Factors Affecting Stigma Resistance in Patients with Bipolar Disorder

Seong Hyuk Kang; Woo Jung Kim; Youn Joo Song; Jae Min Kim; Kee Namkoong; Kyooseob Ha; Hyun-Sang Cho

doi:10.4306/jknpa.2015.54.3.309

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Kang, Kim, Song, Kim, Namkoong, Ha, and Cho: Factors Affecting Stigma Resistance in Patients with Bipolar Disorder

Original Article

Journal of Korean Neuropsychiatric Association 2015; 54(3): 309-315.

Published online: 21 August 2015

DOI: https://doi.org/10.4306/jknpa.2015.54.3.309

Factors Affecting Stigma Resistance in Patients with Bipolar Disorder

Seong Hyuk Kang, MS¹, Woo Jung Kim, MD², Youn Joo Song, MD³, Jae Min Kim, MD³, Kee Namkoong, MD, PhD^3,⁴, Kyooseob Ha, MD, PhD^5,⁶, Hyun-Sang Cho, MD, PhD^3,⁴

¹Department of Medicine, Yonsei University College of Medicine, Seoul, Korea.

²Department of Psychiatry, Eulji Addiction Institute, Gangnam Eulji Hospital, Eulji University, Seoul, Korea.

³Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.

⁴Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.

⁵Seoul National Hospital, Seoul, Korea.

⁶Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.

Address for correspondence: Woo Jung Kim, MD. Department of Psychiatry, Eulji Addiction Institute, Gangnam Eulji Hospital, Eulji University, 202 Dosan-daero, Gangnam-gu, Seoul 06047, Korea. Tel +82-2-3438-1121, Fax +82-2-3438-1001, woojungkim@eulji.ac.kr

Received 16 April 2015 Revised 25 May 2015 Accepted 26 May 2015

Abstract

Objectives

Stigma resistance is an individual capacity to fight the stigma of mental illness and is an issue of ongoing research regarding the stigma. The aim of this study was to evaluate predictors of stigma resistance in patients with bipolar disorder.

Methods

Demographic, clinical, and psychosocial data were collected from 102 bipolar patients in a university mental hospital. Stigma resistance was measured using a subscale of the Internalized Stigma of Mental Illness Scale. Patients completed self-reported questionnaires including items on self-esteem, hopelessness, social support, and social conflict.

Results

Stigma resistance showed positive association with functioning, self-esteem, and social support, and showed negative association with depressive symptoms, hopelessness, and social conflict. In multivariate analysis, stigma resistance was predicted by sex, education, and self-esteem. Self-esteem was the strongest predictive factor of stigma resistance.

Conclusion

In accordance with previous studies, self-esteem was a central role of predicting stigma resistance. A program for improving self-esteem and its related psychosocial factors will be helpful to enhancing stigma resistance in bipolar patients.

Keywords: Stigma resistance, Psychosocial factors, Self esteem, Bipolar disorder

Figures and Tables

Fig. 1

Pathways of prediction of stigma resistance in bipolar disorder. Thick arrows, regression β weights ; thin arrows, correlation coefficients.

Table 1

Demographic and clinical characteristics of the patients with bipolar disorder

BPRS : Brief Psychiatric Rating Scale, YMRS : Young Mania Rating Scale, MADRS : Montgomery-Åsberg Depression Rating Scale, GAF : Global Assessment of Functioning Scale, SUMD : Scale to assess Unawareness of Mental Disorder

Table 2

Correlations coefficients between stigma resistance and other variables

^* : p<0.05, ^† : p<0.01. ISMI : Internalized Stigma of Mental Illness Scale, SR : Stigma resistance, Duration of H/I : Duration of hospitalization(s)/duration of illness, BPRS : Brief Psychiatric Rating Scale, YMRS : Young Mania Rating Scale, MADRS : Montgomery-Åsberg Depression Rating Scale, GAF : Global Assessment of Functioning Scale, SUMD : Scale to assess Unawareness of Mental Disorder, RSES : Rosenberg Self-Esteem Scale, BHS : Beck Hopelessness Scale, SSS : Scale of Social Support, NSIS : Negative Social Interaction Scale

Table 3

Predictive factors of stigma resistance

^* : p<0.05, ^† : p<0.01. ΔR² : change in R², MADRS : Montgomery-Åsberg Depression Rating Scale, GAF : Global Assessment of Functioning Scale, RSES : Rosenberg Self-Esteem Scale, BHS : Beck Hopelessness Scale, SSS : Scale of Social Support, NSIS : Negative Social Interaction Scale

Notes

^{Conflicts of Interest} The authors have no financial conflicts of interest.

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