|
Citation
|
Ellouze S, Jenhani R, Bougacha D, Turki M, Aloulou J, Ghachem R. Encephale (1974) 2022; ePub(ePub): ePub. |
|
Abstract
|
Self-stigma of people with bipolar disorder is an underestimated problem, with serious consequences in terms of clinical severity and social and professional functioning.
OBJECTIVES: This study aimed to evaluate self-stigma in patients with bipolar disorder, to identify socio-demographic and clinical factors associated with it and to analyze the links between self-stigma and functioning in this population.
METHODS: We conducted a cross-sectional, descriptive and analytic study including 61 patients with bipolar disorder meeting criteria of remission. We used the internalized stigma of mental illness (ISMI) to investigate self-stigma, and the functioning assessment short test (FAST) to assess functioning.
RESULTS: The mean age of patients was 43.4 years. The sex ratio was 2.4. Half of the patients were single or divorced (50 %). They had secondary or university education in 69 % of cases and were professionally inactive in 59 % of cases. The socioeconomic level was low or medium in 92 % of cases. A personal judicial record was found in 16 % of patients, a suicide attempt in 41 % of cases. Most patients in our series had bipolar I disorder (92 %). The mean age at onset of the disease was 23.5 years, with a mean duration of disease progression of 20 years. Patients were hospitalized an average of 5.9 times. Most patients (90 %) exhibited psychotic features during their mood relapses. The mean duration of the last remission was 27.9 months. Patients had regular follow-ups at our consultations in 87 % of cases. Among the patients included in the study, 8 % were on long-acting neuroleptics. The mean score on the internalized stigma of mental illness was 2.36±0.56. More than half of our patients (59 %) were self-stigmatized. Discrimination and alienation were found in 51 % of cases, followed by resistance to stigmatization (43 %) and assimilation of stereotypes (41 %). Regarding functioning, a global impairment was noted in more than two thirds of patients (71 %). An alteration in professional functioning was found in 82 % of cases and in cognitive functioning in 69 % of cases. Disruption of the financial sphere concerned 43 % of the patients, and the relational sphere 41 % of them. Autonomy was altered in 41 % of patients. Analysis of the relationships between self-stigma and characteristics of the study population revealed statistically significant associations between higher self-stigma scores and single or divorced status, low socio-economic level and judicial record. In terms of clinical parameters, the mean self-stigma score was significantly associated with a higher total number of thymic episodes and hospitalizations, a longer cumulative duration of hospitalizations and a shorter duration of the last remission. In addition, the mean self-stigma score was associated with significantly more impaired functioning.
CONCLUSIONS: Our study underlines the need to work towards the implementation of management modalities aimed at combating the self-stigmatization of patients with bipolar disorder and mitigating its negative consequences during the course of the disease.
===
Objectifs
Dans ce travail, nous nous sommes proposés d'évaluer l'auto-stigmatisation chez les patients atteints de trouble bipolaire, de relever les facteurs sociodémographiques et cliniques qui lui sont associés et d'étudier l'impact de l'auto-stigmatisation sur le fonctionnement de ces patients.
Méthodes
Nous avons mené une étude transversale, descriptive et analytique incluant 61 patients atteints de trouble bipolaire qui se sont présentés à la consultation de post-cure. Nous avons utilisé l'internalized stigma of mental illness (ISMI) pour étudier l'auto-stigmatisation, et le functioning assessment short test (FAST) pour l'étude du fonctionnement.
Résultats
L'âge moyen des patients était de 43,4 ans. Le sexe ratio était de 2,4. Plus de la moitié de nos patients (59 %) étaient auto-stigmatisés. L'évaluation du fonctionnement a permis d'estimer une déficience globale chez plus des deux tiers des patients (71 %). Des scores moyens d'auto-stigmatisation significativement plus élevés étaient retrouvés chez les patients célibataires ou divorcés, ceux à bas niveau socio-économique, et en présence d'antécédents judiciaires. En outre, le score moyen d'auto-stigmatisation était associé à un nombre total plus élevé des épisodes thymiques et des hospitalisations, à une durée cumulée plus longue des hospitalisations, à une durée plus courte de la dernière rémission et à un fonctionnement plus altéré.
Conclusions
Notre étude souligne la nécessité d'œuvrer afin de mettre en place des modalités de prise en charge, visant à lutter contre l'auto-stigmatisation des patients atteints de trouble bipolaire et à atténuer ses conséquences négatives sur le cours évolutif de la maladie et le fonctionnement des patients.
Language: fr |