Table 4.
Information on articles that have examined the predictors of stigma in people living with bipolar disorders and their families
| Author, Year, |
Location of study | Study type | Sampling method | Sample size | Tools | Finding | |
|---|---|---|---|---|---|---|---|
| 1 | Favre et al. 2022 | Switzerland | Qualitative Method | Purposive sampling | 22 bipolar patients | Qualitative interviews | Items such as lack of information/knowledge, labeling, generalization, banalization and reaction induced by public stigma in the general population, or among professionals such as health care professionals and employers were identified as predictors of stigma in bipolar patients |
| 2 | Shumet et al. 2021 | Ethiopia | Cross-sectional study | Systematic random sampling | 418 bipolar patients | Stigma Scale (DISC) 12 | About 24.9% of people living with bipolar disorder had internal stigma based on the ISMI scale, which was significantly associated with unemployment, low education, low self-esteem, poor social support, and more than three times hospitalization |
| 3 | Pal 2020 | India | Cross-sectional study | Purposive sampling | 75 bipolar patients | The Internalized Stigma of Mental Illness (ISMI) scale | Internal stigma in people living with bipolar disorders was significantly associated with factors such as monthly income, job and social performance, and education, and the fact that internal stigma significantly influenced the self-esteem, participation, and quality of life of people living with bipolar disorders |
| 4 | Engidaw et al. 2020 | Ethiopia | Cross-sectional study | Systematic random sampling | 418 bipolar patients | Quality of Life scale (WHO) | Tolerance to stigma was low in people living with bipolar disorder, which could be related to inadequate education and unemployment in these patients. Having academic education and a suitable job can boost self-esteem in these patients and their families, increasing their self-satisfaction and causing them to become less affected by others’ judgments and prejudices |
| 5 | Clemente et al. 2017 | Brazil |
Qualitative Method (Ethnography) |
Purposive sampling | 23 psychiatrists |
Qualitative interviews Rosenberg Self-Esteem Scale (RSES) |
People living with bipolar disorders experience less stigma due to the individualistic culture in developed societies. This is while stronger interactions and cohesion between people in underdeveloped societies can essentially enhance stigma in these patients |
| 6 | Howland et al. 2016 | USA | Mixed Method | Available sampling |
115 bipolar patients in quantitative phase 21 bipolar patients in the qualitative phase |
Mental Illness (ISMI) scale General Self-Efficacy (GSE) Scale Brief Psychiatric Rating Scale (BPRS) Montgomery–Asberg Depression Rating Scale (MADRS) Young Mania Rating Scale (YMRS) Qualitative interviews |
Internal stigma and self-efficacy were associated with each other, and internal stigma was also associated with depression symptoms such as anxiety, as well as feeling guilty and suspicious in people living with bipolar disorder |
| 7 | Ellison et al., 2015 | UK | Cross-sectional study | Snowballing sampling |
753 members of the UK population (Using an online questionnaire distributed via email, social networking sites and public institutions) |
Clinicians’ Attitudes Scale Version 4 | The prevalence of stigma was between 37 and 57% in people living with bipolar disorders and their families. In addition, it was noted that stigma in people living with bipolar disorders was influenced by hospitalization in psychiatric hospitals and the ability to work, and psychosocial factors and emotional attitudes were reported as two important factors in labeling |
| 8 | Bonnington et al., 2014 | UK | Qualitative Method | Purposive sampling | 29 bipolar patients | Qualitative interviews | Social and cultural structures influence the atmosphere experienced by people living with bipolar disorder. These structures include stereotypes, norms, types of power distribution, communication methods, discriminative categories and labels, health care system, equality law, welfare system, and job status |
| 9 | Sarısoy et al. 2013 | Turkey |
Cross-sectional study |
Available sampling | 228 volunteers were included, 119 patients with bipolar disorder and 109 with schizophrenia | Rosenberg Self-Esteem Scale (RSES) | Internal stigma is seen in one in five people living with bipolar disorders, and anxiety or fear of communicating with others was more common in people living with bipolar disorders with internal stigma than in those without internal stigma |
| 10 |
Cerit et al., |
Turkey |
Cross-sectional study |
Available sampling | 80 bipolar patients | Oslo-3 Social Support Scale | The three predictors of people living with bipolar disorders’ performance were depression severity, perceived social support, and internal labeling, respectively |
| 11 | Thome et al., 2012 | Brazil |
Cross-sectional study |
Available sampling | 60 bipolar patients |
Functioning Assessment Short Test (FAST) Stigma Experiences Scale (SES) Stigma Impact Scale (SIS) |
The presence of depression symptoms and the age of treatment onset and diagnosis were also identified as predictors of internal stigma |
| 12 | Sadeghi et al. 2003 | Iran |
Cross-sectional study |
Available sampling |
100 bipolar patients 100 schizophrenia patients 100 MDD patients |
A self—administered 34 items questionnaire | Significant proportion of the psychiatric patients families suffer from stigmatization which in turn makes them feel ashamed of having such a patient. The type of psychiatric disorder and some of the demographic characteristics play a major role in this regard and significant relationship was observed between the duration of the disorder, number of hospitalization and rate of being humiliated |