The relationship between internalized stigma and coping strategies in bipolar disorder

Abstract

Objective: The aim of this study was to evaluate the relationship between internalized stigma and coping attitudes in patients in remission of bipolar disorder. Method: The study included 77 patients in remission who were diagnosed with bipolar affective disorder according to DSM-IV by applying the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Euthymia was established using the Young Mania Rating Scale and the Hamilton Depression Rating Scale. All patients were evaluated with a Sociodemographic Data Form, the Internalized Stigma in Mental Illness Scale (ISMI) and the Coping Attitudes Rating Scale (COPE). Results: The perceived discrimination subscale scores of patients living in towns/villages were found to be significantly higher than those living in urban areas (p=0.038). A positive correlation was found between the total number of episodes (10.0±10.8), the number of depressive episodes (3.7±4.8) and the history of depression with psychotic features and internalized stigma. Patients showing active coping, planning, use of useful social support, positive reinterpretation and development of coping styles were found to have lower internalized stigma scores and higher stigma resistance; moreover, patients using behaviorally disengaged coping styles had higher internalized stigma scores and lower stigma resistance. Discussion: According to the results of our study, active coping, planning, use of useful social support, positive reinterpretation and support of developmental coping attitudes, which are among the functional coping attitudes, and attempts to reduce the behavioral disregard of maladaptive coping attitudes can be targeted to reduce internalized stigma.