Internalized Stigma Of Mental Illness Research Articles

The Role of Internalized Stigma in Modulating Hope, Self-esteem, and Self-efficacy Among Outpatients with Mental Illness

Background: Mental health disorders influence emotions and behavior and frequently result in stigma, particularly personal stigma, where affected individuals internalize societal biases. This study explores the relationship between internalized stigma and hope, self-esteem, and self-efficacy in individuals with mental illness. Objectives: The aim was to investigate the relationship between internalized stigma and hope, self-esteem, and self-efficacy in patients with mental illness and to contribute to the discourse on mental health care. Methods: A cross-sectional study involving 126 mental illness outpatients from Amirkabir Hospital in Arak, Iran, was conducted. Instruments such as the Internalized Stigma Of Mental Illness (ISMI) Scale, Schneider's Dispositional Hope Scale, Rosenberg's Self-esteem Scale, and the General Self-efficacy Scale were utilized. Data were analyzed using statistical methods. Results: In this study of 126 participants (54% women, 46% men; ages ranging from 18 to 89), the average score for internalized stigma was 61.04 ± 18.37. There were significant negative correlations observed between self-stigma and hope (r = -0.658, P < 0.001), self-esteem (r = -0.666, P < 0.001), and self-efficacy (r = -0.641, P < 0.001). No significant relationships were identified with socio-demographic factors such as age, gender, and marital status. However, a significant relationship was observed between education level, self-stigma, and self-efficacy. Conclusions: The study confirms that internalized stigma significantly affects hope, self-esteem, and self-efficacy in patients with mental disorders. The findings emphasize the necessity for improved psychological services and educational programs to strengthen these factors, thus diminishing the impact of stigma and enhancing patients' lives.

Confronting mental health stigma in Haitian Americans suffering from mental health challenges.

Haitian Americans have been disproportionately exposed to risk factors known to play a significant role in the development of mental illness. Yet despite the documented effectiveness of mental health treatment, a high proportion of Haitian Americans with mental health disorders have not received care. Internalized stigma of mental illness (ISMI) was reported as one of the primary reasons Haitian Americans do not seek help for mental illnesses, resulting in poor long-term outcomes for individuals and families in this community. This quality improvement project characterized ISMI among Haitian Americans, examined associated demographic factors, and tested the impact of a culturally relevant ISMI educational video intervention on willingness to seek mental health treatment. Haitian Americans who self-reported mental illness (N = 20) were recruited from a South Florida clinic. Descriptive statistics, correlations, and thematic analyses were completed to analyze the data. Participants completed the nine-item ISMI scale, watched an educational video about ISMI, completed a post-intervention survey, and engaged in conversations about mental health and ISMI. Sixty-five percent of participants reported mild levels of ISMI. Sex was significantly correlated with ISMI (r = -0.458, p = .042); male participants experienced higher levels of ISMI. The educational video improved participants' knowledge of ISMI, and 85% indicated increased willingness to seek treatment. When caring for Haitian Americans with mental illnesses, nurse practitioners should initiate conversations about ISMI, consider gender differences in mental illness beliefs and attitudes, and provide culturally responsive psychoeducational interventions to promote more mental health treatment utilization.

Internalized Stigma and Adherence to Treatment Among Outpatients with Mental Illness

Background: Treatment adherence, the key to therapy success and patients' quality of life, can be influenced by many factors in psychiatric patients, including self-stigma, alongside insight, illness duration, social support, health beliefs, personality, substance abuse, side effects, and life circumstances. Objectives: This study aims to identify factors, particularly self-stigma, affecting treatment adherence in stable psychiatric outpatients. Methods: A sample of 200 adult mental health patients in Arak, Iran, diagnosed with schizophrenia, bipolar disorder, major depressive disorder, or anxiety disorders, participated in this study. Self-stigma was assessed using the Internalized Stigma of Mental Illness (ISMI) scale, and treatment adherence was measured using the Drug Attitude Inventory (DAI-10). Data were analyzed using descriptive statistics, correlation, regression, and chi-square tests. Results: Among the 200 participants (73 men and 127 women, with an average age of 35.1 years), the average stigma score was 62.8. The mean DAI-10 score was 4.8, with 172 showing positive medication attitudes. Younger, smoking, and alcohol-consuming patients showed lower treatment adherence. Higher self-stigma correlated with lower adherence, but there were no significant associations with gender, marital status, diagnosis, or diagnosis duration. Conclusions: This study highlights the importance of addressing self-stigma as a barrier to treatment adherence in individuals with mental illnesses. Strategies to reduce self-stigma may improve treatment outcomes, especially among younger patients and those with substance use disorders. Further research is warranted to develop effective interventions for enhancing medication adherence in stable psychiatric outpatients.

Childhood trauma and self-stigma in mood disorders

Childhood maltreatment and mood disorders are associated and linked to self-stigma. In this study, we assessed the relationship between childhood trauma and self-stigma in patients with mood disorders. Patients with bipolar disorder (n ​= ​69) and unipolar disorder (n ​= ​111) were recruited from the Mood Disorders Unit of the Geneva University Hospitals in Switzerland. All participants underwent a semi-structured interview to assess mood disorder and fulfilled the Internalized Stigma of Mental Illness (ISMI) scale and the Childhood Trauma Questionnaire (CTQ). The results showed that overall self-stigma was not significantly different between the groups. Linear regression modeling revealed that the ISMI total score was significantly associated with the CTQ total score (estimate ​= ​0.01, p ​= ​0.045). Our findings support the assumption that childhood trauma promotes the development of self-stigma in patients with mood disorders. Therefore, this study underscores the importance of assessing childhood trauma in the management of self-stigma in patients with unipolar and bipolar disorder.

A correlational and cross-sectional study on the relationship between internalized stigma and religious coping in patients with schizophrenia.

Self stigmatization, which occurs as a result of internalization of public stigma in severe mental illnesses, is a factor that impairs the mental well-being of individuals and their compliance with treatment. Data on exactly which factors are associated with internalized stigma are still insufficient. Our aim in this clinical study is to investigate the relationship between internalized stigma and religious coping in patients with schizophrenia. Sociodemographic Data Form, Religious Coping Scale, internalized stigma of mental illness (ISMI) Scale were applied to 147 schizophrenic patients who were followed up by the community mental health center and met the inclusion criteria. The results were analyzed with IBM SPSS 22 package program. Descriptive statistics, Mann-Whitney U test, Pearson Chi-Square, Fisher Exact test, Spearman correlation analysis and multiple linear regression analysis were applied. There was a negative correlation between positive and negative religious coping in patients with schizophrenia (r: -0.467, P < .001); a positive correlation between negative religious coping and social withdrawal (r: 0.711, P < .001) and perceived discrimination (r: 0.706, P < .001); negative correlation between positive religious coping and social withdrawal (r: -0.343, P < .001) and perceived discrimination (r: -0.302, P < .001). There was no significant relationship between other subdimensions of ISMI and religious coping scale. There was a significant negative correlation between ISMI total score and positive religious coping (r: -0.256, P: .002), a significant positive correlation with negative religious coping (r: 0.683, P < .001). Multiple linear regression analysis was applied to reveal the explanatory effect of age, duration of illness and religious coping on internalized stigma, and according to the model obtained (R = 0.729, R2 = 0.516, F = 32.071, P < .001), 51.6% of the change in the total score of the ISMI can be explained by this model. The significant relationship between positive and negative religious coping and internalized stigma in patients included in the study suggests that it may be beneficial to consider religious coping attitudes in addition to other interventions in the fight against stigma in severe mental illnesses such as schizophrenia.

Psychosocial Correlates of Internalized Stigma Among Chinese Individuals With Severe Mental Illness.

The current study aimed to examine internalized stigma and its psychosocial factors among people with severe mental illness in China. A cross-sectional study was performed with 202 adults diagnosed with schizophrenia, bipolar disorder, or schizoaffective disorder in Beijing, China. Participants were evaluated using the Chinese version of the Internalized Stigma of Mental Illness (ISMI) scale, Perceived Devaluation and Discrimination scale, and the Medical Outcomes Study Social Support Survey. Correlation analysis and multiple linear regression analysis demonstrated that 19.8% of participants had moderate-to-high ISMI scores, whereas the sample as a whole indicated a mild level of internalized stigma. A higher level of internalized stigma was associated with greater perceived discrimination, lower social support, lower family income, older age, and distancing coping. These factors may be important to consider for developing tailored interventions in the future. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 37-44.].

Predictors of Medication Adherence among Patients with Bipolar I Disorder

The present study aimed to determine predictors of medication adherence among patients diagnosed with Bipolar I Disorder (BP-I). Another aim was to estimate differences with different marital status  in perceived social support, internalized stigmatization and medication adherence. Correlational research design was used and a sample of 103 participants was gathered using purposive sampling method. Data was collected by administering Multidimensional Scale of Perceived Social Support (MSPSS), Internalized Stigma of Mental Illness (ISMI), and General Medication Adherence Scale (GMAS). Results illustrated perceived social support (R2 = .46, F (3, 99) = 28.52, p&lt;0.001) and internalized stigmatization R2 = .49, F (8, 94) = 11.40, p&lt;0.001) to be significant predictors of medication adherence. Furthermore, it was found that married individuals with bipolar I disorder received more support [F (1, 101) = 4.08, p = .04] and were more adherent to medication [F (1, 101) = 6.35, p = .01] as compared to single individuals with bipolar I disorder. However, no significant difference was found between married and single patients in their experience of internalized stigmatization.  Present study highlights the need for awareness campaign where individuals are informed regarding the importance of their support and also the need for educational workshops for skill building in patients with Bipolar I disorder.

Internalized Stigma and Associated Factors in Patients Applying to Psychiatry Outpatient Clinics, A Descriptive Study

This study was conducted to investigate internalized stigma and related factors in patients applying to psychiatry outpatient clinics. The descriptive-cross-sectional study was conducted with 187 patients. In the survey included in the study, socio-demographic data, data on previous clinical/disease and Internalized Stigma of Mental Illness (ISMI) Scale were used. It was determined that 16.6% of the patients were hospitalized due to mental illness and 10.7% of them were dismissed due to mental disorders. The total mean score of the participants in ISMI was found to be 56.2±11.3. The scale total score of the patients whose education level was university or higher was found to be lower than the other groups (P = 0.012). The mean scores of the patients with children were significantly lower than those without children (P = 0.012) and the patients living in the village compared to the patients living in the city center (P = 0.002). The total ISMI score was found to be higher in patients who were previously hospitalized due to mental illness and patients who were dismissed due to mental disorders (P = 0.016, P = 0.006, respectively). It was determined that there was a positive and low-level significant relationship between disease duration and ISMI total score (r= 0.152; P = 0.038). Educational status, place of residence, hospitalization due to mental illness, dismissal status due to mental disorders and duration of illness were determined as variables affecting the level of internalized stigma in individuals with mental disorders.

Reducing stigma toward mental illness and substance use issues in primary health care in Chile: Protocol of a cluster controlled trial study.

Chile is implementing a Community Mental Health Model with a strong role of primary health care (PHC). PHC has great potential to early detection and provision of accessible and coordinated services to people who present mental illness and/or substance use issues (MISUI). However, stigma toward people with MISUI among PHC professionals is a significant barrier to accessing good quality of care. A wealth of literature supports the importance of reducing stigma for this population. The main goal of this research project is to determine the effectiveness of a comprehensive anti-stigma intervention in reducing stigmatizing attitudes and behaviors among PHC providers toward individuals with MISUI in the Chilean context, using Centros de Salud Familiar (CESFAMs) as the point of intervention. The intervention is based on an initiative that was previously developed in Canada and then also pilot-tested in Lima, Peru, with the Center for Addiction and Mental Health (Ontario, Canada). The model will be culturally adapted with CESFAM PHC provider and user inputs to be relevant and valid to Chile. The 18-month intervention includes five (5) components that are simultaneously implemented in CESFAMs: (1) Develop a Team of Local Champions in each intervention CESFAM, comprising PHC providers and users; (2) Analysis of Internal CESFAM Policies, Procedures, and Protocols to determine areas of improvement in service delivery for individuals with MISUI; (3) Raising Awareness of stigma toward MISUI using various forms of media within the CESFAM; (4) Innovative Contact-Based Education workshops on anti-stigma and recovery principles, co-lead by academic/clinical trainers and a person with lived experience of MISUI; and (5) Recovery-Based Arts, a multi-week arts workshop for PHC providers and users to produce artwork related to MISUI and recovery, culminating in an exhibition to showcase artwork for the CESFAM providers, users, and community. The expected intervention outcomes are the following: Participation in the experimental group will result in a significant decrease in stigmatizing attitudes among PHC providers toward individuals with MISUI compared with the control group as measured by the Chilean version of the Opening Minds Scale for Health Care Providers Scale (OMS-HC); Participation in the experimental group will result in a significant decrease of PHC users experiences of stigma conveyed by PHC providers compared with the control group as measured by the Internalized Stigma of Mental Illness (ISMI) scale, validated for the Chilean population. The changes in attitudes and behaviors within the experimental group will be sustained over time as measured at 6 months-follow-up. To evaluate the effectiveness of this 18-month intervention, a 4-year, two-arm, cluster-randomized controlled trial is proposed, with CESFAMs being the unit of randomization (or "cluster"). Implementation Science approach will be taken to measure relevant implementation outcomes for each component of the intervention, and through qualitative data collection with CESFAM providers and authorities. Data analysis will be carried out using SAS 9.4 (specifically, using POC MIXED and PROC GENMOD) and R 3.5. Mixed-effect modeling will used for both PHC provider and user data, which will include individuals and CESFAMs as random effects and group (intervention/control) as fixed effects. This study represents a new stage of relevant and innovative research in mental health and stigma in Chile that will contribute to improving access and quality of care for people with MISUI. Evaluating the impact of the intervention model and its implementation will provide the necessary tools to scale the intervention up to other CESFAMs across Chile. [www.ClinicalTrials.gov], identifier [NCT05578066].

Auto-stigmatisation et fonctionnement dans le trouble bipolaire

Self-stigma of people with bipolar disorder is an underestimated problem, with serious consequences in terms of clinical severity and social and professional functioning. ObjectivesThis study aimed to evaluate self-stigma in patients with bipolar disorder, to identify socio-demographic and clinical factors associated with it and to analyze the links between self-stigma and functioning in this population. MethodsWe conducted a cross-sectional, descriptive and analytic study including 61 patients with bipolar disorder meeting criteria of remission. We used the internalized stigma of mental illness (ISMI) to investigate self-stigma, and the functioning assessment short test (FAST) to assess functioning. ResultsThe mean age of patients was 43.4 years. The sex ratio was 2.4. Half of the patients were single or divorced (50 %). They had secondary or university education in 69 % of cases and were professionally inactive in 59 % of cases. The socioeconomic level was low or medium in 92 % of cases. A personal judicial record was found in 16 % of patients, a suicide attempt in 41 % of cases. Most patients in our series had bipolar I disorder (92 %). The mean age at onset of the disease was 23.5 years, with a mean duration of disease progression of 20 years. Patients were hospitalized an average of 5.9 times. Most patients (90 %) exhibited psychotic features during their mood relapses. The mean duration of the last remission was 27.9 months. Patients had regular follow-ups at our consultations in 87 % of cases. Among the patients included in the study, 8 % were on long-acting neuroleptics. The mean score on the internalized stigma of mental illness was 2.36±0.56. More than half of our patients (59 %) were self-stigmatized. Discrimination and alienation were found in 51 % of cases, followed by resistance to stigmatization (43 %) and assimilation of stereotypes (41 %). Regarding functioning, a global impairment was noted in more than two thirds of patients (71 %). An alteration in professional functioning was found in 82 % of cases and in cognitive functioning in 69 % of cases. Disruption of the financial sphere concerned 43 % of the patients, and the relational sphere 41 % of them. Autonomy was altered in 41 % of patients. Analysis of the relationships between self-stigma and characteristics of the study population revealed statistically significant associations between higher self-stigma scores and single or divorced status, low socio-economic level and judicial record. In terms of clinical parameters, the mean self-stigma score was significantly associated with a higher total number of thymic episodes and hospitalizations, a longer cumulative duration of hospitalizations and a shorter duration of the last remission. In addition, the mean self-stigma score was associated with significantly more impaired functioning. ConclusionsOur study underlines the need to work towards the implementation of management modalities aimed at combating the self-stigmatization of patients with bipolar disorder and mitigating its negative consequences during the course of the disease.

Internalized stigma and quality of life among recipients of a rural community mental health program in southern Karnataka, India: a cross sectional study

Background: In the field of mental health the role of adherence to medications is an important concept. One of the important reasons to be non-adherent to medications is the presence of stigma among mentally ill patients. The objectives of this study were to measure stigma to mental illness and quality of life among the enrolled patients in a community mental health program.Methods: A cross-sectional study was conducted among 300 persons registered under a rural mental health program selected by consecutive sampling. A questionnaire capturing information on socio-demography, stigma using Internalized stigma of mental illness (ISMI), and quality of life using WHO-BREF QOL questionnaire was used.Results: In study 8 (2.7%) of the study, subjects were suffering from moderate stigma. Factors like gender, type of family, and marital status were significantly associated with total stigma. Quality of life domains was also positively associated with education, occupation, marital status, and socioeconomic status.Conclusions: The study showed minimal existence of stigma and lower mean scores in quality-of-life domains.

Internalized-stigma and dissociative experiences in bipolar disorder.

IntroductionDissociative symptoms have been recently related to bipolar disorder (BD) symptomatology. Moreover, the disease burden carries on a share of perceived self-stigma that amplifies the BD impairment. Internalized stigma and dissociative symptoms often seem overlapping, leading toward common outcomes, with reduced treatment seeking and poor adherence. We hypothesize a potential relationship between dissociation and self-stigma in patients suffering from BD.Materials and methodsIn this cross-sectional study we enrolled a total of 120 adult clinically stable BD outpatients. All participants completed the Internalized Stigma of Mental Illness (ISMI), Dissociative Experiences Scale-II (DES-II), and Manchester Short Assessment of Quality of Life (MANSA).ResultsAverage age and age at BD (BD-I n = 66, 55%; BD-II n = 54, 45%) onset were 46.14 (±4.23), and 27.45 (±10.35) years, with mean disease duration of 18.56 (±13.08) years. Most participants were female (n = 71; 59.2%) and 40 (33%) of them experienced lifetime abuse, with an average of 1.05 (±0.78) suicide attempts. DES scores (mean 31.8, ±21.6) correlated with ISMI total-score, with significant association with spikes in Alienation (13.1, SD±3.1) (p < 0.001) and Stereotype (13.8, SD±3.9) (p < 0.001). Linear regression analysis has shown a significant association between DES total score and alienation (p < 0.001), stereotype (p < 0.001) and MANSA total-score (p < 0.001).DiscussionFor the first time, our data suggests that self-stigma is associated to dissociative symptoms, reducing overall quality of life in BD. The early identification of at-risk patients with previous lifetime abuse and high perceived stigma could lead the way for an ever more precise tailoring of treatment management.

Internalized stigma and self-esteem among remitted patients with bipolar disorder

IntroductionSelf-stigmatization in patients with bipolar disorder could lead to shame, self-judgement, impaired quality of life, and could negatively affect self-esteem imeding recovery.ObjectivesThe aim of this study was to assess self-stigma in remitted patients with bipolar disorder and to evaluate its impact on self-esteem.MethodsWe conducted a cross-sectional, descriptive, and analytical study of 61 patients with bipolar disorder. Euthymia was verified using the Hamilton scale for depression and the Young scale for mania. We used the Internalized Stigma of Mental Illness (ISMI) to evaluate self-stigma, and the Rosenberg scale to assess self-esteem.ResultsThe mean age of patients was 43.4 years. The sex ratio was 2.4. The mean score on the ISMI was 2.36. More than half of our patients (59%) were self-stigmatized. With regard to self-esteem, the mean score obtained on the Rosenberg scale was 27.72. Low or very low self-esteem was found in 54% of patients. The most self-stigmatized patients had significantly lower self-esteem (p&lt;10-3).ConclusionsInternalized stigmatization negatively affects self-esteem of patients with bipolar disorder. Psychoeducation and cognitive behavioral therapy would improve self-esteem and enhance psychosocial treatment adherence and move people with bipolar disorder toward a culture of recovery based on hope and self-determination.DisclosureNo significant relationships.

The impact of self-stigma on functioning among remitted patients with bipolar disorder

IntroductionSelf-stigma is widespread in patients with bipolar disorder, with many consequences for family, social and occupational functioning, as well as treatment adherence.ObjectivesThe aim of this study was to evaluate self-stigma in remitted patients with bipolar disorder and to investigate its impact upon functioning.MethodsWe conducted a cross-sectional, descriptive, and analytical study of 61 patients with bipolar disorder. Euthymia was verified using the Hamilton scale for depression and the Young scale for mania. We used the Internalized Stigma of Mental Illness (ISMI) to evaluate self-stigma, the Functioning Assessment Short Test (FAST) to assess functioning.ResultsThe mean age of patients was 43.4 years. The sex ratio was 2.4. The mean score on the ISMI was 2.36. More than half of our patients (59%) were self-stigmatized. Regarding functioning, a global impairment was noted in more than two thirds of the patients (71%). Occupational functioning was the most affected area (82%). Patients with higher self-stigma scores had significantly more impaired functioning (p&lt;10-3). To decompose the relationship between stigma and functioning into more specific spheres, we found that all scores on the different domains of functioning were associated with a significantly higher mean self-stigma score.ConclusionsThe relationship between self-stigma and functioning seems to be bidirectional. Therefore, improved social functioning could reduce self-stigma and improve self-esteem.DisclosureNo significant relationships.

Self-stigma and coping strategies in remitted Tunisian patients with bipolar disorder

IntroductionPatients with bipolar disorder may adjust their behaviors and choose a coping strategy to face self-stigma and avoid unpleasant social and professional adversities. These coping orientations are either defensive, or active behavioral strategies.ObjectivesThe aim of this study was to assess self-stigma in remitted patients with bipolar disorder and to investigate coping strategies to struggle the internalized stigma.MethodsWe conducted a cross-sectional, descriptive, and analytical study of 61 patients with bipolar disorder. Euthymia was verified using the Hamilton scale for depression and the Young scale for mania. We used the Internalized Stigma of Mental Illness (ISMI) to evaluate self-stigma, the Stigma coping orientation Scale (SCOS) to assess coping strategies.ResultsThe mean age of patients was 43.4 years. The sex ratio was 2.4. The mean score on the ISMI was 2.36. More than half of our patients (59%) were self-stigmatized. Secrecy (57%) and withdrawal (56%) were the most adopted coping strategies. The mean self-stigma score was significantly associated with higher scores on defensive coping strategies such as secrecy (p&lt;10-3) and withdrawal (p&lt;10-3). However, scores on challenging (p&lt;10-3), education (p&lt;10-3) and distancing (p=0.014) strategies were inversely correlated with self-stigma scores. The logistic regression analyses revealed a significant association between defensive coping strategies (secrecy and withdrawal) and internalized stigma.ConclusionsThe relationship between defensive coping strategies and self-stigma appears to be bidirectional. Enhancing coping strategies oriented to education, challenging and engaging patients in social interaction and reducing the use of deleterious coping strategies focusing on secrecy and withdrawal may lead to restrict self-stigma.DisclosureNo significant relationships.

The Effect of Solution Focused Group Psychoeducation Applied to Schizophrenia Patients on Self-Esteem, Perception of Subjective Recovery and Internalized Stigmatization

The study examined the effect of Solution-Focused Group Psychoeducation on self-esteem, subjective perception of recovery, and internalized stigma among patients with schizophrenia 39 patients with schizophrenia were recruited based design of the randomized control-group with pretest and posttest. The patients completed the “Rosenberg Self-Esteem Scale (RSES)”, “Subjective Recovery Assessment Scale (SubRAS)”, and “Internalized Stigma of Mental Illness (ISMI) Scale” in pretest and posttest. After the psychoeducation, ISMI scores decreased in the intervention group (p < 0.001) but increased in the control group (p = 0.599). The posttest RSES score was lower in the intervention group compared to the control group (p = 0.001). A statistically significant difference was found between the pretest and posttest SRAS scores of the intervention group when compared to the control group (p = 0.018). After the psychoeducation, intervention group’ self-esteem and subjective perception of recovery increased, while the severity of internalized stigma decreased.

INTERNALIZED STIGMA, PERCEIVED SOCIAL SUPPORT, AND LIFE QUALITY IN PATIENTS ADMITTED TO A FORENSIC PSYCHIATRY UNIT

Objective: This study aimed to examine internalized stigma, perceived social support, and the quality of life and its associations among patients admitted to a forensic psychiatry unit. Material and Method: A total of 97 patients treated at a High Security Forensic Psychiatry Unit were included. A Sociodemographic Data Form, the Multi-Dimensional Scale of Perceived Social Support (MSPSS), the Internalized Stigma of Mental Illness (ISMI), and the World Health Organization Quality of Life Short Form (WHOQOL) were administered to all patients. Results: The mean ISMI, MSPSS, and WHOQL scores were 74.3±8.4, 38.3±8.4, and 75.9±10.5, respectively. A negative correlation between the total MSPSS and total ISMI scores as well as between total the ISMI and total WHOQOL scores was found; on the other hand, a positive and significant association was determined between the total MSPSS and total WHOQOL scores (p&lt;0.001, r=-0.367; p&lt;0.001, r=-0.550; p&lt;0.001, and r=0.496, respectively). The MSPSS total and sub-scale scores, age, alienation, stereotype endorsement, and perceived discrimination predicted the total WHOQOL score (R2 =0.613; Model F=12.242; p&lt;0.001). Conclusion: Forensic psychiatry patients experience internalized stigma and reduced social support. Increasing levels of internalized stigma were associated with progressively lower levels of perceived social support and life quality. Predictors of the quality of life include the perceived social support, stereotype endorsement, discrimination, and alienation. This study sheds&nbsp;some light on factors affecting the quality of life in this relatively under examined group of forensic psychiatry patients.

THE RELATIONSHIP BETWEEN SOCIAL SUPPORT, INTERNALIZED STIGMA OF MENTAL ILLNESS AND RECOVERY ATTITUDE AMONG PATIENTS WITH SCHIZOPHRENIA IN MAIDUGURI

Purpose: Social support strengthening and hope inspiration about recovery may mitigate stigma of mental illness. The study explored on the level of social support as well as the relationship of social support with internalized stigma and recovery attitude among patients with schizophrenia.  &#x0D; Methodology: Through a cross-sectional design and a convenience sampling method, 282 participants with a diagnosis of schizophrenia completed the study. They were interviewed with the Internalized stigma of Mental illness (ISMI) Scale, Oslo-3 Social Support Scale and Recovery Attitude Questionnaire (RAQ-16). The Statistical Package for Social Sciences (SPSS) version 18 was used for data entry and analysis and Pearson’s correlation analysis was used to assess for the relationship of social support with internalized stigma and recovery attitude.&#x0D; Findings: Perceived social support was moderate to low in majority of the participants (87.5%). The mean scores for social support, internalized stigma and recovery attitude were 3.111 (± 0.748), 2.580 (± 0.245) and 3.561 (± 0.355) respectively.  Social support significantly and negatively correlated with internalized stigma on the domains of stereotype endorsement (r=-0.270; p-0.000), positively correlated with the stigma resistance subscale (r=0.568; p-0.000) and recovery attitude (r=0.428; p-0.000). A negative correlation between recovery attitude and internalized stigma was observed on the domains of stereotype endorsement (r=-0.249; p-0.000) and stigma resistance (r=0.299; p-0.000).&#x0D; Conclusion: The study showed a high level of perceived low to moderate social support and perceived social support both correlated to internalized stigma and recovery attitude.&#x0D; Recommendations: The outcome of this study indicates that strengthening the social support network may enhance positive recovery attitude and mitigate internalized stigma of mental illness. Therefore, there is need to design and adopt mental health intervention that simultaneously targets stigma, promotes recovery attitude and strengthens social support in the overall treatment plan of individuals living with severe mental illness.

Hemifacial spasm and psychiatric comorbidities

Purpose: In Hemifacial spasm (HFS) uncontrolled movements may affect interpersonal communication and these patients may suffer from stigma, depression and anxienty. In this study we aimed to evaluate depression and axiety in patients with HFS and it’s relation with self-stigmatization. Materials and methods: This is a cross-sectional observational study conducted in 27 patients with HFS and 36 healthy controls. Turkish version of The Internalized Stigma of Mental Illness (ISMI) scale, and Hamilton depression and anxiety scales were performed in both groups. Independent samples t test was used to compare the numeric data between groups and Pearson correlation test is used to investigate the correlation of scales’ scores. Results: There was statistically significant difference in mean values of ISMI, HDRS-17 and HAMA scores. There was not statistically significant correlation between ISMI and HDRS-17 and HAMA scores, but we found strong correlation between HDRS-17 and HAMA scores (r:0.928, p:0.000). Conclusion: Our results suggest that depression and anxiety are common in patients with HFS and stigmatization is an important social problem for these patients. To be aware of this, would be helpful for both psychiatric and neurological condition of the patients with HFS.

Internalized Stigma and Resistance Against Stigma as Risk Factors for Suicide in Individuals with Schizophrenia: A Cross-Sectional Study.

Identifying the relationship between internalized stigma and suicide is critical in dealing with schizophrenia. We aimed to examine how internalized stigma and its subcomponents affect suicidality in patients with schizophrenia. The second aim of this study was to identify the risk factors for internalized stigma in schizophrenia. We assessed 114 patients diagnosed with schizophrenia. Structured Clinical Interview for the DSM-5 (SCID-5), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale (CDS), Internalized Stigma of Mental Illness (ISMI), and Suicide Probability Scale (SPS) were applied to the sample. Multivariable linear regression analysis was conducted to determine the risk factors of internalized stigma. Statistically significant correlation between stigma resistance and all SPS scores was found. The correlation between stigma resistance and suicidal thought was independent of the CDS and PANSS scores of the sample. Stigma resistance and depressive situation were the predictive factors for SPS. Only depressive state of the group predicted the level of internalized stigma in the regression analysis. Stigma resistance is an important risk factor for suicide in schizophrenia. Clinicians should focus on interventions to increase resistance against stigma and to determine the depressive situation of patients with schizophrenia.