ISMI Score Research Articles

Self-stigma, hope, dissociation, and personality features in treatment of depressive inpatients resistant to pharmacotherapy

ObjectiveThe goal of this study was to examine the influence of dissociation, hope, personality trait and selected demographic factors in treatment response of this group of patients.MethodsPharmacoresistant depressive inpatients completed clinical global impression – both objective and subjective form, Beck depression inventory, and Beck anxiety inventory at baseline and after six weeks of combined pharmacotherapy and psychotherapy (group cognitive behavioral or group psychodynamic). The Internalized Stigma Of Mental Illness Scale, Dissociative Experience Scale Adult Dispositional Hope Scale, and temperament and character inventory were completed at the start of the treatment with the intention to find predictors of treatment efficacy.ResultsThe study included 72 patients hospitalized for the pharmacoresistant major depression, 63 of them finished the study. The mean scores of BDI-II, BAI, subjCGI, and objCGI significantly decreased during the treatment. BDI-II relative change statistically significantly correlated with the total ISMI score, discrimination experience (ISMI subscale), and harm avoidance (TCI-R personality trait). According to stepwise regression, the strongest factors connected to BDI-II relative change were the duration of the disorder and discrimination experience (ISMI). ObjCGI relative change significantly correlated with the level of dissociation, the total ISMI score, and hope in ADHS total score, and self-directedness. According to stepwise regression, the strongest factor connected to objCGI relative change was discrimination experience (ISMI).ConclusionsAccording to our results, the patients with pharmacoresistant depressive disorders, who have had more experience with discrimination because of their mental struggles, showed a poorer response to treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Personality features, dissociation, self-stigma, hope, and the complex treatment of depressive disorder.

ObjectiveIdentifying the predictors of response to psychiatric and psychotherapeutic treatments may be useful for increasing treatment efficacy in pharmacoresistant depressive patients. The goal of this study was to examine the influence of dissociation, hope, personality trait, and selected demographic factors in treatment response of this group of patients.MethodsPharmacoresistant depressive inpatients were enrolled in the study. All patients completed Clinical Global Impression – both objective and subjective form (CGI), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) at baseline and after 6 weeks of combined pharmacotherapy and psychotherapy (group cognitive-behavioral or group psychodynamic) treatment as an outcome measures. The Internalized Stigma of Mental Illness Scale (ISMI), Dissociative Experience Scale (DES), Adult Dispositional Hope Scale (ADHS), and Temperament and Character Inventory (TCI-R) were completed at the start of the treatment with the intention to find the predictors of treatment efficacy.ResultsThe study included 72 patients who were hospitalized for the pharmacoresistant major depression; 63 of them completed the study. The mean scores of BDI-II, BAI, subjCGI, and objCGI significantly decreased during the treatment. BDI-II relative change statistically significantly correlated with the total ISMI score, Discrimination Experience (ISMI subscale), and Harm Avoidance (TCI-R personality trait). According to stepwise regression, the strongest factors connected to BDI-II relative change were the duration of the disorder and Discrimination Experience (domain of ISMI). ObjCGI relative change significantly correlated with the level of dissociation (DES), the total ISMI score, hope in ADHS total score, and Self-Directedness (TCI-R). According to stepwise regression, the strongest factor connected to objCGI relative change was Discrimination Experience (domain of ISMI). The existence of comorbid personality disorder did not influence the treatment response.ConclusionAccording to the results of the present study, patients with pharmacoresistant depressive disorders, who have had more experience with discrimination because of their mental struggles, showed a poorer response to treatment.

Self-perceived cognitive deficits and their relationship with internalized stigma and quality of life in patients with schizophrenia.

BackgroundWe investigated self-perceived cognitive deficits and their relationship with internalized stigma and quality of life in patients with schizophrenia in order to shed light on the clinical correlates of subjective cognitive deficits in schizophrenia.MethodsSeventy outpatients with schizophrenia were evaluated. Patients’ self-perceived cognitive deficits, internalized stigma, and subjective quality of life were assessed using the Scale to Investigate Cognition in Schizophrenia (SSTICS), the Internalized Stigma of Mental Illness Scale (ISMI), and the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4), respectively. Correlation and regression analyses controlling for the severity of symptoms of schizophrenia were performed, and a mediation analysis was conducted to examine the hypothesis that internalized stigma mediates the relationship between self-perceived cognitive deficits and subjective quality of life.ResultsPearson’s partial correlation analysis showed significant correlations among the SSTICS, ISMI, and SQLS-R4 scores (P<0.01). Multiple regression analysis showed that the SSTICS and ISMI scores significantly predicted the SQLS-R4 score (P<0.01). Mediation analysis revealed that the strength of the association between the SSTICS and SQLS-R4 scores decreased from β=0.74 (P<0.01) to β=0.56 (P<0.01), when the ISMI score was statistically controlled. The Sobel test revealed that this difference was significant (P<0.01), indicating that internalized stigma partially mediated the relationship between self-perceived cognitive deficits and quality of life.ConclusionThe present study indicates that self-perceived cognitive deficits are significantly associated with internalized stigma and quality of life. Furthermore, internalized stigma was identified as a partial mediator of the relationship between self-perceived cognitive deficits and quality of life. These findings suggest that clinicians should be aware that patients with schizophrenia experience significantly greater self-stigma when they suffer subjective cognitive deficits, and that this may further compromise their quality of life.

Social Functioning and Internalized Stigma in Individuals Diagnosed with Substance Use Disorder

The aim of this descriptive study was to determine social functioning and internalized stigma in individuals with substance use disorder. The study sample consisted of 105 patients diagnosed with substance use disorder according to the DSM-IV-TR diagnostic criteria. A Descriptive Information Form, Internalized Stigma of Mental Illness Scale (ISMI) and Social Functioning Scale (SFS) were used for data collection. Average total SFS score of the patients was 103.25±25.09 points, indicating an intermediate level of social functioning. Average total ISMI score of patients was 2.92±0.48 points, reflecting a high level of internalized stigma. A negative significant association was observed between the internalized stigma levels and social functioning of patients. These results suggest that rehabilitation of substance users should include counseling services in order to reduce internal perception of stigma and improve their social functioning.

Self-stigmatization, Treatment Adherence and Discontinuation of Medication: Cross-sectional Study

Self stigmatization is an important factor playing role in social life of patients, but also discourages therapy. Aim of our study was to found connection between self stigmation, adherence and discontinuation of drug treatment. It is a cross-section study of ambulatory patients of Department of psychiatry, University hospital Olomouc, Czech Republic. Data were gathered from 332 probands from six basic diagnostic categories. From defined variables these affected self-stigamtization: education level, marital status, age, age of onset of disorder, number of hospitalizations, number of attended psychiatrist, dose of antidepresantns, score of subjective and objective CGI and level of adherence. Level of adherence was influenced by marital status, age, age of onset of disorder, dose of anxiolytics, score of subjective and objective and ISMI score. There was no significant difference is ISMI score between patients from different diagnostic categories. Level of adherence significantly differs between patients with depression and schizophrenic patients. Level of self-stigmatization proved to be an important factor in influencing both level of adherence and discontuniation of drugs. More attention should be payed to issue of self-stigmation.

Internalized Stigmatization in Bipolar Patients: Relationship with Clinical Properties, Quality of Life and Treatment Compliance

This study aimed to investigate the impact of the internalized stigmatization on bipolar disorder (BD) patients. The study included 100 BD patients that provided written informed consent to participate. Diagnosis of the BD patients that were in remission and receiving outpatient treatment was performed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and patient data were recorded using SKIP-TURK. In addition, the patients were administered the Internalized Stigma of Mental Illness Scale (ISMI), Mood Stabilizer Compliance Questionnaire (MSQC), and World Health Organization Quality of Life Assessment, abbreviated form (WHOQOL-BREF). Internalized stigmatization was observed in 46% of the BD patients; these patients had higher functionality scores, shorter regression periods, and more depressive episodes than those without internalized stigmatization. Although internalized stigmatization occurred more frequently in seasonal and rapid cycling patients, both attributes were prodrome of internalized stigmatization. Internalized stigmatization was observed more frequently in patients with low socioeconomic status, low level of education, rural residence, lack of work, and more children. There was a strong correlation between ISMI score, and WHOQOL-BREF and MSQC scores. The clinical features of the BD and internalized stigmatization were observed to affect each other. Furthermore, stigmatization affected treatment compliance and quality of life.