Internalized stigma (IS), in addition to the illness itself, is one of the major challenges that people with mental health problems have to face. The aim of this scoping review and meta-analysis is to update knowledge about this issue and to investigate the influence of different sociodemographic, psychosocial, and clinical variables on IS. English and Spanish articles were searched between 2010 and 2019, in different databases, with no restriction on culture or geographical area. Only studies that used the Internalized Stigma of Mental Illness Scale (ISMI) as a measure of IS were included. A total of 61 studies remained for the review and 52 for the meta-analysis (N = 11,072). Self-esteem, quality of life, hopeful feelings and stigmatizing experiences, as well as clinical variables (depressive symptoms and subjective recovery), were strongly associated with IS. The association of insight with IS was not confirmed. Empowerment showed a weaker relationship than in a previous meta-analysis. Gender and age, education, occupational situation, and marital status were weakly associated with IS, and sometimes inconsistently. Subjective recovery, depressive symptomatology, or experienced and perceived social stigma have begun to be studied in recent years. The update on the subject reveals the impact of clinical and psychosocial variables, also underlining the relevance of recently incorporated variables such as depressive symptomatology, subjective recovery, and perceived discrimination. The results highlight the need to carry out longitudinal studies with more representative samples and in new geographical areas with variables rarely or not yet studied in relation to IS.

Major depressive disorder (MDD) is one of the most prevalent conditions among mental disorders in individuals over 65 years. People over 65 who suffer from MDD are often functionally impaired, chronically physically ill, and express cognitive problems. The concordance between a clinician-assessed MDD diagnosis in a primary care setting and MDD assessed with a structured clinical interview in older adults is only approximately 18%. Network analysis may provide an alternative statistical technique to better understand MDD in this population by a dimensional approach to symptomatology. The aim of this study was to carry out a network analysis of major depressive disorder (MDD) in people over 65 years old. A symptom network analysis was conducted according to age and gender in 555 people over 65, using a sample from the MentDis_ICF65+ Study. The results revealed different networks for men and women, and for the age groups 65–74 and 75–84. While depressive mood stood out in women, in men the network was more dispersed with fatigue or loss of energy and sleep disturbances as the main symptoms. In the 65–74 age group, the network was complex; however, in the 75–84 age group, the network was simpler with sleep disturbances as the central symptom. The gaps between the networks indicate the different characteristics of MDD in the elderly, with variations by gender and age, supporting the idea that MDD is a complex dynamic system that has unique characteristics in each person, rather than a prototypical classification with an underlying mental disorder. These unique characteristics can be taken into account in the clinical practice for detection and intervention of MDD.