City Research Online

Abstract

Background: Self-stigma in patients with severe mental health disorders is linked to shame, reduced self-esteem and lower quality of life. Though internalization of external attitudes about mental health disorders it affects individuals on cognitive, emotional, and behavioural level. However, little is known about the differential nature and severity of self-stigma in individuals with different mental health disorders.

Methods: This systematic review and meta-analysis summarizes quantitative studies on self-stigma in non-affective psychosis, depressive, and bipolar disorder published between January 1, 2000, and June 26, 2024 (PUBMED, PsycINFO, Web of Science). We included peer-reviewed studies with samples diagnosed according to DSM or ICD that used validated self-stigma measures. The primary outcome was the mean on the internalized stigma of mental illness (ISMI) scale, which comprises five subscales: alienation, stereotype endorsement, discrimination experience, social withdrawal, and stigma resistance. In addition, data about hospitalisation, duration of illness, ethnicity, education, and illness severity were extracted. Subgroup and meta-regression analyses were conducted to explore moderators.

Findings: Among 2628 identified studies, 162 met inclusion criteria yielding a total sample of 24483 patients: 19350 with non-affective psychosis (k = 134), 2339 with depressive (k = 23), and 2618 with bipolar disorder (k = 32). There were no significant differences in mean ISMI between any of the diagnostic groups (all p > 0·62) or the ISMI subscales (all p > 0·05). Moderator analyses revealed no significant effects of demographic or clinical variables on overall self-stigma levels.

Interpretation: There were no differences in reported overall internalized stigma levels between diagnostic groups, indicating the shared experience of stigma across the three mental health disorder groups. The findings suggest that differential levels of external stigma associated with these diagnostic groups do not directly map to self-stigma, however, indicating that preventive and therapeutic strategies are equally needed across the diagnostic groups.

Publication Type:	Other (Preprint)
Publisher Keywords:	Self-stigma, alienation, cognitive endorsement, social withdrawal negative stereotypes, severe mental health disorders.
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Psychology & Neuroscience
SWORD Depositor:	Symplectic Administrator

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