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Self perception of stigma in mentally ill patients in Tehran, Iran. Helia Ghanean MD. PhD student Umea university, department of psychiatry , Sweden Iran university of medical sciences. Iran , population 70 million. Persian Azari Kurdish, Lur, Baloch, Turkmen.

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self perception of stigma in mentally ill patients in tehran iran

Self perception of stigma in mentally ill patients in Tehran, Iran

Helia Ghanean

MD. PhD student

Umea university, department of psychiatry , Sweden

Iran university of medical sciences

slide2

Iran , population 70 million.

Persian

Azari

Kurdish, Lur, Baloch, Turkmen.

90% Shia Muslim, Sunni Muslim, Zoroastrian, Jewish, Christian.

Tehran, the capital, 11 million inhabitants.

stigma
Stigma
  • Mental illness is probably one of the most stigmatizing disorder in all cultures.
  • Stigmatization:
    • External factors.
    • Internal factors.
holly quran
Holly Quran
  • According to holy Quran people suffering from a disease for example mental disorder should be treated with respect.

Is there Less stigmatizing behaviour in Islamic societies ?

self perception of stigma internalized stigma
Self perception of stigma =Internalized Stigma
  • Self stigmatization: Perception of the difference/ deviance.
  • Importance of self-stigmatization = General stigmatization (stigmatization from people around him/her).
concept of internalized stigma
Concept of Internalized Stigma
  • The concept of Internalized stigma was developed by J.Ritsher et al (2003) .
  • Internalized stigma is the devaluation, shame, secrecy and withdrawal trigged by applying negative stereotypes to oneself.
slide7
Aim
  • To determine the experience of Internalized stigma in Mentally ill patients in Tehran, Iran.
  • To include stigma reduction as a verifiable treatment goal in addition to symptom reduction.
questionnaire
Questionnaire

6 items

7 items

5 items

ISMIS, 29 items

6 items

5 items

design
Design
  • Study design: Cross-sectional study
  • Sampling method: Non-probability
  • Analysis of variance: Chi-square, ANOVA.
  • Followed by an open ended question asked by first author.
subjects
Subjects
  • Participants :
  • 130 diagnosed patients with depressivedisorders, Schizophrenia spectrum, Bipolar mood spectrum disorders.
  • From admitted and out patient clinic of :
        • Rasoul hospital
        • Navab hospital
        • Razi Mental Hospital
  • The participation were on voluntary basis.
pilot study
Pilot study
  • ISMIS translated to Farsi and back translated to English.
  • Pilot study : 30 individuals, the internal consistency was 0.87.
  • Questions were comprehensive, only question 24was not easy understood in Farsi.
reliability and validity
Reliability and validity

Cronbach’s alpha Total 29 items Farsi version= 0.90

Cronbach’s alpha of different versions of ISMIS

results
Results
  • Mean age : 29 range of( 18-60).
  • 40% Female.
  • 57%single, 7% divorced or widowed.
  • Majority with high school diploma degree.
  • 80% Unemployed.
examples of responses
Examples of responses
  • ‘‘ Blind man crossing street recieves help, even cars have options for disables but nothing is provided for us’’.
    • ‘‘I wish my family could understand that psychiatric patients are like other patients, like those with cancer or cardiac disease’’.
stigma and education
Stigma and education
  • We found association between discrimination experience , social withdrawal and education.
  • Higher education = lesser experience of stigma.
  • No significant association between subscales and gender, marital status and occupation.
of stigma prevalence
of stigma Prevalence
  • What is Normative , High level or Low level of stigma?
lysaker roe et al model
Lysaker , Roe et al model
  • <2 minimal stigma
  • 2-2.5 mild stigma
  • 2.5 -3 moderate stigma
  • >3 severe stigma

40%

21%

27%

12%

conclusion
Conclusion
  • Comparing these findings, we can conclude that the level of stigma in patients suffering from mental illness is estimated HIGH (40%).
  • Same study performed on patients with Epilepsy findings show less stigma experience(23%) comparing to mentally ill.
recommendations
Recommendations
  • Willingness of patients to talk about their situation gives us strong indication for further more qualitative studies.
  • It seems necessary to inform the public about the cause of psychiatric problems and possible effective treatments.