Magnitude of internalised stigma and associated factors among people with bipolar disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study.
OBJECTIVES
To assess the magnitude of internalised stigma and associated factors among patients with bipolar disorder attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.


DESIGN
Institution-based cross-sectional study design.


SETTING
Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.


PARTICIPANTS
We recruited about 418 participants using systematic sampling technique for an interview during the study period.


MEASUREMENT
Data were collected by face-to-face interviews. Internalized Stigma of Mental Illness scale was used to measure internalised stigma. The Rosenberg Self-Esteem Scale and the Oslo-3 Social Support were instruments used to assess the associated factors. Bivariate and multivariate logistic regressions were performed to identify factors associated with the outcome variable. ORs with 95% CI were computed to determine the level of significance.


RESULTS
The magnitude of internalised stigma was 24.9% (95% CI: 21.2% to 28.9%). In the multivariate analysis, unemployed (adjusted OR (AOR)=2.3, 95% CI: 1.0 to 5.0), unable to read and write (AOR=3.3, 95% CI: 1.05 to 10.7), poor social support (AOR=5.3, 95% CI: 1.9 to 15.0), ≥4 previous hospitalisations due to bipolar disorder (AOR=2.6, 95% CI: 1.1 to 6.1) and low self-esteem (AOR=2.4, 95% CI: 1.1 to 5.1) had a significant association with internalised stigma.


CONCLUSIONS
One in four patients with bipolar disorder reported high internalised stigma. Unemployment, low educational status, low self-esteem, poor social support and being hospitalised more than three times before were significantly associated with internalised stigma. Thus, a stigma-reduction programme focusing on self-esteem improvement and psychological health of patients to increase their stigma resistance to counteracting effects of internalised stigma is essential.
['Shumet|Shegaye|S|0000-0001-7714-7455', 'W/Michele|Bethlehem|B|', 'Angaw|Dessie|D|0000-0001-9827-2255', 'Ergete|Temesgen|T|', 'Alemnew|Nigus|N|']
D001714:Bipolar Disorder D003430:Cross-Sectional Studies D005002:Ethiopia D006801:Humans D015995:Prevalence D057545:Social Stigma
adult psychiatry anxiety disorders depression & mood disorders