Addressing Mood Disorder Diagnosis' Stigma With an Honest, Open, Proud (HOP)-Based Intervention: A Randomized Controlled Trial

Abstract

Introduction: The public stigma and self-stigma contribute to the dilemma of disclosing or not one's own mental illness diagnosis. Studies suggest that revealing it diminishes stress, besides helping with self-esteem. Honest, Open, Proud (HOP) is a group program that aids in the process of deciding on it, reducing its impact. Considering the relevance of this issue, the present study aimed to apply a HOP-based intervention in a group of patients diagnosed with mood disorders.Methods: A randomized controlled clinical trial was used, including 61 patients with mood disorders, of whom 31 were diagnosed with depression and 30 were diagnosed with bipolar disorder. They were randomly placed on the intervention (HOP) or the control group (unstructured psychoeducation). The evaluations occurred before (T0) and after (T1) the sessions. We administered eight scales, from which three presented relevant results: Coming Out with Mental Illness Scale (COMIS), Cognitive Appraisal of Stigma as a Stressor (CogApp), and Authenticity Scale.Results: The intervention groups (depression and bipolar) did not present a significant change regarding the decision to disclose their diagnostics. However, the depression group showed a decrease on the perception of stigma as a stressor (T0 = 0.50 vs. T1 = −1.45; p = 0.058). Improvements in post-intervention results were seen for both groups (depression and bipolar) on the Authenticity Scale—self-alienation subscale (T0 = 10.40 vs. T1 = 12.37, p = 0.058).Conclusion: Our HOP-based intervention appeared to be an important program to aid patients in facing stigma stress, showing positive effects, whether helping to diminish stress or to improve self-conscience, both of which have indirect effects on self-stigma. As it is a compact program, it can bring benefits when applying to public health institutions.

Perceived public stigma and perceived public exposure by persons living with bipolar disorder: A qualitative study

“…Henderson et al (2020) also recommended improving the understanding of pre-existing demographic differences in stigma outcomes to better understand and address the social processes that influence stigma at the individual level. Some authors suggest that anti-stigma interventions should be disorder-specific (Cassidy & Erdal, 2020; Maassen et al, 2018; Modelli et al, 2021), while other argue that discrimination against devalued minorities is similar and therefore there is no need for disease-specific approaches or context-tailored interventions (Jackson-Best & Edwards, 2018; Nyblade et al, 2019; Stangl et al, 2019; Van Brakel et al, 2019). In this study, people with BD reported specific features of the public stigma of BD compared with other mental illnesses, and most themes were related to features specific to BD.…”

Stigma Toward Substance Dependence: Causes, Consequences, and Potential Interventions

“…In both cases, these individuals model behavior, provide social support, and engage in verbal persuasion regarding normative attitudes, beliefs, and behaviors. Some existing effective interventions employ strategic disclosure of one's condition to reduce public stigma and to empower people with mental illness and SUD (P. W. Corrigan & Rao, 2012;Kundert & Corrigan, 2021;Modelli et al, 2021). These interventions could be scaled up, multiplying their impact, by integrating a network intervention approach that incorporates allies as change agents to alter the normative social context.…”