A cross-sectional study of internalized stigma in euthymic patients of bipolar disorder across its predominant polarity

Abstract

Introduction: Patients with bipolar affective disorder (BPAD), when classified according to their predominant polarity (PP), tend to show differences in their clinical correlates. Patients with BPAD show significant internalized stigma. The current study was conducted to investigate the differences in internalized stigma between various PP in BPAD. Methods: Seventy-five euthymic patients with BPAD were recruited and classified into their PP using appropriate criteria (two-thirds predominance). They were compared on the scores of the Stigma Scale (SS), Rosenberg Self-Esteem Scale (RSES), Participation Scale, and World Health Organization Quality of Life-BREF version – Hindi (QOL-BREF). Results: No significant differences were observed among the various PP on the total scores of SS. Patients with manic PP (MPP) and indeterminate PP (IPP) showed more difficulty in disclosure compared to depressive PP (DPP). In MPP and DPP, years of completed education, self-esteem, participation, and QOL were correlated to discrimination, but no such trend could be observed for IPP. Conclusion: Internalized stigma in individual PP is different from the attributes that affect BPAD as a whole. Although the groups did not differ in terms of internalized stigma, patients with DPP faced higher difficulty and disclosure. Subtle trends emerged which should be kept in mind while forming antistigma measures. Small sample size, purposive sampling, and cross-sectional design were the major limitations of this study.