What is stigma?

There are several interacting levels of stigma: social, structural, and internalised. Social (public) stigma occurs within a large group, such as members of the general public, who collectively adopt stereotypes about the victims of stigma. Structural stigma refers to the institutional rules, policies, and procedures that restrict the rights and opportunities of particular groups of people. Internalised stigma occurs within an individual, such that a person’s attitude may reinforce a negative self-perception of mental disorders, resulting in reduced sense of self-worth, anticipation of social rejection and often a desire for social distance.

Stigma can be an important barrier to seek out proper treatment. Interventions to reduce stigma include mass media programs, contact with patients either in person, by video or immaginary, education programs, family interventions, and symptom simulation.

What is the evidence regarding stigma toward bipolar disorder?

Moderate to low quality evidence suggests medium to high levels of internalised stigma in patients, and lower levels of internalised stigma in family members and caregivers of people with bipolar disorder.

Moderate to high quality evidence indicates medium to strong relationships between more internalised stigma and more symptom severity, less hope, less self-esteem, less empowerment, less self-efficacy, less quality of life, less social support and less treatment adherence.

Moderate to low quality evidence suggests public attitudes towards bipolar disorder are generally more positive than public attitudes towards schizophrenia, but less positive than public attitudes towards depression. Mass media interventions may reduce prejudice, but not discrimination, against people with any mental disorder.

April 2019

Last updated at: 4:16 am, 8th April 2019
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