Abstract
Stigma of major depressive disorder (MDD) is an important public health problem. This study aimed to examine the level of perceived stigma and its associated factors in MDD patients in five Asian countries, including China, Korea, Malaysia, Singapore, and Thailand. A total of 547 outpatients with MDD were included from Asian countries. We used the stigma scale of the Explanatory Model Interview Catalogue (EMIC) to assess stigma. The Montgomery–Asberg Depression Rating Scale (MADRS), Symptoms Checklist 90-Revised (SCL-90-R), Fatigue Severity Scale (FSS), Sheehan Disability Scale (SDS), 36-Item Short-Form Health Survey (SF-36), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess symptoms, clinical features, functional impairment, health status, and social support. The stigma scores of patients under 55 years old were significantly higher than those equal to or greater than 55 years old (P < 0.001). The stigma scores exhibited significant negative correlation with age; MSPSS scores of family, friends, and others; and SF-36 subscale of mental health, but significant positive correlation with MADRS, FSS, SDS, and SCL-90-R subscale scores of depression, interpersonal sensitivity, obsession–compulsion, psychoticism, and somatization. Multivariate regression analysis revealed that age, SCL-90-R interpersonal sensitivity, obsession–compulsion, psychoticism, MSPSS scores of friends and others, and SF-36 of mental health were significantly associated with the level of perceived stigma. These findings suggest that MDD patients who are young, have a high degree of interpersonal sensitivity and psychoticism, have low health-related quality of life, and have low social support are the target population for stigma interventions in Asia.
Highlights
Major depressive disorders (MDDs) are a very highly prevalent and seriously disabling public health problem worldwide
Among 547 MDD patients from five Asian countries, we found significant negative correlations between the EMIC stigma scores and age, mental health, quality of life as assessed by the SF-36, and several domains of social support as assessed by Multidimensional Scale of Perceived Social Support (MSPSS)
Significant positive correlations were found between the EMIC stigma scores and depressive severity, certain psychological characteristics, fatigue degree, and social functioning as assessed by the Sheehan Disability Scale (SDS)
Summary
Major depressive disorders (MDDs) are a very highly prevalent and seriously disabling public health problem worldwide. According to the latest China Mental Health Survey, the lifetime prevalence of MDD was 6.8% [3]. Less than 8% of individuals with MDD had ever sought any types of professional help in China [4]. This treatment rate was significantly lower than that seen in Western countries, including America [5]. Mental health stigma can be conceptualized in a variety of ways, and it has usually been classified as perceived stigma and personal stigma. Stigma emerged as an important barrier to the treatment of depression and other mental illnesses. Discovering the associated factors of stigma may be a critical pathway for the development of public strategies and interventions to reduce stigma in an MDD population
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