Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.
Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China.
Transl Psychiatry. 2022 Oct 4;12(1):429. doi: 10.1038/s41398-022-02170-y.
The association between coronavirus disease (COVID-19) vaccine acceptance and perceived stigma of having a mental illness is not clear. This study examined the association between COVID-19 vaccine acceptance and perceived stigma among patients with recurrent depressive disorder (depression hereafter) using network analysis. Participants were 1149 depressed patients (842 men, 307 women) who completed survey measures of perceived stigma and COVID-19 vaccine attitudes. T-tests, chi-square tests, and Kruskal-Wallis tests were used to compare differences in demographic and clinical characteristics between depressed patients who indented to accepted vaccines and those who were hesitant. Hierarchical multiple regression analyses assessed the unique association between COVID-19 vaccine acceptance and perceived stigma, independent of depression severity. Network analysis examined item-level relations between COVID-19 vaccine acceptance and perceived stigma after controlling for depressive symptoms. Altogether, 617 depressed patients (53.7%, 95 confidence intervals (CI) %: 50.82-56.58%) reported they would accept future COVID-19 vaccination. Hierarchical multiple regression analyses indicated higher perceived stigma scores predicted lower levels of COVID-19 vaccination acceptance (β = -0.125, P < 0.001), even after controlling for depression severity. In the network model of COVID-19 vaccination acceptance and perceived stigma nodes, "Feel others avoid me because of my illness", "Feel useless", and "Feel less competent than I did before" were the most influential symptoms. Furthermore, "COVID-19 vaccination acceptance" had the strongest connections with illness stigma items reflecting social rejection or social isolation concerns ("Employers/co-workers have discriminated", "Treated with less respect than usual", "Sense of being unequal in my relationships with others"). Given that a substantial proportion of depressed patients reported hesitancy with accepting COVID-19 vaccines and experiences of mental illness stigma related to social rejection and social isolation, providers working with this group should provide interventions to reduce stigma concerns toward addressing reluctance in receiving COVID-19 vaccines.
新冠病毒疾病（COVID-19）疫苗接种与对患有精神疾病的耻辱感之间的关系尚不清楚。本研究使用网络分析，考察了复发性抑郁障碍（以下简称抑郁）患者的 COVID-19 疫苗接种接受度与感知耻辱感之间的关系。研究对象为 1149 名抑郁患者（842 名男性，307 名女性），他们完成了感知耻辱感和 COVID-19 疫苗态度的调查测量。T 检验、卡方检验和克鲁斯卡尔-沃利斯检验用于比较有意愿接种疫苗的抑郁患者和犹豫不决的抑郁患者在人口统计学和临床特征方面的差异。分层多重回归分析评估了 COVID-19 疫苗接种接受度与感知耻辱感之间的独特关联，独立于抑郁严重程度。网络分析在控制抑郁症状的情况下，考察了 COVID-19 疫苗接种接受度与感知耻辱感之间的项目水平关系。共有 617 名抑郁患者（53.7%，95%置信区间[CI]%：50.82-56.58%）报告称他们将接受未来的 COVID-19 疫苗接种。分层多重回归分析表明，感知耻辱感得分越高，COVID-19 疫苗接种接受度越低（β=-0.125，P<0.001），即使控制了抑郁严重程度。在 COVID-19 疫苗接种接受度和感知耻辱感节点的网络模型中，“感觉别人因为我的病而避开我”、“感觉自己没用”和“感觉自己不如以前有能力”是最具影响力的症状。此外，“COVID-19 疫苗接种接受度”与反映社会排斥或社会隔离问题的疾病耻辱感项目（“雇主/同事歧视”、“待遇不如往常”、“在与他人的关系中感到不平等”）的联系最强。鉴于相当一部分抑郁患者对接受 COVID-19 疫苗犹豫不决，并且经历了与社会排斥和社会隔离相关的精神疾病耻辱感，与这一群体合作的提供者应提供干预措施，以减少对接受 COVID-19 疫苗的抵触情绪。
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