correlation coefficient and structural equation modelling were used for data analysis. The quality of life was negatively correlated with self-stigma, positively correlated with social support, giving up coping, and not significantly correlated with confrontation coping and avoidance coping. Self-stigma has significant indirect effects on quality of life through social support and coping style. Further clinical intervention strategies for decreasing self-stigma as well as strengthening social support and positive coping styles are needed to inform diabetic foot ulcer patients, thus improving their quality of life.
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Affiliation(s)
- Ruzhen Luo
- Xiangya Nursing SchoolCentral South UniversityChangshaChina
| | - Yunan Ji
- School of NursingTianjin HospitalTianjinChina
| | - Yan‐hui Liu
- School of NursingTianjin University of Traditional Chinese MedicineTianjinChina
| | - Hongyu Sun
- School of NursingPeking UniversityBeijingChina
| | - Siyuan Tang
- Xiangya Nursing SchoolCentral South UniversityChangshaChina
| | - Xuechun Li
- School of NursingTianjin University of Traditional Chinese MedicineTianjinChina
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Kılıç A, Görmez A, Yeni Elbay R, Özer BU. Internalized stigma in obsessive compulsive disorder: Correlates and associations with quality of life. Arch Psychiatr Nurs 2022; 39:37-45. [PMID: 35688542 DOI: 10.1016/j.apnu.2022.03.006] [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: 06/26/2021] [Revised: 01/20/2022] [Accepted: 03/13/2022] [Indexed: 11/16/2022]
Abstract
In the present study we aimed to measure IS among outpatients with OCD, and to assess its relationship with clinical and sociodemographic variables, and quality of life. Out of 100 patients assessed, 79 patients with OCD were included in the study. Each patient was assessed using the SCID-5 CV, Y-BOCS, ISMI Scale, and WHOQOL-BREF. There was a strong correlation of IS with lower QoL and severity of OCD symptoms. Avoidance behavior, psychological health and social relationship domains emerged as independent factors related to IS in the regression analysis. There is a need for further studies on a larger samples to identify the specifics of the development and impact of IS in people with OCD.
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Affiliation(s)
- Alperen Kılıç
- Istanbul Medipol University, Faculty of Medicine, Department of Psychiatry, TEM Avrupa Otoyolu Göztepe Çıkışı No: 1, 34214 Bağcılar, İstanbul, Turkey
| | - Aynur Görmez
- Istanbul Medeniyet University Faculty of Medicine, Göztepe Training and Research Hospital Department of Psychiatry, Eğitim Mah., 34722 Kadıköy, İstanbul, Turkey.
| | - Rümeysa Yeni Elbay
- Istanbul Medeniyet University Faculty of Medicine, Göztepe Training and Research Hospital Department of Psychiatry, Eğitim Mah., 34722 Kadıköy, İstanbul, Turkey
| | - Bahtiyar Umut Özer
- Istanbul Medeniyet University Faculty of Medicine, Göztepe Training and Research Hospital Department of Psychiatry, Eğitim Mah., 34722 Kadıköy, İstanbul, Turkey
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de Filippis R, Menculini G, D'Angelo M, Carbone EA, Tortorella A, De Fazio P, Steardo L. Internalized-stigma and dissociative experiences in bipolar disorder. Front Psychiatry 2022; 13:953621. [PMID: 35966460 PMCID: PMC9372275 DOI: 10.3389/fpsyt.2022.953621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Dissociative symptoms have been recently related to bipolar disorder (BD) symptomatology. Moreover, the disease burden carries on a share of perceived self-stigma that amplifies the BD impairment. Internalized stigma and dissociative symptoms often seem overlapping, leading toward common outcomes, with reduced treatment seeking and poor adherence. We hypothesize a potential relationship between dissociation and self-stigma in patients suffering from BD. MATERIALS AND METHODS In this cross-sectional study we enrolled a total of 120 adult clinically stable BD outpatients. All participants completed the Internalized Stigma of Mental Illness (ISMI), Dissociative Experiences Scale-II (DES-II), and Manchester Short Assessment of Quality of Life (MANSA). RESULTS Average age and age at BD (BD-I n = 66, 55%; BD-II n = 54, 45%) onset were 46.14 (±4.23), and 27.45 (±10.35) years, with mean disease duration of 18.56 (±13.08) years. Most participants were female (n = 71; 59.2%) and 40 (33%) of them experienced lifetime abuse, with an average of 1.05 (±0.78) suicide attempts. DES scores (mean 31.8, ±21.6) correlated with ISMI total-score, with significant association with spikes in Alienation (13.1, SD±3.1) (p < 0.001) and Stereotype (13.8, SD±3.9) (p < 0.001). Linear regression analysis has shown a significant association between DES total score and alienation (p < 0.001), stereotype (p < 0.001) and MANSA total-score (p < 0.001). DISCUSSION For the first time, our data suggests that self-stigma is associated to dissociative symptoms, reducing overall quality of life in BD. The early identification of at-risk patients with previous lifetime abuse and high perceived stigma could lead the way for an ever more precise tailoring of treatment management.
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Affiliation(s)
- Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | | | - Martina D'Angelo
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Elvira Anna Carbone
- Psychiatry Unit, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | | | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Luca Steardo
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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He Z, Chiu JWT, Lin Y, Akinwunmi B, Wong TH, Zhang CJP, Ming WK. The Construct Structures of Psychological and Behavioral Responses to COVID-19 Pandemic in Pregnant Women. Front Psychiatry 2022; 13:796567. [PMID: 35903641 PMCID: PMC9323087 DOI: 10.3389/fpsyt.2022.796567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
AIM The present study aimed to investigate the construct structure behind the psychosocial response, behavioral response, prenatal depression, and post-traumatic stress disorder (PTSD) in pregnant women during the COVID-19 pandemic in China. METHOD The validated Chinese version of the Edinburgh Postnatal Depression Scale (EPDS), PTSD CheckList (PCL)-6, and two newly established scales for COVID-19-related psychological and behavioral responses were used. Structural equation modeling (SEM) analysis was applied to evaluate the structural relationships of psychological and behavioral responses during the COVID-19 pandemic. RESULTS Of the 1,908 mothers who completed the questionnaires, 1,099 met the criteria for perinatal depression, and 287 were positively screened for PTSD, where 264 women exceed the cut-off points for both. Pregnant women with full-time or part-time jobs tended to have the lowest scores of EPDS (10.07 ± 5.11, P < 0.001) and stress levels (23.85 ± 7.96, P = 0.004), yet they were more likely to change their behavior in accordance with the COVID-19 outbreak (13.35 ± 3.42, P = 0.025). The structural model fit the data (χ2 = 43.260, p < 0.001) and resulted in satisfactory fit indices (CFI = 0.984, TLI = 0.959, RMSEA = 0.072, and χ2/df = 10.815), all path loadings were significant (p < 0.05). The SEM indicates that the level of QoL was attributable to the occurrence of PND, leading to PTSD, and COVID-19 related behavioral and psychological responses. CONCLUSION The inter-relationships between the COVID-19-related psychosocial and behavioral responses have been assessed, indicating that the pandemic increased the burden of perinatal depression. Psychoeducation, as well as other psychological interventions, may be needed to alleviate the COVID-19-based anxiety and increase their engagement in protective behaviors.
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Affiliation(s)
- Zonglin He
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Science, City University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Division of Life Science, The Hong Kong University of Science and Technology, Hong Kong, Hong Kong SAR, China
| | - Joyce Wai-Ting Chiu
- International School, Jinan University, Guangzhou, China.,Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Department of Psychology, University of York, York, United Kingdom
| | - Yuchen Lin
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Babatunde Akinwunmi
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.,Center for Genomic Medicine (CGM), Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston, MA, United States
| | - Tak Hap Wong
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, China.,Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, China
| | - Casper J P Zhang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Science, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Sayed TA, Ali MM, Hadad S. Risk factors and impact of stigma on psychiatric patients in Sohag. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00403-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Stigma among psychiatric patients is pervasive all over the world. Our aim in this study was to investigate risk factors for stigma related to psychiatric disorders and to demonstrate the major consequences of mental stigma for patients who experience mental illness. We conducted a cross-sectional study and applied a stigma scale to 573 patients with psychiatric disorders who attended our outpatient psychiatry clinic. Participants were divided into two groups, group I (no.262) with low stigma score and group II (no.311) with high stigma score. The two groups were compared in term of socio-demographic characteristics (age, gender, level of education, residency, marital status, employment and socioeconomic level), factors related to the psychiatric disorder (duration of illness, number of psychiatric hospital admission and diagnosis) and impact of psychiatric illness (follow-up visits, adherence to medications and suicidal thoughts or attempts).
Results
The mean age of patients with high stigma score (group II) was 29 ± 6 years. High stigma score was more common in females (53.7%), illiterate (11.9%), living in rural areas (58.2%), single (22.83%), unemployed (44.37%) and low socioeconomic class (59.49%). Patients with a high stigma score showed longer duration of psychiatric disorder (43 ± 8 months), more frequent number of psychiatric hospital admission (4.3 ± 0.5) and schizophrenia ((11.25%) and other psychotic disorders (6.49%) were common diagnoses. Patients with a high stigma score show poor adherence to medication (47.91%) and follow-up (44.05%) and a high frequency of suicidal ideation or attempt (47.91%). Significant risk factors predicting high mental stigma were level of education (explaining about 23% of the risk, P = 0.03), duration of mental illness (explaining about 25% of the risk, P = 0.019), number of hospital admissions (explaining about 22.7% of the risk, P = 0.032), diagnosis of mental illness (explaining about 27.7% of the risk, P = 0.01).
Conclusion
Mental stigma is more prevalent among young aged individuals, females, single, unemployed, living in rural areas and those with lower educational and socioeconomic level. Mental stigma has a parallel correlation with psychiatric disorder duration, number of psychiatric hospital admissions, as well as diagnosis of psychotic disorder. The stigma of mental illness from the viewpoint of the patient may lead to delaying the access to care as well as poor adherence to medications and follow-up. Anti-stigma measures can contribute to diminishing the psychiatric illness effect.
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Shoib S, Das S, Gupta AK, Saleem T, Saleem SM. Perceived stress, quality of life, and coping skills among patients with schizophrenia in symptomatic remission. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00153-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Schizophrenia is one of the worst diseases with its ubiquitous challenges due to its unique psychopathology and life events. Patients with schizophrenia use various coping strategies to overcome distress. The aim of the study was to evaluate the association between perceived stress, quality of life, and coping skills in patients with schizophrenia in remission. A total of 48 consecutive patients of schizophrenia, in remission, attending outpatient department of psychiatry at Academic hospital, South India, who satisfied the inclusion and exclusion criteria were recruited for the present study. The participants were assessed on Positive and Negative Symptoms Scale, Ways of Coping Checklist – Revised and Perceived Stress Scale and WHO Quality of Life. Results were analyzed using appropriate statistical package software v 16.0.
Result
Highest medial was found in self-controlling and positive reappraisal coping skills. Distancing is associated with high physical domain of quality of life whereas patients with good social support score more in social and physical domain of quality of life.
Conclusion
Patients with history of schizophrenia even though in remission dwell a stressful life. They often need different kind of social support or cognitive aids. In that view, studying their stress level, ability to cope with it, and quality of life will help us to manage them in better way.
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Shumye S, Amare T, Derajew H, Endris M, Molla W, Mengistu N. Perceived quality of life and associated factors among patients with severe mental illness in Ethiopia: a cross-sectional study. BMC Psychol 2021; 9:152. [PMID: 34602067 PMCID: PMC8489038 DOI: 10.1186/s40359-021-00664-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 09/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background Severe mental illness is strongly associated with an impaired quality of life. This intern can affect the treatment adherence and outcomes of the illness. However, there are insufficient studies in the literature pertaining to the quality of life of patients with severe mental illness in Ethiopia. Therefore, assessing the quality of life of patients with severe mental illness and its correlates is a yardstick measure of the effectiveness of the mental health service. Methods An institutional based cross-sectional study was conducted from May 1 to 16, 2019 at Amanuel Mental Specialized Hospital. A systematic random sampling technique was used to get a total number of 387 samples. Data were collected using interview-administered questionnaires; World Health Organization Quality of Life Brief Version, Morisky Medication Adherence Screening Tool, Oslo Social Support Scale, and Jacoby Stigma Scale. Simple and multiple linear regression analysis were used to assess the contributing factors of quality of life in the participants and B coefficient with 95% CI confidence interval was used. The statistical significance was accepted at p value < 0.05. Results The result showed that the Mean quality of life score of patients with severe mental illness for each domain (mean ± SD) was 41.3 ± 7.5, 42.8 ± 8.2, 38.9 ± 8.9, and 41.8 ± 6.5 for physical, psychological, social and environmental, respectively. Multiple regression analysis showed that age of participants was strongly positively correlated with all domains of quality of life. It predicts above 45% of the variability in each domain. Social support is also another strong predictor which was negatively correlated with all domains of quality of life, except physical. Conclusion This study revealed that the mean score quality of life of patients with severe mental illness in each domain was low. This demonstrates a need for improving the quality of life of people with severe mental illness by integration of a positive mental health approach and bio-psychosocial view with biological treatment of severe mental illness. Moreover, in Collaboration with medical professionals, people with severe mental illness should screen and managed for any comorbid medical conditions.
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Affiliation(s)
- Seid Shumye
- Department of Psychiatry, Dilla University, P.O. Box (DU): 419, Dilla, Ethiopia
| | - Tadele Amare
- Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | - Habtamu Derajew
- Department of Psychiatry, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
| | - Merdia Endris
- Department of Psychiatry, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
| | - Wondwosen Molla
- Department of Midwifery, Dilla University, P.O. Box (DU): 419, Dilla, Ethiopia
| | - Nebiyu Mengistu
- Department of Psychiatry, Dilla University, P.O. Box (DU): 419, Dilla, Ethiopia.
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Dubreucq J, Plasse J, Franck N. Self-stigma in Serious Mental Illness: A Systematic Review of Frequency, Correlates, and Consequences. Schizophr Bull 2021; 47:1261-1287. [PMID: 33459793 PMCID: PMC8563656 DOI: 10.1093/schbul/sbaa181] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Self-stigma is associated with poor clinical and functional outcomes in Serious Mental Illness (SMI). There has been no review of self-stigma frequency and correlates in different cultural and geographic areas and SMI. The objectives of the present study were: (1) to review the frequency, correlates, and consequences of self-stigma in individuals with SMI; (2) to compare self-stigma in different geographical areas and to review its potential association with cultural factors; (3) to evaluate the strengths and limitations of the current body of evidence to guide future research. A systematic electronic database search (PubMed, Web of Science, PsycINFO, Scopus, and Ovid SP Cumulative Index to Nursing and Allied Health Literature [CINAHL]) following PRISMA guidelines, was conducted on the frequency, correlates, and consequences of self-stigma in SMI. Out of 272 articles, 80 (29.4%) reported on the frequency of self-stigma (n = 25 458), 241 (88.6%) on cross-sectional correlates of self-stigma and 41 (15.0%) on the longitudinal correlates and consequences of self-stigma. On average, 31.3% of SMI patients reported high self-stigma. The highest frequency was in South-East Asia (39.7%) and the Middle East (39%). Sociodemographic and illness-related predictors yielded mixed results. Perceived and experienced stigma-including from mental health providers-predicted self-stigma, which supports the need to develop anti-stigma campaigns and recovery-oriented practices. Increased transition to psychosis and poor clinical and functional outcomes are both associated with self-stigma. Psychiatric rehabilitation and recovery-oriented early interventions could reduce self-stigma and should be better integrated into public policy.
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Affiliation(s)
- Julien Dubreucq
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, Lyon, France
- Centre référent de réhabilitation psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France
- Fondation FondaMental, Créteil, France
| | - Julien Plasse
- Réseau Handicap Psychique, Grenoble, France
- Centre Ressource de Réhabilitation Psychosociale et de Remédiation cognitive, Centre Hospitalier Le Vinatier, Bron, France
| | - Nicolas Franck
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, Lyon, France
- Centre Ressource de Réhabilitation Psychosociale et de Remédiation cognitive, Centre Hospitalier Le Vinatier, Bron, France
- Pôle Centre Rive Gauche, Centre Hospitalier Le Vinatier, Bron, France
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15
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González-Sanguino C, Castellanos MÁ, González-Domínguez S, Muñoz M. Talking about mental illness, professional help, self-esteem and health. A structural equation model of implicit and explicit internalized stigma. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01930-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Abo-Rass F, Werner P, Shinan-Altman S. Self-stigma formation process among younger and older Israeli Arabs diagnosed with depression. Aging Ment Health 2021; 25:1071-1076. [PMID: 32347106 DOI: 10.1080/13607863.2020.1758901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Self-stigma is common among persons with depression. Still, studies that examined the process of self-stigma concentrated mostly on younger adults (ages 18-65) with mental illness in general, with a limited number of studies examining older adults with depression. This study was aimed to examine and compare the self-stigma formation process and its relation to self-esteem among younger (ages 18-64) and older Israeli Arabs (age 65+) diagnosed with depression. The study was based on a self-stigma model which defines the self-stigma formation process as composed of three stages: stereotypes awareness, stereotype agreement, and self-concurrence. METHOD A total of 160 younger and older Israeli Arabs with depression completed measures of self-stigma formation process, self-esteem, and socio-demographic and health characteristics. RESULTS The self-stigma formation process was found as a multi-level and progressive model for both younger and older adults, despite that older adults reported significantly higher levels of self-stigma in all stages of the process. Low self-esteem was significantly associated with higher levels of stereotype agreement and self-concurrence in both age groups. CONCLUSION The self-stigma formation process provides an adequate model for understanding depression self-stigma in both younger and older adults. Appropriate intervention programs aiming to reduce self-stigma should be developed, focusing on reducing the three stages of self-stigma.
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Affiliation(s)
- Fareeda Abo-Rass
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Perla Werner
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Degnan A, Berry K, Humphrey C, Bucci S. The relationship between stigma and subjective quality of life in psychosis: A systematic review and meta-analysis. Clin Psychol Rev 2021; 85:102003. [DOI: 10.1016/j.cpr.2021.102003] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/20/2021] [Accepted: 02/23/2021] [Indexed: 12/24/2022]
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18
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Sum MY, Chan SKW, Tse S, Bola JR, Ng RMK, Hui CLM, Lee EHM, Chang WC, Chen EYH. Relationship between subjective quality of life and perceptions of recovery orientation of treatment service in patients with schizophrenia and major depressive disorder. Asian J Psychiatr 2021; 57:102578. [PMID: 33592390 DOI: 10.1016/j.ajp.2021.102578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/15/2021] [Accepted: 01/24/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study aimed to investigate the relationship between subjective quality of life (QOL) and the specific domains of perceptions of recovery orientation of treatment services in patients with schizophrenia and major depressive disorder (MDD). METHODS One hundred and seventy-nine patients with schizophrenia spectrum disorders and fifty-seven patients with MDD were recruited. Patients were assessed on subjective QOL, self-reported depressive symptoms, illness severity, functioning, and perception of recovery orientation of the service environment (RSA). A multiple linear regression model was used to assess the relationship between QOL and RSA score, controlling for all other factors. Spearman correlation analysis was used to examine the relationship between RSA domains and total QOL in each diagnostic group separately. RESULTS The regression model explained 47.4 % of the variance observed in total QOL. Depressive symptoms, functioning and RSA were significantly associated with total QOL in the model. Domains one (life goals) and five (individually tailored services) of the RSA were associated with QOL in both groups. Domains two (patient involvement) and three (diversity of treatment options) were associated with total QOL only in patients with schizophrenia. CONCLUSION Our findings highlight that perceptions of recovery orientation of service, depressive symptoms and functioning significantly affected the subjective QOL of patients with serious mental illness. The differential relationship observed between QOL and domains of RSA in patients with MDD and schizophrenia suggests that targeted interventions meeting the needs of different patient groups may be crucial to improve QOL of patients.
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Affiliation(s)
- Min Yi Sum
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region
| | - Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Samson Tse
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong Special Administrative Region
| | - John R Bola
- Department of Applied Social Studies, City University of Hong Kong, Hong Kong Special Administrative Region
| | - Roger Man Kin Ng
- Department of Psychiatry, Kowloon Hospital, Hong Kong Special Administrative Region
| | - Christy Lai Ming Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region
| | - Edwin Ho Ming Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region
| | - Wing Chung Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Eric Yu Hai Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region
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19
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Abo-Rass F, Shinan-Altman S, Werner P. Health-related quality of life among Israeli Arabs diagnosed with depression: the role of illness representations, self-stigma, self-esteem, and age. J Affect Disord 2020; 274:282-288. [PMID: 32469817 DOI: 10.1016/j.jad.2020.05.125] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/13/2020] [Accepted: 05/17/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Studies that examined health-related quality of life (HRQoL) and related factors among people diagnosed with depression, have only focused on sociodemographic and clinical factors. This study examined the contribution of illness representations (IRs), self-stigma, self-esteem, and age group (younger adults aged 18 to 64 and older adults aged 65+) to HRQoL among Israeli Arabs diagnosed with depression. METHODS A convenience sample of 160 Israeli Arabs with depression completed measures of cognitive and emotional IRs, self-stigma, self-esteem, HRQoL, and sociodemographic and health characteristics. RESULTS Participants reported low levels of HRQoL, with the older adults reporting significantly lower levels of HRQoL in comparison to those reported by the younger adults. Low levels of HRQoL were significantly associated with negative cognitive and emotional IRs, high levels of self-stigma, and low levels of self-esteem. Cognitive IRs, self-stigma, self-esteem, and age group were found to be the main determinants of HRQoL. LIMITATIONS Limitations of the study include use of a cross-sectional design among culturally homogeneous sample. This limits the generalizability of our results and conclusions, and prevented us from determining causal relationships. CONCLUSIONS This study emphasizes the role of cognitive IRs, self-stigma, and self-esteem, as well as age, in the HRQoL of individuals diagnosed with depression. Intervention programs should be mindful of these determinants in order to improve the HRQoL of individuals diagnosed with depression.
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Affiliation(s)
- Fareeda Abo-Rass
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | | | - Perla Werner
- Department of Community Mental Health, University of Haifa, Haifa, Israel.
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20
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Caqueo-Urízar A, Urzúa A, Habib J, Loundou A, Boucekine M, Boyer L, Fond G. Relationships between social stigma, stigma experience and self-stigma and impaired quality of life in schizophrenia across three Latin-American countries. Eur Arch Psychiatry Clin Neurosci 2020; 270:513-520. [PMID: 31240445 DOI: 10.1007/s00406-019-01035-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/20/2019] [Indexed: 12/11/2022]
Abstract
The relationships between stigma and quality of life in schizophrenia (QoL) have been extensively explored but have mostly focused on self-stigma and self-esteem and have never been explored in Latin-America. The objective of this study was to determine which stigma dimensions were associated with QoL in a sample of community-dwelling SZ subjects of three Latin-American countries. Stabilized outpatients with SZ were recruited in three Mental Health Services in three Latin-American countries: Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). Stigma and Qol-SZ were evaluated by self-administered questionnaires, the Internalized Stigma of Mental Illness scale (ISMI-12) and the SQoL-18. 253 participants were included. In multivariate analyses, QoL has been associated with each stigma dimension (social stigma, stigma experience and self-stigma), independently of age, gender, education level, ethnicity, age at illness onset, illness symptomatology and mental health treatment. More specifically, social stigma was significantly associated with impaired psychological and physical well-being, self-esteem and friendship. Self-stigma was significantly associated with impaired psychological well-being, self-esteem and autonomy. The present results confirm the importance of stigma in QoL of SZ subjects and identify new targets to develop stigma-orientated programs. Most of the previous programs have focused on self-stigma while social stigma has shown to be associated with a wide range of impaired QoL areas. Stigma and QoL may have a bidirectional relationship and targeting some specific QoL areas (like autonomy through self-empowerment approaches) may also improve the effectiveness of these programs to reduce stigma impact on the quality of life of subjects with schizophrenia. Future studies should also explore differences across countries as subjects from Bolivia were more frequently Aymara and reported higher stigma and lower QoL than SZ subjects from other countries.
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Affiliation(s)
| | - Alfonso Urzúa
- Universidad Católica del Norte, Avda. Angamos 0610, Antofagasta, Chile
| | - Julia Habib
- Aix-Marseille Univ, School EA 3279: CEReSS - Health Service Research and Quality of Life Center, 13005, Marseille, France
| | - Anderson Loundou
- Aix-Marseille Univ, School EA 3279: CEReSS - Health Service Research and Quality of Life Center, 13005, Marseille, France
| | - Mohamed Boucekine
- Aix-Marseille Univ, School EA 3279: CEReSS - Health Service Research and Quality of Life Center, 13005, Marseille, France
| | - Laurent Boyer
- Aix-Marseille Univ, School EA 3279: CEReSS - Health Service Research and Quality of Life Center, 13005, Marseille, France
| | - Guillaume Fond
- Aix-Marseille Univ, School EA 3279: CEReSS - Health Service Research and Quality of Life Center, 13005, Marseille, France. .,Assistance publique des hôpitaux de Marseille, AP-HM, 27 Boulevard Jean Moulin, 13005, Marseille, France.
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21
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Woon LSC, Khoo SI, Baharudin A, Midin M. Association between insight and internalized stigma and other clinical factors among patients with depression: A cross-sectional study. Indian J Psychiatry 2020; 62:186-192. [PMID: 32382179 PMCID: PMC7197844 DOI: 10.4103/psychiatry.indianjpsychiatry_612_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/25/2019] [Accepted: 02/11/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Insight influences treatment adherence among patients with depression. These patients also experience considerable social and self-stigma. The relationship between insight and internalized stigma has been extensively studied among patients with schizophrenia but not patients with depression. AIM This study aimed to determine the relationship between the level of insight in illness and internalized stigma among patients with depression and to identify the clinical factors associated with impaired insight. MATERIALS AND METHODS A cross-sectional survey was conducted among adult psychiatric outpatients with depressive disorders at a teaching hospital in Kuala Lumpur for 10 months. Sociodemographic and illness-related data were gathered. Two questionnaires, Mood Disorder Insight Scale (MDIS) and Internalized Stigma of Mental Illness Scale (ISMI), were administered. RESULTS Ninety-nine respondents participated in the study (female: 63.6%; Malay: 41.4%; mean age: 46.4 years). The median duration of illness was 6.0 years. More respondents were taking combination therapy (59.6%). There was a statistically significant correlation between ISMI and MDIS scores (r s = 0.339, P = 0.001). On bivariate analyses, intact insight was associated with non-Malay race, combination therapy, higher average ISMI scores and subscores for alienation, stereotype endorsement, discrimination experience, and social withdrawal. Combination therapy, higher scores for alienation, and social withdrawal subscales were associated with a greater likelihood for intact insight in logistic regression model. CONCLUSIONS Significant association exists between insight and internalized stigma in patients with depression. Interventions to reduce the impact of internalized stigma while improving patients' insight are required.
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Affiliation(s)
- Luke Sy-Cherng Woon
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Siew Im Khoo
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Azlin Baharudin
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Marhani Midin
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Tan XW, Seow E, Abdin E, Verma S, Sim K, Chong SA, Subramaniam M. Subjective quality of life among patients with schizophrenia spectrum disorder and patients with major depressive disorder. BMC Psychiatry 2019; 19:267. [PMID: 31477079 PMCID: PMC6721340 DOI: 10.1186/s12888-019-2248-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 08/20/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The goal of clinicians and healthcare workers providing treatment to patients with psychiatric disorders, has shifted over time from focusing on the symptoms alone towards functional improvement. In this study, we aimed to compare the subjective quality of life (QoL) among patients with schizophrenia spectrum disorders and major depressive disorder (MDD). METHODS QoL scores were collected using 36-item Short Form Survey Instrument. QoL scores were compared between 203 outpatients with schizophrenia spectrum disorders and 185 outpatients with MDD using analysis of covariance. The Positive and Negative Syndrome Scale was administered to assess the severity of psychiatric symptoms among patients with schizophrenia and Personal Health Questionnaire-8 items was utilized to assess the severity of depressive symptoms among patients with MDD. The correlation coefficient (r) of socio-demographic factors and core psychiatric symptoms with QoL were analyzed using multiple linear regression. RESULTS As compared to patients with MDD, patients with schizophrenia reported better health scores in all QoL subdomains, except for physical function (PF). Among patients with schizophrenia, old age was correlated with better mental health (MH, r = 0.35) and PF (r = 0.37). Compared to those of Chinese ethnicity, those of Malay, Indian and other ethnicity were correlated with worse PF (r = - 0.43 for Malays; r = - 0.30 for Indians and r = - 0.34 for other ethnicities). Longer duration of mental illness was correlated with worse MH (r = - 0.30), worse PF (r = - 0.38) and worse scores on role limitations due to physical health problems (RP, r = - 0.30). Among patients with MDD, older age was correlated with worse PF (r = - 0.33) and patients without comorbid physical illness reported less bodily pain (r = 0.45) and better general health (r = 0.34). Moreover, all psychiatric symptoms among patients with schizophrenia were negatively correlated with QoL, but the strength of the correlation was less than that between depressive symptoms and QoL among patients with MDD. CONCLUSION Patients with schizophrenia generally reported better QoL as compared to patients with MDD. The correlates of QoL differed between patients with schizophrenia and patients with MDD. This study adds to the understanding of QoL among patients with mental illnesses and may aid in better management of these patients with different psychiatric diagnoses.
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Affiliation(s)
- Xiao Wei Tan
- Research Division, Buangkok Green Medical Park, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Esmond Seow
- 0000 0004 0469 9592grid.414752.1Research Division, Buangkok Green Medical Park, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Edimansyah Abdin
- 0000 0004 0469 9592grid.414752.1Research Division, Buangkok Green Medical Park, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Swapna Verma
- 0000 0004 0469 9592grid.414752.1Department of Psychosis, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore ,0000 0001 2180 6431grid.4280.eDuke-NUS Medical School, National University of Singapore, Singapore, 169857 Singapore
| | - Kang Sim
- 0000 0004 0469 9592grid.414752.1Research Division, Buangkok Green Medical Park, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore ,0000 0001 2224 0361grid.59025.3bLee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 639798 Singapore
| | - Siow Ann Chong
- 0000 0004 0469 9592grid.414752.1Research Division, Buangkok Green Medical Park, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore ,0000 0004 0469 9592grid.414752.1Department of Psychosis, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore ,0000 0001 2224 0361grid.59025.3bLee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 639798 Singapore
| | - Mythily Subramaniam
- 0000 0004 0469 9592grid.414752.1Research Division, Buangkok Green Medical Park, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore ,0000 0001 2224 0361grid.59025.3bLee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 639798 Singapore
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Alexová A, Kågström A, Winkler P, Kondrátová L, Janoušková M. Correlates of internalized stigma levels in people with psychosis in the Czech Republic. Int J Soc Psychiatry 2019; 65:347-353. [PMID: 31113271 DOI: 10.1177/0020764019850204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Internalized stigma negatively affects lives and prognosis of individuals with psychosis. AIM This study aimed to identify correlates of internalized stigma among individuals with psychosis in a sample of community care users in the Czech Republic. METHODS A cross-sectional study was conducted among 133 community service users with psychosis. A shortened version of the Internalized Stigma of Mental Illness (ISMI-10) scale was used alongside the 5-level EQ-5D version (EQ-5D-5L), assessing health-related quality of life. Descriptive and linear regression analyses were performed in order to determine levels of internalized stigma and its correlates. RESULTS High levels of internalized stigma were reported in 25% of participants. Lower internalized stigma levels were associated with better self-reported health status and being married, and higher internalized stigma with a longer period of time since initial contact with psychiatric care. CONCLUSION Lower internalized stigma levels are associated with better self-reported health-related quality of life. In addition, clients having used psychiatric care for longer periods of time reported significantly higher internalized stigma levels. Therefore, authors suggest self-stigma reduction interventions based in a community setting with an emphasis on targeting clients with chronic psychosis.
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Affiliation(s)
- Aneta Alexová
- 1 National Institute of Mental Health, Klecany, Czech Republic.,2 Faculty of Social Sciences, Charles University, Prague, Czech Republic
| | - Anna Kågström
- 1 National Institute of Mental Health, Klecany, Czech Republic
| | - Petr Winkler
- 1 National Institute of Mental Health, Klecany, Czech Republic.,3 Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Endriyani L, Chien CH, Huang XY, Chieh-Yu L. The influence of adherence to antipsychotics medication on the quality of life among patients with schizophrenia in Indonesia. Perspect Psychiatr Care 2019; 55:147-152. [PMID: 29578605 DOI: 10.1111/ppc.12276] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 02/20/2018] [Accepted: 02/24/2018] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Investigating factors that can predict medication adherence and quality of life, as well as the influence of adherence to medication on the quality of life among patients with schizophrenia. DESIGN AND METHODS This study applies descriptive cross-sectional design. Participants were determined from outpatient clinic in a psychiatric hospital in Indonesia. Several questionnaires were used, including self-report, Glasgow Antipsychotics Side-effect Scale, drug attitude inventory and SQOL-18. FINDINGS Side-effect factor (p < .05) could influence medication adherence. Residential area (p < .05) could significantly influence quality of life. There was also a correlation between medication adherence and quality of life (p < .05). PRACTICE IMPLICATIONS Findings suggest to put more emphasis on assessing medication side effects.
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Affiliation(s)
- Lia Endriyani
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ching-Hui Chien
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Xuan-Yi Huang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Liu Chieh-Yu
- Graduate Institute of Nurse-Midwifery, National Taipei University of Nursing and Health Sciences,, Taipei, Taiwan
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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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Szcześniak D, Kobyłko A, Wojciechowska I, Kłapciński M, Rymaszewska J. Internalized stigma and its correlates among patients with severe mental illness. Neuropsychiatr Dis Treat 2018; 14:2599-2608. [PMID: 30349258 PMCID: PMC6183546 DOI: 10.2147/ndt.s169051] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the perceived level of internalized stigma among patients with severe mental illnesses and its relationship with demographic and clinical variables in Poland. PATIENTS AND METHODS A study sample (n=114, mean age=42.46±14.1 years; 55% of females) consisting of patients with nonorganic psychotic disorders as well as unipolar and bipolar affective disorders was evaluated (58% of outpatients and 39% of inpatients). All patients filled in the Internalized Stigma of Mental Illness (ISMI) scale (maximum severity=4). The demographic and clinical data were collected. RESULTS The study population demonstrated a mild level of internalized stigma (2.23±0.5). The highest score was observed in the alienation domain (2.63±0.8) and reflected moderate severity. The lowest score was noted in the stereotype endorsement domain (2.08±0.6). Moreover, the highest degree of internalized stigma was present in participants with unipolar affective disorder and was of moderate severity (2.46±0.6), while the level was moderate in the alienation domain (2.85±0.8). The level of vocational training education was the only variable associated with higher internalized stigma (P=0.02). There were no associations between gender, employment, and marital status and internalized stigma. The duration of the disease was the only clinical factor showing a significant positive correlation with stigma internalization (r=0.23; P=0.01). The number of hospital admissions and suicide attempts was not significantly correlated with internalized stigma. CONCLUSION People with severe mental illnesses in Poland experience a mild level of self-reported internalized stigma. Internalized stigmatization was most strongly associated with alienation, which indicates the need for stigma assessment procedures followed by stigma intervention programs in daily clinical practice. This is in accordance with the trend of environmental "open door" psychiatry, which could be the first step to decrease the level of stigma and internalized stigma in psychiatric patients in Poland.
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Affiliation(s)
- Dorota Szcześniak
- Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry,
| | - Agnieszka Kobyłko
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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Lim MWZ, Lee J. Determinants of Health-Related Quality of Life in Schizophrenia: Beyond the Medical Model. Front Psychiatry 2018; 9:712. [PMID: 30618882 PMCID: PMC6305274 DOI: 10.3389/fpsyt.2018.00712] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 12/04/2018] [Indexed: 01/05/2023] Open
Abstract
Background: Improving Quality of Life (QoL) in Schizophrenia is an important treatment objective in the shift toward person-centered and recovery-oriented care. Health-Related Quality of Life (HRQoL) is a focused aspect of QoL that is directly impacted by healthcare intervention. This aim of the current study was to ascertain the clinical determinants of HRQoL in Schizophrenia and their collective contribution to HRQoL. Methods: 157 stable outpatients with schizophrenia were recruited for this study. Data collected included sociodemographic information and clinical characteristics. HRQoL was assessed on the RAND-36. Psychopathology was assessed on the Positive and Negative Syndrome Scale (PANSS) and functioning measured on the Global Assessment Scale (GAS). Findings: Multiple regression revealed that the Physical Health Component (PHC) of the RAND-36 was associated with positive symptoms (beta = -0.218, p = 0.005) and presence of psychiatric comorbidity (beta = -0.215, p = 0.003). The Mental Health Component (MHC) was associated with depressive (beta = -0.364, p < 0.001) and positive (beta = -0.175, p = 0.021,) symptoms. Symptoms, functioning, presence of psychiatric comorbidities, gender and age account for 20.3% of the total variance observed in HRQoL. Conclusion: Depressive and positive symptoms are key clinical determinants of HRQoL in people with schizophrenia. However, the medical model-looking solely at clinical determinants-could not account for a large proportion of variance in HRQoL. Hence, future research beyond the medical model is required to uncover the determinants of HRQoL in Schizophrenia. Identifying these factors will contribute toward developing a holistic and person-centered management plan for people with schizophrenia.
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Affiliation(s)
- Madeline W Z Lim
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore, Singapore.,Department of Psychosis, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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