Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr 52, Hamburg 20146, Germany.
Institute and Outpatients Clinic for Psychosomatic Medicine and Psychotherapy, Martinistr 52, Hamburg 20146, Germany.
J Psychosom Res. 2018 Dec;115:71-75. doi: 10.1016/j.jpsychores.2018.10.014. Epub 2018 Oct 26.
The study aims to investigate (1) the magnitude of public stigma towards individuals with somatic symptom disorder (SSD), (2) differences in public stigma between SSD and depression, and (3) predictors of social distance towards individuals with SSD.
Analyses are based on a national telephone survey in Germany (N = 1004). Two vignettes with symptoms of SSD were used. Vignettes differed regarding main type of symptom (pain vs. fatigue) and existence of an earlier somatic disease (yes vs. no). Stigma was measured by stereotypes, negative emotional reactions, and desire for social distance.
There were no significant differences in public stigma regarding type of symptom and existence of an earlier somatic disease. Two of three components of public stigma under study (stereotypes and desire for social distance) showed higher values in case of depression compared to SSD (both vignettes pooled). Age and negative emotional reactions were positively associated with desire for social distance in case of both SSD vignettes, whereas associations with stereotypes and experience (own affliction and contact to persons afflicted) were inconsistent. Education was not associated with social distance towards people with SSD.
Results indicated public stigma towards people affected by SSD in Germany. Compared with depression, SSD stigma was lower in most components. Magnitude of SSD stigma was similar, irrespective of main type of symptom (pain vs. fatigue) and existence of an earlier somatic disease (yes vs. no). Reducing SSD stigma could help to improve illness behaviour and prevent chronification.
本研究旨在调查：（1）公众对躯体症状障碍（SSD）患者的污名程度；（2）SSD 与抑郁症之间污名程度的差异；（3）预测对 SSD 患者产生社会距离的因素。
分析基于德国一项全国性电话调查（N=1004）。使用了两个具有 SSD 症状的病例。病例在主要症状类型（疼痛与疲劳）和是否存在先前的躯体疾病方面存在差异（是/否）。污名通过刻板印象、负面情绪反应和对社会距离的渴望来衡量。
在症状类型和先前躯体疾病的存在方面，公众对 SSD 的污名没有显著差异。在所研究的公众污名的三个组成部分中的两个（刻板印象和对社会距离的渴望），在抑郁症病例中比 SSD 病例更高（两种病例混合）。年龄和负面情绪反应与 SSD 两种病例的对社会距离的渴望呈正相关，而与刻板印象和经验（自身患病和接触患病者）的关联则不一致。教育与对 SSD 患者的社会距离无关。
研究结果表明，德国公众对受 SSD 影响的人群存在污名。与抑郁症相比，SSD 的污名在大多数组成部分中较低。SSD 污名的严重程度相似，无论主要症状类型（疼痛与疲劳）和先前躯体疾病的存在（是/否）如何。减少 SSD 污名可能有助于改善疾病行为并预防慢性化。
