Internalized stigma and its correlates among patients with severe mental illness

Figures & data

Table 1 Demographic and clinical characteristics of the study sample

	Total sample (n=114)	Psychotic disorders (n=51)	Unipolar affective disorder, depression (n=44)	Bipolar affective disorders (n=19)	Statistical comparison between clinical groups, P-value
Age (years)	42.46±14.1	37.01±12.5*	48.45±13.8*	43.21±13.8	Pairwise comparisons using
					Wilcoxon rank sum test
					PD vs D, P=0.00043
Gender (F/M)	63/51	23/28	29/15	11/8	Pearson’s chi-squared test; ns
Education					Pearson’s chi-squared test; ns
Elementary	12 (11)	9 (75)	2 (17)	1 (8)
Vocational training	30 (38)	8 (27)	16 (53)	6 (20)
Secondary school	43 (19)	23 (53)	15 (35)	5 (12)
Higher education	22 (26)	9 (41)	7 (32)	6 (27)
Not completed	7 (6)	2 (29)	4 (57)	1 (14)
Employment					Pearson’s chi-squared test; ns
Unemployment	25 (22)	13 (52)	10 (40)	2 (8)
Retirement	11 (10)	3 (27)	7 (64)	1 (9)
Annuity	47 (41)	24 (51)	16 (34)	7 (15)
Hired	24 (21)	7 (29)	9 (38)	8 (33)
Not completed	7 (6)	4 (57)	2 (29)	1 (14)
Marital status					Pearson’s chi-squared test; ns
Single	53 (46)	39 (74)	9 (17)	5 (9)
Married	33 (29)	4 (12)	20 (61)	9 (27)
Divorced	16 (14)	6 (37)	7 (44)	3 (19)
Widowed	8 (7)	2 (15)	6 (75)	–
Not completed	4 (4)	–	2 (50)	2 (50)
Treatment					Pearson’s chi-squared test; ns
Outpatient	67 (58)	29 (43)	26 (39)	12 (18)
Inpatient	44 (39)	21 (48)	16 (36)	7 (16)
Not completed	3 (3)	1 (33)	2 (67)	–
Duration of the disease (years)	9.65±8.7	9.41±8.0	8.59±7.7	12.57±11.8	Kruskal–Wallis rank sum test; ns
Number of hospitalization	5.95±6.9	6.61±7.1*	4.40±5.2*	7.68±9.2	Kruskal–Wallis rank sum test; PD vs D, P=0.011
Suicide attempts					Pearson’s chi-squared test; ns
Yes	46 (40)	21 (46)	19 (41)	6 (13)
No	64 (56)	28 (44)	24 (38)	12 (18)
Not completed	4 (4)	2 (50)	1 (25)	1 (25)
Insight					Pearson’s chi-squared test; P=0.047
Yes	79 (69)	32 (41)	31 (39)	16 (20)
No	23 (20)	16 (70)	5 (22)	2 (8)
No data	12 (11)	3 (25)	8 (67)	1 (8)

Notes: Data are presented as n (%) or mean±SD.

* Statistically significant P-value.

Abbreviations: D, depression; PD, psychotic disorder; F, female; M, male; ns, not significant.

Table 2 Internalized stigma in mental disorders in the study sample

Variables	Total sample (n=114)	Psychotic disorder (n=51)	Unipolar affective disorder, depression (n=42)	Bipolar affective disorder (n=19)	Statistical comparison between clinical groups,a P-value
ISMI total score	2.23±0.5	2.19±0.5	2.46±0.6	2.39±0.5	PD vs D, P=0.039
ISMI total (raw score)	67.02±15.1	63.20±13.5	71.06±16.2	68.77±14.6	PD vs D, P=0.045
Alienation	2.63±0.8	2.42±0.8	2.85±0.8	2.66±0.8	PD vs D, P=0.015
Stereotype endorsement	2.08±0.6	1.95±0.6	2.22±0.6	2.12±0.5	ns
Perceived discrimination	2.30±0.7	2.25±0.7	2.27±0.7	2.48±0.7	ns
Social withdrawal	2.33±0.8	2.16±0.7	2.51±0.8	2.41±0.7	ns
Stigma resistance	2.37±0.6	2.27±0.6	2.46±0.6	2.46±0.5	ns

Notes: Data are presented as n (%) or mean±SD.

a Kruskal–Wallis rank sum test; in the case of a significant difference, a pairwise comparison using Wilcoxon rank sum test was used.

Abbreviations: D, depression; PD, psychotic disorder; ISMI, Internalized Stigma of Mental Illness; ns, not significant.

Figure 1 Correlation between age and stereotype endorsement in the study sample.

Table 3 The level of internalized stigma perception as measured by ISMI in relation to demographic and clinical variables in the whole study sample

Variables	ISMI total score
Gender
Female	2.31±0.5	Kruskal–Wallis rank sum test
Male	2.34±0.5	ns
Education
Elementary	2.46±0.5	Kruskal–Wallis rank sum test;
Vocational training	2.51±0.6a	P=0.02
Secondary school	2.28±0.5	*Pairwise comparisons
Higher education	2.06±0.5*	Wilcoxon rank sum test; P=0.02
Employment
Unemployment	2.16±0.5	Kruskal–Wallis rank sum test
Retirement	2.32±0.6	P=0.06 (ns)
Annuity	2.47±0.4
Hired	2.30±0.6
Marital status
Single	2.28±0.5	Kruskal–Wallis rank sum test
Married	2.35±0.5	ns
Divorced	2.46±0.6
Widowed	2.50±0.5

Notes:

a Kruskal–Wallis rank sum test; in the case of a significant difference, a pairwise comparison using Wilcoxon rank sum test was used.

* Statistically significant P-value.

Abbreviations: ISMI, Internalized Stigma of Mental Illness; ns, not significant.