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自我污名与双相障碍:系统评价和最佳证据综合。

Self-stigma and bipolar disorder: A systematic review and best-evidence synthesis.

机构信息

Mood disorder unit, Psychiatric Specialties Service, Geneva University Hospital, Geneva, Switzerland.

Mood disorder unit, Psychiatric Specialties Service, Geneva University Hospital, Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland.

出版信息

J Affect Disord. 2023 Aug 15;335:273-288. doi: 10.1016/j.jad.2023.05.041. Epub 2023 May 17.

Abstract

BACKGROUND

Bipolar disorder is a severe and chronic mental illness characterized by recurrent major depressive episodes and mania or hypomania. In addition to the burden of the disease and its consequences, self-stigma can impact people with bipolar disorder. This review investigates the current state of research in self-stigma in bipolar disorder.

METHODS

An electronic search was carried out until February 2022. Three academic databases were systematically searched, and best-evidence synthesis was made.

RESULTS

Sixty-six articles were related to self-stigma in bipolar disorder. Seven key themes were extracted from these studies: 1/ Comparison of self-stigma in bipolar disorder and other mental illnesses, 2/ Sociocultural context and self-stigma, 3/ Correlates and predictors of self-stigma, 4/ Consequences of self-stigma, 5/ Treatments and self-stigma, 6/ Management of self-stigma, and 7/ Self-stigma and recovery in bipolar disorder.

LIMITATIONS

Firstly, a meta-analysis could not be performed due to the heterogeneity of the studies. Secondly, limiting the search to self-stigma has excluded other forms of stigma that also have an impact. Thirdly, the under-reporting of negative or nonsignificant results due to publication bias and unpublished studies might have limited the accuracy of this reviews' synthesis.

CONCLUSION

Research on self-stigma in persons with bipolar disorder has been the focused on different aspects, and interventions to reduce self-stigmatization have been developed, but evidence of their effectiveness is still sparse. Clinicians need to be attentive to self-stigma, its assessment, and its empowerment in their daily clinical practice. Future work is required to establish valid strategies to fight self-stigma.

摘要

背景

双相情感障碍是一种严重且慢性的精神疾病,其特征为反复发作的重度抑郁发作和躁狂或轻躁狂。除了疾病负担及其后果外,自我污名也会影响双相情感障碍患者。本综述调查了双相情感障碍自我污名的研究现状。

方法

进行了电子检索,截至 2022 年 2 月。系统性地检索了三个学术数据库,并进行了最佳证据综合。

结果

与双相情感障碍自我污名相关的文章有 66 篇。从这些研究中提取了 7 个关键主题:1/ 双相情感障碍与其他精神疾病的自我污名比较,2/ 社会文化背景与自我污名,3/ 自我污名的相关因素和预测因素,4/ 自我污名的后果,5/ 治疗与自我污名,6/ 自我污名管理,7/ 双相情感障碍中的自我污名与康复。

局限性

首先,由于研究的异质性,无法进行荟萃分析。其次,由于仅关注自我污名,因此排除了其他形式的污名,这些污名也会产生影响。第三,由于发表偏倚和未发表的研究,负面或无显著性结果的报告不足,可能限制了本综述综合结果的准确性。

结论

针对双相情感障碍患者自我污名的研究已聚焦于不同方面,并且已经开发了减少自我污名化的干预措施,但关于其有效性的证据仍然稀少。临床医生在日常临床实践中需要注意自我污名、对其进行评估并赋予其权力。需要进一步研究以制定有效的策略来对抗自我污名。

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