Self-stigma, insight and related factors among major depressive disorder, general anxiety disorder and obsessive-compulsive disorder patients: a cross-sectional study from Iran.

Background: Self-stigma toward psychiatric disorders is a major barrier to help-seeking and treatment adherence, significantly impacting patients' quality of life. Insight is one of the key factors influencing internalized stigma. Therefore, this study aims to assess the relationship between self-stigma and insight among patients with Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), and Obsessive-Compulsive Disorder (OCD).

Methods: A total of 140 participants included individuals diagnosed with MDD, GAD and OCD who had not experienced recurrent episodes over the past six months with convenience sampling. They were recruited from the outpatient clinics of the Tehran Psychiatry Institute and the Brain and Cognition Clinic in Tehran, Iran, between July 2021 and June 2022. Self-stigma was assessed using the Mental Illness Stigma Scale, a 34-item questionnaire in which higher scores indicate greater stigma. Insight was evaluated using three agree/disagree statements regarding self-identification as mentally ill, perceived need for psychiatric consultation, and perceived need for psychiatric medication.

Results: A total of 140 patients were included in the study. Of these, 89 (63.6%) considered themselves mentally ill, 126 (90%) acknowledged the need for psychiatric consultation, and 113 (80.7%) recognized the need for psychiatric medication. The mean stigma score was 64.5 ± 21.0. Patients who recognized the need for psychiatric consultation and medication had significantly higher stigma scores compared to those who did not (p = 0.002, d = 0.87 and p = 0.003 d = 0.66 respectively).

Conclusions: As one of the few studies examining the association between stigma and insight in patients with MDD, GAD and OCD, this research serves as a foundation for further exploration in this field. The current findings show that the recognition of need for psychiatric consultation as well as medication had significantly higher self-stigma compared to those who did not among participants.