Internalized stigma and its correlates among patients with severe mental illness

Abstract

PurposeThe 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 methodsA 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.ResultsThe 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.ConclusionPeople 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.

Trajectories and mental health-related predictors of perceived discrimination and stigma among homeless adults with mental illness

“…Higher levels of prejudicial and stigmatizing attitudes have also been reported by individuals experiencing suicidal ideation or who have attempted suicide [59]. Mental illness severity has previously been identified as a predictor of stigma among people with mental health problems [62,63]. In our study, participants with alcohol abuse were also more likely to be a member of the high discrimination trajectory group, and those with substances dependence tended to be part of the moderate to high stigma group trajectory.…”

Internalized stigma among patients with mood disorders in Ethiopia: a cross-sectional facility-based study

“…Having no history of suicidal attempt to decrease the stigma score as compared to having a history of suicidal attempt in this study but finding from Poland indicates suicidal attempt not associated with internalized stigma [26]. This difference might be due to our study is specific to mood disorders which have a high risk of suicide.…”

“…Low self-esteem, hope, and well-being, general functioning, age, sex, income, unemployment, education, duration of illness, adherence, having depressive episode, duration of illness, poor social support, presence of medication side effect, recovery, severity of symptoms, insight, family history of mental illness and substance use were factors associated with internalized stigma [10,12,[24][25][26][27][28][29][30][31][32].…”

Internalized Stigma and Associated Factors among Patients with Major Depressive Disorder at the Outpatient Department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019: A Cross-Sectional Study

“…Having chronic major depressive disorder of ≥2-year duration was 3.21 times more likely to have a high internalized stigma than those who have less than 2 years of duration of illness. This is supported by different studies conducted in India [17] and Poland [20]. The possible reason for this association might be long-lasting poor social and occupational functioning resulting from the illness.…”

“…Most studies done in western and Asian countries show that a high magnitude of internalized stigma among patients with depressive disorder ranges from 21.7 to 51.4% [17][18][19][20][21][22][23]. Accordingly, a study done in 13 European countries assessed the levels of internalized stigma among patients with mood disorders and they found that moderate to high levels of internalized stigma is present in 21.7% of individuals [4].…”