Personal stigma, problem appraisal and perceived need for professional help in currently untreated depressed persons

Abstract

The role of stigma in help-seeking for depression is unclear. We hypothesize that in persons experiencing symptoms of depression, personal stigmatizing attitudes impair appraisal of the present condition as mental health problem and thus reduce the perceived need for professional help. We recruited a sample of 25 currently untreated depressed persons from the general population using local newspaper articles and emails that listed symptoms of depression avoiding the term "depression" or any other potentially stigma-associated term. We elicited personal stigmatizing attitudes, appraisal of the present problem as mental health problem, and perceived need for any medical or therapeutic help. In linear regression analyses controlling for depression severity and previous help-seeking, high personal stigma was related to lower problem appraisal (beta, -0.38; p<0.05) and to lower perceived need (beta, -0.59, p<0.01). Lower problem appraisal was associated with lower perceived need. Regressing need on both problem appraisal and stigma reduced the direct influence of stigma on need, indicating a partial mediation of this relationship by problem appraisal. Our small sample prohibited the use of path models. Personal stigmatizing attitudes in persons suffering from a depressive syndrome pose an important barrier to help, impairing appraisal of depressive symptoms as potential mental health problem and decreasing perceived need for professional help.