Hellström Lone, Gren Voldby Katrine, Eplov Lene Falgaard
Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Hellerup, Denmark.
Nord J Psychiatry. 2023 May;77(4):319-328. doi: 10.1080/08039488.2022.2105946. Epub 2022 Aug 5.
Stigma affects people with mental illness globally, however, it is proposed that stigma is less prevalent in wealthier countries and that people hold more positive attitudes in Northern and Western Europe. Even so, accounts from surveys in Denmark and Sweden reveal that stigma is very much prevalent.
This scoping review aims to shed light on the body of literature regarding mental-health-related stigma in the Nordic Countries and identify knowledge gaps.
We searched four electronic databases in December 2017 and again in June 2020. All types of empirical studies (qualitative, quantitative, and mix-methods) examining the stigma of people with mental illness were included.
In total, 61 studies were included. Overall, findings from the Nordic countries resemble global findings. Studies are primarily descriptive, and mostly survey studies of attitudes toward people with mental illness in the general population. Few studies focus on discrimination, and those who do, measure intended behavior in hypothetical situations rather than actual acts of discrimination in real-life situations. Studies were mostly conducted on a community or organizational level; no studies were identified on a system level. Experienced stigma and discrimination by patients, but also relatives, were a focus in one-third of the studies. Very few studies of interventions to reduce stigma and discrimination were identified.
More studies into stigma on a system or institutional level are needed. Ways to measure acts of discrimination should be invented. Furthermore, interventions to reduce stigma and discrimination should be developed, targeting all levels of society.
耻辱感在全球范围内影响着精神疾病患者，然而，有人提出耻辱感在较富裕国家不太普遍，且北欧和西欧的人们持有更积极的态度。即便如此，丹麦和瑞典的调查结果显示耻辱感仍然非常普遍。
本范围综述旨在阐明北欧国家与心理健康相关耻辱感的文献，并找出知识空白。
我们于2017年12月和2020年6月对四个电子数据库进行了检索。纳入了所有类型的实证研究（定性、定量和混合方法），这些研究探讨了精神疾病患者的耻辱感。
总共纳入了61项研究。总体而言，北欧国家的研究结果与全球研究结果相似。研究主要是描述性的，大多是对普通人群对精神疾病患者态度的调查研究。很少有研究关注歧视，而关注歧视的研究中，大多是测量假设情境下的预期行为，而非现实生活中实际的歧视行为。研究大多在社区或组织层面进行；未发现系统层面的研究。三分之一的研究关注患者及其亲属所经历的耻辱感和歧视。很少有研究涉及减少耻辱感和歧视的干预措施。
需要在系统或机构层面开展更多关于耻辱感的研究。应发明测量歧视行为的方法。此外，应针对社会各层面制定减少耻辱感和歧视的干预措施。
