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

Abstract

BackgroundStigma 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.MethodsThis 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.ResultsOverall 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.ConclusionBased 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.

Mental Illness Stigma. A Comparative Cross-sectional Study of Social Stigma, Internalized Stigma and Self-esteem

“…The obtained results reveal the presence of IS in the whole sample, with slightly higher IS scores in Group-I, even though these differences were not statistically significant. These results are similar to other studies where the presence of moderate IS is also observed throughout the sample, but significant differences in IS scores were normally found in these studies, with more IS in people who had a diagnosis of SMI (Alonso et al, 2008;Holubova et al, 2018;Karidi et al, 2015;Maharjan & Panthee, 2019).…”

Association between stigma and depression among urban refugees in Mbarara Municipality, Southwestern Uganda

“…It is characterized by cognitive, emotional, and behavioral components often conceptualized as internalized or enacted stigma affecting a particular trait, among individuals (10). Enacted stigma is the negative attitudes held by members of the public about devalued people whereas self-stigma occurs when people internalize those public attitudes and suffer numerous negative consequences as a result (11).…”

Psikiyatri Kliniğinde Yatan Hastaların Bakım Gereksinimleri ve Özsaygı Düzeylerinin İncelenmesi

“…Çalışmadaki katılımcıların ifade ettiği rollerini yerine getirememe ve sosyal yaşamdaki dışlanma bireylerde içselleştirilmiş damgalanmaya neden olabilir ki, yapılan çalışmalar içselleştirilmiş damgalanma ile düşük özsaygı arasındaki ilişkiyi ortaya koymaktadır [22,[33][34][35]…”