Depresyona İlişkin Tutumlar ve Damgalanmayı Etkileyen Faktörlerin İncelenmesi

Abstract

Objective: Depression is a frequently seen syndrome in community, which could be effectively treated when appropriate care is accessed. One of the important barriers for seeking care and treatment in depression has been stigmatization, as in other psychiatric disorders. Stigma towards depression and other psychiatric disorders may differ between young and old age groups, and is also affected by other sociodemographic and clinical factors. In this study it is aimed to investigate the relationship of sociodemographic factors and attitudes towards depression and its treatment between young and old age groups in a clinical population. Method: A total of 133 patients (18-88 years old, n=37 old-age group, n=96 young-age group) with a diagnosis of depression who applied to Hacettepe University Psychiatry Outpatient Clinic were recruited in this study. First a semi-structured clinical interview was performed for every patient using SCID-1 (Structured Clinical Interview for DSM-IV Axis 1 Disorders), then all the patients were evaluated using the “depression section” of a survey from Attitudes Towards Mental Disorders Study (RUTUP), Internalized Stigma of Mental Illness Scale (ISMI), The Self-Stigma of Depression Scale (SSDS), Beck Depression Inventory (BDI), and Antidepressant Adherence Scale (AAS) in patients taking antidepressant therapy. Young and old age groups were compared on stigmatization, and the relation of sociodemographic and clinical features with stigmatization was examined. Also in this study validity and reliability analyses for The Self-Stigma of Depression Scale were performed. Statistical analyses were performed using SPSS version 23.0 for windows. Depending on the sample characteristics, chi-square analysis, Mann Whitney U test, and Pearson correlation analysis were conducted. Statistical significance was accepted as p< 0.05. Results: As young and old age groups were compared, ISMI total scores (z=2.822, p=0.005), ISMI alienation sub-scale scores (z=2.696, p=0.007), social withdrawal subscale scores (z=2.455, p=0.014), and stigma resistance subscale scores (z=2.817, p=0.005) were found to be higher in young-age group than old-age group. vii SSDS total score was not different between two groups (z=0.660, p=0.509), but SSDS social inadequacy subscale score was higher in young-age group (z=2.166, p=0.030). A positive correlation was found between SSDS total score and ISMI total score (r=.485, p=0.000) and BDI score (r=.303, p=0.000). Regarding sociodemographic features, working group was found to have higher scores on ISMI stigma resistance subscale compared to housewives and students (z=13.461, p=0.009), and retired group was found to have higher scores on SSDS social inadequacy subscale (z=10.621, p=0.031). Other sociodemographic factors were not found to have any effect on the scores of stigmatization scales. Regarding the clinical features, patients with the first episode were found to have higher scores on ISMI alienation subscale compared to patients with long follow-up (z=2.224, p=0.026), patients with comorbid physical disorders to have higher scores on ISMI total (z=-2.270 p=0.023), ISMI alienation subscale (z=-2.398 p=0.016), ISMI social withdrawal subscale (z=-2.321 p=0.020) compared with the ones with no other physical disorders. A negative correlation was found between the time since first admission for psychiatric treatment and ISMI perceived stigmatization subscale (r=-0.197, p=0.025). No significant relation was found between other clinical factors and stigmatization scale or subscale scores. No statistically significant difference was found between young and old age groups regarding the answers to RUTUP depression survey, but negative attitudes were seen to be very common in all the subjects. Conclusion: As in the other psychiatric disorders, stigmatization is very common also for depression, and it is found to be related to different features including age, working status, time since first admission and some other sociodemographic factors. In order to help for decreasing the negative attitudes and increasing the help seeking behavior, some interventions should be conducted both in psychiatry clinics and society.