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Perceptions of self-stigma and its correlates among older adults with depression: a preliminary study

Published online by Cambridge University Press:  09 July 2009

Perla Werner ,
Ifat Stein-Shvachman  and
Jeremia Heinik
Perla Werner*
Affiliation:
Department of Gerontology, University of Haifa, Israel
Ifat Stein-Shvachman
Affiliation:
Department of Gerontology, University of Haifa, Israel
Jeremia Heinik
Affiliation:
Margoletz Psychogeriatric Center, Ichilov Hospital and Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
*
Correspondence should be addressed to: Perla Werner, Ph.D., Professor and Dean, Faculty of Social Welfare and Health Sciences, University of Haifa, Mt. Carmel, Haifa 31905, Israel. Phone: +972-4-8249565; Fax: +972-4-8240573. Email: [email protected].
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Abstract

Background: Depression is common in old age and is often associated with stigma. However, to date, little is known about self-stigma (internalization of stigmatic beliefs) in depressed older people despite its importance and consequences. The aim of this study was to examine self-stigma and its correlates in depressed older people.

Methods: Phone interviews were conducted with 54 persons diagnosed with major depression (78% female, average age = 74) from a psychogeriatric clinic in the central area of Israel. Self-stigma was assessed using an adapted version of the Internalized Stigma of Mental Health (ISMI) scale. Symptoms of depression were assessed using the short form of the Geriatric Depression Scale (GDS). Self-esteem was measured using Rosenberg's Self Esteem Scale. Information regarding sociodemographic and psychiatric health characteristics was also collected.

Results: Self-stigma was relatively moderate with 10% to 20% of the participants reporting self-stigma. Those who reported higher levels of self-stigma were younger than those who did not report it. Income and education were lower in persons who reported high levels of stigmatization. Persons who reported stigmatization scored higher on the GDS and reported lower self-esteem than those without stigmatization.

Conclusions: This study represents an effort to examine the correlates of self-stigma in depressed older people. Since self-stigma exists among older adults, further studies are required to extend this body of knowledge.

Keywords

self-stigmadepressionolder adultsmental illness
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 6 , December 2009 , pp. 1180 - 1189
Copyright
Copyright © International Psychogeriatric Association 2009

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References

Alexopoulos, G. S. (2004). Late-life mood disorders. In Sadavoy, J., Jarvik, L. F., Grossberg, G. T. and Meyers, B. S. (eds.), Comprehensive Textbook of Geriatric Psychiatry. 3rd edn (pp. 609–653). New York: W. W. Norton & Company.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Baldwin, R. (2002). Depressive disorders. In Jacoby, R. and Oppenheimer, C. (eds.), Psychiatry in the Elderly. 3rd edn (pp. 627–676). Oxford: Oxford University Press.Google Scholar
Barney, L. J., Griffiths, K. M., Jorm, A. F. and Christensen, H. (2006). Stigma about depression and its impact on help-seeking intentions. Australia and New Zealand Journal of Psychiatry, 40, 1, 51–54.CrossRefGoogle ScholarPubMed
Berge, M. and Ranney, M. (2005). Self-esteem and stigma among persons with schizophrenia: implications for mental health. Care Management Journal, 6, 139–144.Google ScholarPubMed
Blankertz, L. (2001). Cognitive components of self esteem for individuals with severe mental illness. American Journal of Orthopsychiatry, 71, 457–465.CrossRefGoogle ScholarPubMed
Bosworth, H. B., Voils, C. I., Potter, G. G. and Steffens, D. C. (2008). The effects of antidepressant medication adherence as well as psychosocial and clinical factors on depression outcome among older adults. International Journal of Geriatric Psychiatry, 23, 129–134.CrossRefGoogle ScholarPubMed
Cernovsky, Z. Z., Landmark, J. A., Merskey, H. and Husni, M. (2004). Clinical correlates of insight in schizophrenia. Psychological Reports, 95, 821–827.CrossRefGoogle ScholarPubMed
de Mendoca Lima, C. A. (2004). The reduction of stigma and discrimination against older people with mental disorders: a challenge for the future. Archives of Gerontology and Geriatrics, 9, 109–120.CrossRefGoogle Scholar
de Mendoca Lima, C. A., Levav, I., Jacobsson, L. and Rutz, W. (2003). Stigma and discrimination against older people with mental disorders in Europe. International Journal of Geriatric Psychiatry, 18, 679–682.CrossRefGoogle Scholar
Djerner, J. K. (2006). Prevalence and predictors of depression in populations of elderly: a review. Acta Psychiatrica Scandinavica, 113, 372–387.CrossRefGoogle Scholar
Doraiswamy, P. M., Khan, Z. M., Donahue, R. M. and Richard, N. E. (2002). The spectrum of quality-of-life impairments in recurrent geriatric depression. Journal of Gerontology, 57, 134–137.Google ScholarPubMed
Fung, K. M., Tsang, H. W., Corrigan, P. W., Lam, C. S. and Cheung, W. M. (2007). Measuring self-stigma of mental illness in China and its implications for recovery. International Journal of Social Psychiatry, 53, 408–418.CrossRefGoogle Scholar
Fung, K. M., Tsang, H. W. H. and Corrigan, P. W. (2008). Self-stigma of people with schizophrenia as predictor of their adherence to psychosocial treatment. Psychiatric Rehabilitation Journal, 32, 95–104.CrossRefGoogle ScholarPubMed
Griffiths, K. M., Christensen, H. and Jorm, A. (2008). Predictors of depression stigma. BMC Psychiatry, 8, 25–37.CrossRefGoogle ScholarPubMed
Kahng, S. K. and Mowbray, C. T. (2005). What affects self-esteem of persons with psychiatric disabilities: the role of causal attribution of mental illnesses. Psychiatric Rehabilitation Journal, 28, 354–361.CrossRefGoogle ScholarPubMed
Kanter, J. W., Rusch, L. C. and Brondino, M. J. (2008). Depression self-stigma: a new measure and preliminary findings. Journal of Nervous and Mental Disease, 196, 663–670.CrossRefGoogle ScholarPubMed
Kivelä, S. L. and Pahkala, K. (2001). Depressive disorder as a predictor of physical disability in old age. Journal of the American Geriatrics Society, 49, 290–296.CrossRefGoogle ScholarPubMed
Koenig, H. G. and Blazer, D. J. (2004). Mood disorders. In Blazer, D. J., Steffens, D. C. and Busse, E. W. (eds.), The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 3rd edn (pp. 241–268) Arlington, VA: American Psychiatric Publishing.Google Scholar
Kunikata, H., Mino, Y. and Nakajima, K. (2005). Quality of life of schizophrenic patients living in the community: the relationships with personal characteristics, objective indicators and self esteem. Psychiatry and Clinical Neuroscience, 59, 163–169.CrossRefGoogle ScholarPubMed
Ladin, K. (2008). Risk of late-life depression across 10 European Union countries: deconstructing the education effect. Journal of Aging and Health, 20, 653–670.CrossRefGoogle ScholarPubMed
Licht-Strunk, E., van Marwijk, H. W. J., Hoekstra, T., Twisk, J. W. R., de Haan, M. and Beekman, A. T. F. (2009). Outcome of depression in later life in primary care: longitudinal cohort study with three years’ follow-up. BMJ, 338, 449–466.CrossRefGoogle ScholarPubMed
Link, B. G., Struening, E. L., Neese-Todd, S., Asmussen, S. and Phelan, J. C. (2001). The consequences of stigma for the self esteem of people with mental illnesses. Psychiatric Services, 52, 1621–1626.CrossRefGoogle ScholarPubMed
Luchsinger, J. A., Honig, L. S., Tang, M. X. and Devanand, D. P. (2008). Depressive symptoms, vascular risk factors, and Alzheimer's disease. International Journal of Geriatric Psychiatry, 23, 922–928.CrossRefGoogle ScholarPubMed
Luppa, M., Heinrich, S., Angermeyer, M. C., Konig, H. H. and Riedel-Heller, S. G. (2008). Healthcare costs associated with recognized and unrecognized depression in old age. International Psychogeriatrics, 20, 1219–1229.CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Steinberg, M., Tschanz, J. T. (2000). Mental and behavioral disturbances in dementia: findings from The Cache County Study on Memory in Aging. American Journal of Psychiatry, 157, 708–714.CrossRefGoogle Scholar
Lysaker, P. H., Tsai, J., Yanos, P. and Roe, D. (2008). Associations of multiple domains of self-esteem with four dimensions of stigma in schizophrenia. Schizophrenia Research, 98, 194–200.Google ScholarPubMed
Mackin, R. S. and Arean, P. A. (2007). Cognitive and psychiatric predictors of medical treatment adherence among older adults in primary care clinics. International Journal of Geriatric Psychiatry, 22, 55–60.CrossRefGoogle ScholarPubMed
Mehta, K. M., Yaffe, K., Langa, K. M., Sand, L., Whooley, M. A. and Corinsky, K. E. (2003). Additive effects of cognitive function and depressive symptoms on mortality in elderly community-living adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 58, 461–467.CrossRefGoogle ScholarPubMed
Papadopoulos, F. C. et al. (2005). Prevalence and correlates of depression in late life: a population based study from a rural Greek town. International Journal of Geriatric Psychiatry, 20, 350–357.CrossRefGoogle ScholarPubMed
Pyne, J. M., Kue, E. J., Schroeder, P. J., Fortney, J. C., Edlund, M. and Sullivan, G. (2004). Relationship between perceived stigma and depression severity. Journal of Nervous and Mental Disease, 192, 278–283.CrossRefGoogle ScholarPubMed
Ritsher, J. B., Otilingam, P. G. and Grajales, M. (2003). Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Research, 12, 3–49.Google Scholar
Rosenberg, M. (1979). Conceiving the Self. New York: Basic Books.Google Scholar
Rusch, L. C., Kanter, J. W., Manos, R. C. and Weeks, C. E. (2008). Depression stigma in a predominantly low income African American sample with elevated depressive symptoms. Journal of Nervous and Mental Disease, 196, 919–922.Google Scholar
Rush, N., Angermeyer, M. C. and Corrigan, P. W. (2005). Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. European Psychiatry, 20, 529–539.CrossRefGoogle Scholar
Schlenk, E. A., Dumbar-Jacob, J. and Engberg, S. (2004). Medication non-adherence among older adults: a review of strategies and interventions for improvement. Journal of Gerontological Nursing, 30, 33–43.CrossRefGoogle ScholarPubMed
Schmitt, D. P. and Allik, J. (2005). Simultaneous administration of Rosenberg self-esteem scale in 53 nations: exploring the universal culture-specific features of global self-esteem. Journal of Personality and Social Psychology, 89, 623–642.CrossRefGoogle ScholarPubMed
Sirey, J. A. et al. (2001). Perceived stigma as predictors of treatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158, 479–481.CrossRefGoogle Scholar
Tsang, H. W. H., Fung, K. M. T. and Corrigan, P. W. (2006). Psychosocial treatment compliance scale for people with psychotic disorders. Australian and New Zealand Journal of Psychiatry, 40, 561–569.CrossRefGoogle ScholarPubMed
Tse, W. S. and Bond, A. J. (2004). The impact of depression on social skills: a review. Journal of Nervous and Mental Disease, 192, 260–268.CrossRefGoogle Scholar
United Nations (2007). World population ageing. Population Newsletter, 83, 11–12.Google Scholar
Unützer, J., Patrick, D. L, Diehr, P., Simon, G., Grembowski, D. and Katon, W. (2000). Quality adjusted life years in older adults with depressive symptoms and chronic medical disorders. International Psychogeriatrics, 12, 15–33.CrossRefGoogle ScholarPubMed
Werner, P. (2009). Mental disorders in the elderly population in Israel. In Levav, I., (ed.), The Epidemiology of Mental and Behavioral Disorders in Israel. Jerusalem: Ministry of Health.Google Scholar
Werner, P., Aviv, A. and Barak, Y. (2008). Self stigma, self esteem and age in persons with schizophrenia. International Psychogeriatrics, 20, 174–187.CrossRefGoogle ScholarPubMed
Yen, C., Chen, C., Lee, Y., Tang, T., Yen, J. and Ko, C. (2005). Self-stigma and its correlates among outpatients with depressive disorders. Psychiatric Services, 56, 599–601.CrossRefGoogle ScholarPubMed
Yen, C., Chen, C., Lee, Y., Tang, T., Ko, C. And Yen, J. (2009). Association between quality of life and self-stigma, insight, and adverse effects of medication in patients with depressive disorders. Depression and Anxiety. Epublished ahead of print, doi: 10.1002/da.20413.CrossRefGoogle Scholar
Yesevage, J. A. et al. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar