Abstract:

Objectives: Many people with mental illness are subject to social and objective exclusion, discrimination, and stigma. One of the mental illnesses most exposed to stigma is bipolar disorder (BD). This study aimed to ascertain patient perceptions of social support and examine the association between internalized stigma, self-esteem, and clinical course in patients with bipolar disorder. Method: This cross-sectional study enrolled 103 patients with BD. Sociodemographic form, Internalized Stigma of Mental Illness Inventory (ISMI), Rosenberg Self-Esteem Scale (RSE), Multidimensional Scale of Perceived Social Support (MSPSS) were used to collect data in this study. Results: The mean age of 103 patients with BD was 40,67±10,53. 46 (44.7%) of these participants were female. The ISMI score was higher in patients who were unemployed than in those who were employed (p=0.050). In terms of ISMI scores, those with residual symptoms had significantly higher scores than those without (p=0,001). The ISMI scores of those whose medication was inconsistent were significantly higher than those who were compliant with their medication (p=0.004). ISMI had a positive correlation between the number of depressions (p<0.001; r=0.243); medication non-adherence (p<0.001; r=0.282). ISMI had negative correlation between RSE (r=-0.711; p<0,001); MSPSS (r=-0,384; p<0,001). In multivariate linear regression, internalized stigma was significantly higher among those with low self-esteem, those who reported a lower level of social support from their friends, and those with residual symptoms. Conclusions: The link between stigma, self-esteem, and social support, and their effects on patients with BD, have important implications for psychiatric care. Direct interventions to reduce the negative effects of stigma in BD deserve clinical attention as they may potentially improve outcomes.

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