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      Prevalence of self-stigma and its association with self-esteem among psychiatric patients in a Nepalese teaching hospital: a cross-sectional study

      research-article
      ,
      BMC Psychiatry
      BioMed Central
      Mental illness, Self-esteem, Self-stigma

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          Abstract

          Background

          Stigma against mental illness cuts across all age, religion, ethnic origin or socio-economic status. Similarly, self-stigma among psychiatric patients is also prevalent worldwide. The consequences of self-stigma are low self-esteem, increased severity of symptoms, low treatment adherence, increased rate of suicidality and decreased quality of life. Thus, this study aims to find the prevalence of self-stigma and its association with self-esteem of patients with mental illness in Nepal.

          Methods

          This was a cross-sectional study conducted among 180 patients with mental illness attending a psychiatric Outpatient Department (OPD). Non-probability purposive sampling technique was used for the study. The data was collected by face to face interview technique. Structured interview schedule questionnaire (brief version of internalized stigma scale and Rosenberg self-esteem scale) was used to collect the data. Descriptive statistics, inferential statistics and correlation analysis were used for data analysis. P value was set at 0.05.

          Results

          Overall prevalence of self-stigma was 54.44%. Among those who had self-stigma 48% had mild self-stigma, 34.7% had moderate self-stigma and 17.3% had severe self-stigma. Among the five components of self-stigma scale, the highest mean score was on stereotype endorsement, followed by discrimination experience, social withdrawal, stigma resistance, and the lowest for the component of alienation. Furthermore, strong negative correlation ( r = − 0.74) was found between self-stigma and self-esteem. The correlation was still significant ( r = − 0.69) after controlling for socio-demographic and clinical variables. Hospital admission and diagnostic category of respondents were significantly associated with self-stigma. However, no significant association was found between socio-demographic variables and self-stigma.

          Conclusion

          Based on the findings of this study, it can be concluded that self-stigma is prevalent among psychiatric patients in Nepal. Most of the respondents experienced stereotype endorsement. Also, higher self-stigma is significantly associated with poor self-esteem suggesting self-stigma reduction programs. Furthermore, strong negative relationship between self-stigma and self-esteem suggests some causal relationship studies to confirm if self-esteem enhancement program can be beneficial to reduce self-stigma among psychiatric patients.

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          Most cited references27

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          Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries.

          Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems is needed. This study links two large, international datasets to explore the association between public stigma in 14 European countries (Eurobarometer survey) and individual reports of self-stigma, perceived discrimination and empowerment among persons with mental illness (n=1835) residing in those countries [the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) study]. Individuals with mental illness living in countries with less stigmatizing attitudes, higher rates of help-seeking and treatment utilization and better perceived access to information had lower rates of self-stigma and perceived discrimination and those living in countries where the public felt more comfortable talking to people with mental illness had less self-stigma and felt more empowered. Targeting the general public through mass anti-stigma interventions may lead to a virtuous cycle by disrupting the negative feedback engendered by public stigma, thereby reducing self-stigma among people with mental health problems. A combined approach involving knowledge, attitudes and behaviour is needed; mass interventions that facilitate disclosure and positive social contact may be the most effective. Improving availability of information about mental health issues and facilitating access to care and help-seeking also show promise with regard to stigma.
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            Interventions targeting mental health self-stigma: A review and comparison.

            With growing awareness of the impact of mental illness self-stigma, interest has arisen in the development of interventions to combat it. The present article briefly reviews and compares interventions targeting self-stigma to clarify the similarities and important differences between the interventions.
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              • Record: found
              • Abstract: found
              • Article: not found

              The Impact of Illness Identity on Recovery from Severe Mental Illness.

              The impact of the experience and diagnosis of mental illness on one's identity has long been recognized; however, little is known about the impact of illness identity, which we define as the set of roles and attitudes that a person has developed in relation to his or her understanding of having a mental illness. The present article proposes a theoretically driven model of the impact of illness identity on the course and recovery from severe mental illness and reviews relevant research. We propose that accepting a definition of oneself as mentally ill and assuming that mental illness means incompetence and inadequacy impact hope and self-esteem, which further impact suicide risk, coping, social interaction, vocational functioning, and symptom severity. Evidence supports most of the predictions made by the model. Implications for psychiatric rehabilitation services are discussed.
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                Author and article information

                Contributors
                shantamaharjan@pahs.edu.np
                +977-1-5521634 , bimupanthee@gmail.com , bimalapanthee@pahs.edu.np
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                7 November 2019
                7 November 2019
                2019
                : 19
                : 347
                Affiliations
                ISNI 0000 0004 4677 1409, GRID grid.452690.c, Patan Academy of Health Sciences, School of Nursing and Midwifery, ; Lalitpur, Nepal
                Article
                2344
                10.1186/s12888-019-2344-8
                6836475
                31699070
                43499437-ddf2-4bd1-88b0-24789c3eca3b
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 2 July 2019
                : 27 October 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100009647, University Grants Commission- Nepal;
                Award ID: FRG-73/74-HS-09
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Clinical Psychology & Psychiatry
                mental illness,self-esteem,self-stigma
                Clinical Psychology & Psychiatry
                mental illness, self-esteem, self-stigma

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