Świtaj Piotr, Grygiel Paweł, Leciak Joanna, Stefaniak Izabela, Opozda-Suder Sylwia, Anczewska Marta
Maria Sklodowska-Curie Medical Academy in Warsaw, Pl. Żelaznej Bramy 10, 00-136, Warsaw, Poland.
First Department of Psychiatry, Institute of Psychiatry and Neurology in Warsaw, Warsaw, Poland.
Sci Rep. 2025 Jan 27;15(1):3432. doi: 10.1038/s41598-025-87559-7.
People diagnosed with bipolar disorder (BD) commonly experience self-stigma, which negatively affects various health outcomes. The aim of the present study was to elucidate the mechanisms through which self-stigma may contribute to suicidality among bipolar patients by investigating the mediating roles of loneliness and depressive symptoms. A total of 140 patients with BD were cross-sectionally assessed with self-report scales measuring self-stigma, loneliness, depressive symptoms and suicidal ideation, and with a clinician-rated scale evaluating overall psychopathology. Path analysis was used to analyze the data. Self-stigma was directly related to more severe loneliness, depressive symptoms and suicidal thoughts. There were also significant direct effects of loneliness on depressive symptoms and depressive symptoms on suicidal ideation. The direct effect of loneliness on suicidality was non-significant. The following indirect effects on suicidal ideation were found: from self-stigma via depressive symptoms, from loneliness via depressive symptoms and a sequential effect from self-stigma through loneliness and depressive symptoms. Our findings clearly indicate that interventions aiming to reduce the risk of suicide among people with BD should be comprehensive and take into account not only psychiatric symptoms, but also social context and the psychological aspects of living with this diagnosis.
被诊断为双相情感障碍（BD）的人通常会经历自我污名化，这会对各种健康结果产生负面影响。本研究的目的是通过调查孤独感和抑郁症状的中介作用，阐明自我污名化可能导致双相情感障碍患者自杀倾向的机制。共有140名双相情感障碍患者接受了横断面评估，使用自我报告量表测量自我污名化、孤独感、抑郁症状和自杀意念，并使用临床医生评定量表评估整体精神病理学。采用路径分析对数据进行分析。自我污名化与更严重的孤独感、抑郁症状和自杀念头直接相关。孤独感对抑郁症状以及抑郁症状对自杀意念也有显著的直接影响。孤独感对自杀倾向的直接影响不显著。发现了以下对自杀意念的间接影响：从自我污名化经由抑郁症状，从孤独感经由抑郁症状，以及从自我污名化通过孤独感和抑郁症状的连续效应。我们的研究结果清楚地表明，旨在降低双相情感障碍患者自杀风险的干预措施应该是全面的，不仅要考虑精神症状，还要考虑社会背景以及患有这种疾病的心理方面。
