Stigma Resistance and Its Associated Factors among People with Bipolar Disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

Abstract

Background. Stigma resistance is the capacity to cope and remain unaffected by mental illness stigmatization. In bipolar patients, having low stigma resistance may result in a higher internalized stigma, low self-esteem, and poor treatment outcome. In Ethiopia, the prevalence of stigma resistance among bipolar patients is not well known. Therefore, this study is aimed at assessing the prevalence of stigma resistance and its associated factors among bipolar patients at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Method. An institutional-based cross-sectional study was conducted from May 8th to June 14th, 2016, at Amanuel Mental Specialized Hospital. The study participants were selected using a systematic random sampling technique. The stigma resistance subscale of the internalized stigma of mental illness was used to measure stigma resistance. Bivariable and multivariable logistic regression was computed to identify factors associated with stigma resistance. Accordingly, variables with P values of less than 0.05 were considered as statistically significant predictors of stigma resistance with a 95% confidence interval. Results. In this study, 418 participants completed the interview with a response rate of 98.8%. The prevalence of low stigma resistance was 56.9% (95%CI=51.9‐61.6%). Being unemployed (AOR=1.65; 95%CI=1.35‐1.87), high internalized stigma (AOR=3.04; 95%CI=1.83‐5.05) and low self-esteem (AOR=2.13; 95%CI=1.72‐6.76) were significantly associated with low stigma resistance. Conclusions and Recommendation. More than half of the bipolar patients attending the Amanuel Mental Specialized Hospital had low stigma resistance. Therefore, stigma reduction programs have focused on improving self-esteem and reducing internalized stigma to increase their stigma resistance. Mental health information dissemination regarding community support and reengagement of people with bipolar disorder is highly recommended.

Stigma in people living with bipolar disorder and their families: a systematic review

“…The analysis of available studies revealed that many factors could effectively predict stigma in people living with bipolar disorders and their families, including social and cultural structures, inefficient welfare system, low education, unemployment or lack of a suitable job, low self-esteem, poor communication skills, lack of intimate relationships with others, lack of being understood by others, poor social support, collectivist cultures, young age at disease onset, recurrent hospitalizations, gender, disease severity, disease duration, discriminative labels, lack of information/knowledge, generalization, banalization and reaction induced by public stigma in the general population, or among professionals such as health care professionals and employers. This finding was consistent with the results of Bonnington, Clemente, Favre, Sadeghi, Engidaw, Shumet, Thome, Cerit, Sarisoy, Howland, Ellison, Nilsson and Pal (Bonnington & Rose 2014 ; Clemente et al 2017 ; Favre et al 2022 ; Sadeghi et al 2003 ; Engidaw et al 2020 ; Shumet et al 2021 ; Thomé et al 2012 ; Cerit et al 2012 ; Sarısoy et al 2013 ; Howland et al 2016 ; Ellison et al 2015 ; Nilsson et al 2016 ; Pal 2020 ).…”

Predictors of suicidal ideation, attempts among adults living with HIV attending ART follow-ups at Tirunesh Beijing General Hospital, Addis Ababa, Ethiopia: a cross-sectional study

“…Data were collected by interviewing the selected study participants and reviewing medical records using a validated questionnaire which was adapted from the following studies 12–15. WHO’s Composite International Diagnostic Interview suicide manual was used to assess suicidal ideation and attempt 12.…”

“… 12–15 WHO’s Composite International Diagnostic Interview suicide manual was used to assess suicidal ideation and attempt. 12 Depression was assessed using the Patients Health Questionnaire version-9 13 while social support was measured using the Oslo Social Support scale 14 and stigma related to HIV/AIDS was assessed by the perceived HIV stigma scale. 15 The reliability of the data was checked by Cronbach’s alpha tests.…”