Sun Yan, Chen Gang, Wang Li, Li Nan, Srisurapanont Manit, Hong Jin Pyo, Hatim Ahmad, Chen Chia-Hui, Udomratn Pichet, Bae Jae Nam, Fang Yi-Ru, Chua Hong Choon, Liu Shen-Ing, George Tom, Bautista Dianne, Chan Edwin, Rush A John, Yang Hong, Su Yun-Ai, Si Tian-Mei
Institute of Mental Health, Peking University Sixth Hospital, Beijing, China.
National Clinical Research Center for Mental Health Disorders and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China.
Front Psychiatry. 2019 May 15;10:321. doi: 10.3389/fpsyt.2019.00321. eCollection 2019.
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 ( < 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.
重度抑郁症(MDD)的污名化是一个重要的公共卫生问题。本研究旨在调查中国、韩国、马来西亚、新加坡和泰国这五个亚洲国家MDD患者的感知污名水平及其相关因素。共纳入了来自亚洲国家的547名MDD门诊患者。我们使用解释性模型访谈目录(EMIC)的污名量表来评估污名。使用蒙哥马利-阿斯伯格抑郁评定量表(MADRS)、症状自评量表90修订版(SCL-90-R)、疲劳严重程度量表(FSS)、希恩残疾量表(SDS)、36项简短健康调查(SF-36)和多维感知社会支持量表(MSPSS)来评估症状、临床特征、功能损害、健康状况和社会支持。55岁以下患者的污名得分显著高于55岁及以上患者(<0.001)。污名得分与年龄、家庭、朋友和他人的MSPSS得分以及SF-36心理健康子量表呈显著负相关,但与MADRS、FSS、SDS以及SCL-90-R抑郁、人际敏感、强迫、精神病性和躯体化子量表得分呈显著正相关。多因素回归分析显示,年龄、SCL-90-R人际敏感、强迫、精神病性、朋友和他人的MSPSS得分以及心理健康的SF-36与感知污名水平显著相关。这些发现表明,年龄较小、人际敏感和精神病性程度较高、健康相关生活质量较低且社会支持较少的MDD患者是亚洲污名干预的目标人群。