Association between quality of life and self-stigma, insight, and adverse effects of medication in patients with depressive disorders

ArticleinDepression and Anxiety 26(11):1033-9 · November 2009with12 Reads
DOI: 10.1002/da.20413 · Source: PubMed
  • 41.78 · Kaohsiung Medical University
  • 34.29 · Universitäre Psychiatrische Kliniken Basel
  • 3rd Yu Lee
    27.34 · Chang Gung Memorial Hospital
  • 36.77 · Kaohsiung Medical University
Abstract
The aims of this study were to examine whether different domains of quality of life (QOL) are differently affected by depressive disorders by comparing QOL of subjects with and without depressive disorders, and to examine the association of QOL with self-stigma, insight and adverse effects of medication among subjects with depressive disorders. The QOL on the four domains of the WHOQOL-BREF Taiwan version were compared between the 229 subjects with depressive disorders and 106 control subjects. Among the depressive subjects, the association between the four QOL domains and subjects' self-stigma, insight, and adverse effects of medication were examined using multiple regression analyses by controlling for the influence of depression, socio-demographic and clinical characteristics and family function. Depressive subjects had poorer QOL on the physical, psychological and social relationship domains than the non-depressive control group. The depressive subjects who had more severe self-stigma had poorer QOL on all four domains. The depressive subjects who perceived more severe adverse effects from medication had poorer QOL on the physical, psychological and environmental domains. However, insight was not associated with any domain of QOL in patients with depressive disorders. The results of this study demonstrate that different domains of QOL are differently affected by depressive disorders, and that clinicians must consider the negative influences of self-stigma and adverse effects from medication on QOL of subjects with depressive disorders.
    • "The assessments consisted of two measures to assess participants' explicit and implicit stigma toward mental illness, the Taiwanese version of the Stigma Assessment Scale (T-SAS) and the Computerized Implicit Association Test (IAT) for implicit stigma of mental illness. The 8-item 5-point SAS, developed by Corrigan [16] and used to assess medical students' explicit attitudes toward mental illness before, [17] was translated to T- SAS, which showed good validity [18, 19] . A higher score indicates a higher level of explicit stigma toward mental illness. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective This study examines the differences in explicit and implicit stigma between medical and non-medical undergraduate students at baseline; the changes of explicit and implicit stigma in medical undergraduate and non-medical undergraduate students after a 1-month psychiatric clerkship and 1-month follow-up period; and the differences in the changes of explicit and implicit stigma between medical and non-medical undergraduate students. Methods Seventy-two medical undergraduate students and 64 non-medical undergraduate students were enrolled. All participants were interviewed at intake and after 1 month. The Taiwanese version of the Stigma Assessment Scale and the Implicit Association Test were used to measure the participants’ explicit and implicit stigma. Results Neither explicit nor implicit stigma differed between two groups at baseline. The medical, but not the non-medical, undergraduate students had a significant decrease in explicit stigma during the 1-month period of follow-up. Neither the medical nor the non-medical undergraduate students exhibited a significant change in implicit stigma during the one-month of follow-up, however. There was an interactive effect between group and time on explicit stigma but not on implicit stigma. Conclusion Explicit but not implicit stigma toward mental illness decreased in the medical undergraduate students after a psychiatric clerkship. Further study is needed to examine how to improve implicit stigma toward mental illness.
    Full-text · Article · Oct 2015
    • "The association between discrimination and psychological distress in people with ID is reported to be stronger in the presence of lower levels of material and social resources (Emerson, 2010). No published study has examined the impact of stigma on quality of life in people with ID, although a similar association between stigma and quality of life has been reported in people with mental illness (Yen et al., 2009). Contrary to previous reports in the mental health literature (Henderson et al., 2013), higher levels of self-reported stigma were associated with a higher use of services, particularly contacts with community intellectual disability services and police. "
    [Show abstract] [Hide abstract] ABSTRACT: No studies have investigated the relationship between self-reported stigma and multiple health outcomes in people with intellectual disabilities (ID). The association between self-reported stigma and symptoms of anxiety and depression (psychological distress), quality of life, service utilisation and adherence to treatment were examined. Cross sectional study of 229 participants with ID (without mental illness) recruited from 12 centres in England. Self-reported stigma was positively associated with psychological distress, and number of contacts with services, particularly contact with community intellectual disability services and the police, and negatively associated with quality of life. It was not associated with adherence to treatment. Self-reported stigma was also associated with refusal of at least one service in the last six months. The relationship between stigma and quality of life and stigma and service use were mediated by psychological distress. The Cross-sectional design of this study prevents inferences being made about the direction of causality. IQ was not formally assessed but was based on clinical data. This study provides evidence that stigma may contribute to poor psychological health in people with ID, may be a burden on services due to higher service utilisation but may also prevent people from accessing appropriate services. Services should consider screening people at risk of psychological distress due to stigmatising treatment and provide appropriate support. There is an urgent need to develop evidence-based interventions to reduce societal stigma against people with ID and to reduce the impact of stigma when it is experienced by individuals with ID. Copyright © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Aug 2015
    • "SEM analyses did not provide any significant association between the number of depressive episodes and previous psychiatric admissions with self-stigma. This is in line with previous studies which found that self-stigma did not predict clinical outcomes or medication adherence in depressed patients at 1-year follow up [50]. In addition, although Ancova found an association between employment status and level of self-stigma, this relationship was not supported by SEM. "
    [Show abstract] [Hide abstract] ABSTRACT: Introduction Individual social capital has been recognized as having an important role for health and well-being. We tested the hypothesis that poor social capital increases internalized stigma and, in turn, can reduce empowerment among people with major depressive disorder (MDD). Materials and methods This is a cross-sectional multisite study conducted on a sample of 516 people with MDD in 19 European countries. Structural Equation Models were developed to examine the direct and indirect effects of self-stigma and social capital on empowerment. Results Social capital and self-stigma accounted for 56% of the variability in empowerment. Higher social capital was related to lower self-stigma (r = –0.72, P < 0.001) which, in turn, partially mediated the relationship between social capital and empowerment (r = 0.38, P < 0.001). Conclusions Social capital plays a key role in the appraisal of empowerment, both directly and through the indirect effect mediated by self-stigma. In order to improve empowerment of people with MDD, we identify strategies to foster individual social capital, and to overcome the negative consequences related to self-stigma for attainment of life goals.
    Full-text · Article · Jan 2014 · Journal of Affective Disorders
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