Tesfaye Elias, Worku Benyam, Girma Eshetu, Agenagnew Liyew
1Department of Psychiatry, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
2Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Int J Ment Health Syst. 2020 May 6;14:32. doi: 10.1186/s13033-020-00365-8. eCollection 2020.
Information on the degree of internalized stigma experienced by patients with mood disorders in Ethiopia is limited. This study attempted to assess the levels of internalized stigma and factors associated with it in patients with mood disorders who were on follow-up as an outpatient in a Psychiatry clinic at Saint Paul's Hospital, Addis Ababa, Ethiopia.
A facility-based cross-sectional study employed, and a consecutive sampling technique was used to get study participants (235 cases with mood disorders). Internalized stigma of mental illness scale used to assess stigma of study subjects. The collected data were cleaned, checked for completeness, coded and entered into Epi-data version 3.1 data entry software and exported to SPSS version 20 statistical software for analysis. Univariate linear regression analysis was done to see the association between dependent and independent variables at P-value < 0.25 and multivariate linear regression analysis was done to identify predictor variables at P-value < 0.05.
Nearly one-third (31.5%) of the patients had moderate or high levels of internalized stigma, and more than half (54.9%) of the respondents had moderate or high stigma resistance and self-esteem score of (67.2%). About a quarter (27.7%) had moderate to high levels of discrimination experience and a similar proportion (26.4%) had moderate to severe or extreme disability. Females had significantly higher internalized stigma (std. β = .169 with P < 0.01) than men. Adherence to medication was significantly correlated with lower internalized stigma (std. β = - .212 with P < 0.01).
These findings suggested that moderate to high internalized stigma occurred among approximately 1 in 3 people with a mood disorder in the urban city of Ethiopia. So, working on adherence to medication, self-esteem of patients and psycho-education about stigma is crucial to reducing the internalized stigma of people with a mood disorder and special attention should give to female patients.
埃塞俄比亚情绪障碍患者内化耻辱感程度的相关信息有限。本研究试图评估在埃塞俄比亚亚的斯亚贝巴圣保罗医院精神病科门诊接受随访的情绪障碍患者的内化耻辱感水平及其相关因素。
采用基于机构的横断面研究,并使用连续抽样技术获取研究参与者(235例情绪障碍患者)。使用精神疾病内化耻辱感量表评估研究对象的耻辱感。收集到的数据进行清理、检查完整性、编码,并录入Epi-data 3.1数据录入软件,然后导出到SPSS 20统计软件进行分析。进行单变量线性回归分析以查看P值<0.25时因变量和自变量之间的关联,并进行多变量线性回归分析以确定P值<0.05时的预测变量。
近三分之一(31.5%)的患者有中度或高度内化耻辱感,超过一半(54.9%)的受访者有中度或高度耻辱感抵抗力,自尊得分(67.2%)。约四分之一(27.7%)有中度至高度歧视经历,类似比例(26.4%)有中度至重度或极重度残疾。女性的内化耻辱感显著高于男性(标准β=0.169,P<0.01)。坚持服药与较低的内化耻辱感显著相关(标准β=-0.212,P<0.01)。
这些发现表明,在埃塞俄比亚城市中,约三分之一的情绪障碍患者存在中度至高度内化耻辱感。因此,致力于提高患者的服药依从性、自尊以及开展关于耻辱感的心理教育对于减少情绪障碍患者的内化耻辱感至关重要,并且应特别关注女性患者。