Internalized Stigma Among Individuals With Bipolar Disorder: Associations With Sociodemographic and Clinical Characteristics From a Specialized Affective Disorders Unit.
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引用次数: 0
Abstract
Background: Bipolar disorder (BD) is a complex mood disorder among the leading causes of disability worldwide. Internalized stigma refers to the awareness of negative stereotypes adopted by society and the agreement with these judgments, often associated with impaired functionality and social adaptation. Studies examining internalized stigma and related factors in BD are limited.
Aims: Our study aimed to evaluate the associations between internalized stigma and sociodemographic, marital, and clinical characteristics of individuals with BD.
Method: One hundred and eighteen individuals with BD followed up at a specialized affective disorders unit were included. Participants' data were collected via follow-up documents and clinical interviews. The Internalized Stigma of Mental Illness Scale (ISMIS) was administered to assess internalized stigma.
Results: The mean ISMIS total score was 56.50. Being unemployed (p = .012, B = 0.208), shorter BD duration (p < .001, B = -0.302), presence of inter-episode residual symptoms (p = .004, B = 0.248), and higher depressive scores (p = .001, B = 0.275) predicted increased internalized stigma. Younger age (p = .002, B = -0.264), being female (p = .007, B = 0.226), absence of mania dominance (p = .019, B = 0.190), and higher depressive scores (p = .002, B = 0.260) predicted alienation scores. The presence of inter-episode residual symptoms predicted both stereotype endorsement (p < .001, B = 0.320) and perceived discrimination (p < .001, B= 0.358). Younger age (p = .001, B= -0.281) and a total number of depressive episodes (p = .015, B = 0.212) also predicted perceived discrimination. Shorter BD duration (p = .005, B = -0.238), absence of seasonality (p = .047, B = 0.169), and higher depressive scores (p < .001, B = 0.320) predicted social withdrawal, while a history of hospitalization (p = .033, B = 0.203) predicted stigma resistance.
Conclusions: Considering that internalized stigma is increased in earlier stages of BD, as well as in individuals with inter-episode residual symptoms, it might be important to implement effective psychosocial practices for internalized stigma, which might be modifiable through targeted interventions in the earlier periods. Therefore, a multidimensional and holistic approach toward internalized stigma may positively contribute to the functionality and quality of life of patients with BD.
背景：双相情感障碍（BD）是一种复杂的情绪障碍，是全球致残的主要原因之一。内化耻辱是指意识到社会所采用的负面刻板印象并同意这些判断，通常与功能受损和社会适应有关。关于双相障碍内化病耻感及相关因素的研究有限。目的：本研究旨在评估内化病耻感与双相障碍患者的社会人口学、婚姻和临床特征之间的关系。方法：纳入118名双相障碍患者，在一个专门的情感障碍单位随访。参与者的数据通过随访文件和临床访谈收集。采用内化病耻感量表（ISMIS）评估内化病耻感。结果：ISMIS总分平均为56.50分。失业(p =。012, B = 0.208)，较短的双相障碍持续时间（p B = -0.302），存在发作间残留症状(p =。004, B = 0.248)，较高的抑郁得分(p =。001, B = 0.275)预测内化耻辱感增加。年龄较小(p =。002, B = -0.264)，为女性(p =。007, B = 0.226)，无躁狂症显性(p =。019, B = 0.190)，且抑郁得分较高（p = 0.190）。002, B = 0.260)预测疏离感得分。发作间残留症状的存在预测刻板印象认可（p B= 0.320）和感知歧视（p B= 0.358）。年龄较小(p =。0.001， B= -0.281)，总抑郁发作次数(p =。015, B = 0.212)也能预测感知歧视。BD持续时间较短(p =。005, B = -0.238)，季节性缺失(p =。047, B = 0.169)，较高的抑郁评分（p B = 0.320）预测社交退缩，而住院史（p = 0.169）预测社交退缩。033, B = 0.203)预测柱头抗性。结论：考虑到内化耻辱感在双相障碍早期阶段以及在有发作间残留症状的个体中增加，实施有效的内化耻辱感心理社会实践可能很重要，这可能是通过早期有针对性的干预来改变的。因此，对内化耻辱感采取多维和整体的方法可能对双相障碍患者的功能和生活质量有积极的贡献。
期刊介绍：
The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities.
Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas.
The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.
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