Perceived stigma among individuals with common mental disorders

Health Services Research Unit, Institut Municipal d'Investigació Mèdica, (IMIM-Hospital del Mar), Barcelona, Spain.
Journal of Affective Disorders (Impact Factor: 3.38). 04/2009; 118(1-3):180-6. DOI: 10.1016/j.jad.2009.02.006
Source: PubMed


Severe mental disorders are associated with social distance from the general population, but there is lack of data on the stigma reported by individuals with common mental disorders.
To identify the correlates and the impact of stigma among individuals with common mental disorders.
Cross-sectional, household interview survey of 8796 representing the non-institutionalized adults of Belgium, France, Germany, Italy, the Netherlands and Spain. Two perceived stigma questions (embarrassment and discrimination) were asked to respondents with significant disability. Health-related quality of life measured by the SF-12, work and activity limitation and social limitation were also assessed.
Among the 815 participants with a 12-month mental disorder and significant disability, 14.8% had perceived stigma. Stigma was significantly associated with low education, being married/living with someone and being unemployed. Perceived stigma was associated with decreased quality of life (SF-12 PCS score -4.65; p<0.05), higher work and role limitation and higher social limitation.
Individuals with mental disorders are more likely to report stigma if they have lower education, are married, or are unemployed. Perceived stigma is associated with considerably decrease in quality of life and role functioning. Health professionals and society at large must be aware of these findings, which suggest that fighting stigma should be a public health priority.

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    • "It was also found that experiences of rejection and anticipation of discrimination were prevalent among individuals in treatment for SUDs (Luoma et al., 2007). The stigma attached to SUDs acts upon different life domains and can have adverse consequences for the quality of life of individuals and their life opportunities such as employment or housing (Alonso et al., 2009; Link & Phelan, 2006). In addition, stigma may prevent individuals from seeking professional help for SUDs. "
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    ABSTRACT: Background: Substance use disorders (SUDs) are among the most severely stigmatised conditions; however, little is known about the nature of these stigmatising attitudes. Aims: To assess and compare stigmatising attitudes towards persons with SUDs among different stakeholders: general public, general practitioners (GPs), mental health and addiction specialists, and clients in treatment for substance abuse. Methods: Cross-sectional study (N=3,326) in which stereotypical beliefs, attribution beliefs (e.g. perceptions about controllability and responsibility for having an addiction), social distance and expectations about rehabilitation opportunities for individuals with substance use disorders were assessed and compared between stakeholders. Results: Individuals with substance use disorders elicited great social distance across all stakeholders. Stereotypical beliefs were not different between stakeholders, whereas attribution beliefs were more diverse. Considering social distance and expectations about rehabilitation opportunities, the general public was most pessimistic, followed by GPs, mental health and addiction specialists, and clients. Stereotypical and attribution beliefs, as well as age, gender and socially desirable answering, were not associated with social distance across all stakeholders. Conclusion: The general public and GPs expressed more social distance and were more negative in their expectations about rehabilitation opportunities, compared to mental health and addiction specialists and clients. Although stigmatising attitudes were prevalent across all groups, no striking differences were found between stakeholders.
    International Journal of Social Psychiatry 08/2015; 61(6):539-549. DOI:10.1177/0020764014562051 · 1.15 Impact Factor
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    • "However, contradicting this, there is now a considerable body of evidence documenting that in many LAMIC settings, experiences of stigma, discrimination and human rights abuses due to mental illness are common and severe (Phillips et al. 2002; Thara et al. 2003; Murthy, 2005; Lee et al. 2005; Botha et al. 2006; Lee et al. 2006; Lauber & Rossler, 2007; Alonso et al. 2009; Barke et al. 2011; Drew et al. 2011; Sorsdahl et al. 2012; Lasalvia et al. 2013). One international study using population-wide data from 16 countries found even higher rates of reported stigma among people with mental disorders in developing (31.2%) than in developed (20%) countries (Alonso et al. 2008). "
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    ABSTRACT: This paper aims to provide an overview of evidence from low- and middle-income countries (LAMICs) worldwide to address: the nature of stigma and discrimination, relevant context-specific factors, global patterns of these phenomena and their measurement and quantitative and qualitative evidence of interventions intended to reduce their occurrence and impact. The background to this study is that the large majority of studies concerned with identifying effective interventions to reduce stigma and discrimination originate in high-income countries (HICs). This paper therefore presents such evidence from, and relevant to, LAMICs. Conceptual overview of the relevant peer-reviewed and grey literature on stigma and discrimination related to mental illness in LAMICs are available in English, Spanish, French and Russian. Few intervention studies were identified related to stigma re-education in LAMICs. None of these addressed behaviour change/discrimination, and there were no long-term follow-up studies. There is therefore insufficient evidence at present to know which overall types of intervention may be effective and feasible and in LAMICs, how best to target key groups such as healthcare staff, and how far they may need to be locally customised to be acceptable for large-scale use in these settings. In particular, forms of social contacts, which have been shown to be the most effective intervention to reduce stigma among adults in HICs, have not yet been assessed sufficiently to know whether these methods are also effective in LAMICs. Generating information about effective interventions to reduce stigma and discrimination in LAMICs is now an important mental health priority worldwide.
    Epidemiology and Psychiatric Sciences 05/2015; 24(5):1-14. DOI:10.1017/S2045796015000359 · 3.91 Impact Factor
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    • "Most instruments used in measuring personal stigma of mental illness have considered different ways in which stigma is experienced; some are focused on stigmatisation of the self [3,21], others are based in the direct experience of discrimination [13,22], some on the perception of stigma [23,24], and more recent studies have considered the anticipated discrimination [5,25]. Most instruments evaluate both perception and experience of the stigma and some consider self-stigma [26]. "
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    ABSTRACT: Background People with schizophrenia face prejudice and discrimination from a number of sources including professionals and families. The degree of stigma perceived and experienced varies across cultures and communities. We aimed to develop a cross-cultural measure of the stigma perceived by people with schizophrenia. Method Items for the scale were developed from qualitative group interviews with people with schizophrenia in six countries. The scale was then applied in face-to-face interviews with 164 participants, 103 of which were repeated after 30 days. Principal Axis Factoring and Promax rotation evaluated the structure of the scale; Horn’s parallel combined with bootstrapping determined the number of factors; and intra-class correlation assessed test-retest reliability. Results The final scale has 31 items and four factors: informal social networks, socio-institutional, health professionals and self-stigma. Cronbach’s alpha was 0.84 for the Factor 1; 0.81 for Factor 2; 0.74 for Factor 3, and 0.75 for Factor 4. Correlation matrix among factors revealed that most were in the moderate range [0.31-0.49], with the strongest occurring between perception of stigma in the informal network and self-stigma and there was also a weaker correlation between stigma from health professionals and self-stigma. Test-retest reliability was highest for informal networks [ICC 0.76 [0.67 -0.83]] and self-stigma [ICC 0.74 [0.64-0.81]]. There were no significant differences in the scoring due to sex or age. Service users in Argentina had the highest scores in almost all dimensions. Conclusions The MARISTAN stigma scale is a reliable measure of the stigma of schizophrenia and related psychoses across several cultures. A confirmatory factor analysis is needed to assess the stability of its factor structure.
    BMC Psychiatry 06/2014; 14(1):182. DOI:10.1186/1471-244X-14-182 · 2.21 Impact Factor
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