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The impact of self-stigma in people with diagnosis of severe mental illness: a cross-sectional pilot study from a community psychiatry unit in Porto, Portugal
- A. S. Pinto, M. Almada, I. Fonseca, A. Sousa, A. Lopes
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S866-S867
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Introduction
Self-stigma refers to the process in which a person internalizes negative stereotypes, beliefs, and prejudices about their mental illness, adopting a stigmatized view of themselves. Severe mental illness is one of the most socially exclusive stigmata and is associated with poor clinical and functional outcomes and social withdrawal.
ObjectivesIn Portugal, investigation regarding self-stigma is scarce. In this study, we aim to evaluate the impact of self-stigma among people with diagnosis of severe mental illness (SMI). For this goal we assess the prevalence of self-stigma of psychiatric patients with diagnosis SMI; and investigate the correlates of elevated self-stigma levels.
MethodsFifty-one outpatients with SMI, were recruited from a community psychiatry unit from Porto, Portugal. After informed consent, evaluations included sociodemographic data, illness characteristics, and self-reported standardized scales. Self-stigma (ISMI), self-esteem (RSES) and quality of life (WHO-QoL) were assessed. Data analyses were performed using the SPSS version 28.0 (IBM Corp., Armonk, NY). p-values<0.05 were considered significant.
ResultsFrom the study sample, 66.7% were male, with mean age of 44.8±11.0 and 56.9% were single. 33.3% reported living with their parents while 31.4% were living with a partner/spouse. The majority of participants had a diagnosis of schizophrenia (60.8%). Concerning the level of education, 58.8% completed basic education, but most patients were retired due to illness (62.7%). In this study, moderate to high self-stigma levels was found in 31.4% participants. Proportion of elevated self-stigma was significantly higher in unemployed/retired patients vs. those who were active (39.0% vs. 0%; P=0.021). No significant correlations were found with age, level of education, age at diagnosis, duration of illness, and number of hospitalizations. In the correlations analysis, a negative correlation between self-stigma and self-esteem (rho=-0.745; P<0.001), as well as self-stigma and quality of life (rho=-0.585; P<0.001) was found. A positive relationship between self-esteem and quality of life (rho=0.551; P<0.001) was found.
ConclusionsThis study investigates, for the first time, the prevalence of self-stigma among outpatients with SMI in a community psychiatric unit from Porto. Our findings suggest a high prevalence of elevated levels of self-stigma among these patients. A significant association with being unemployed/retired was also found. Our results support previous evidence that internalized stigma is strongly associated with diminished self-esteem and impaired quality of life, in particular those aspects related to physical and psychological complaints. Targeting internalized stigma and self-esteem among patient with SMI will likely improve their quality of life, besides improving their clinical and functional outcomes.
Disclosure of InterestNone Declared
Folie a Quatre
- A. Almada, M. Constante, P. Casquinha, M. Heitor
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- Journal:
- European Psychiatry / Volume 30 / Issue S1 / March 2015
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction
Induced delusional disorder (ICD-10) / Shared psychotic disorder (DSM-IV-TR) is characterized by delusional beliefs shared between 2 or more people with a close relationship. DSM-5 no longer separates delusional disorder from shared delusional disorder.
ObjectivesThis case report aims to describe and discuss a case of shared delusional beliefs, providing an updated review on this disorder and other related conditions.
MethodsA psychiatric interview of a patient and a friend involved in the same delusional belief system was undertaken. A review of the literature namely in PubMed data base and Google Scholar with the key words 'Folie a deux/quatre”, 'induced delusional disorder” and 'shared psychotic disorder” was also conducted.
ResultsCase study of a 32-year-old woman with normal functioning assessed in the emergency room with the initial complaint of insomnia, in the context of a family conflict. During the clinical interview, grandiose delusional beliefs regarding angels and of self reference were elicited. These beliefs were found to be shared between the patient, a friend, a brother and a cousin. A clinical report and a diagnostic discussion were made, based on a bibliographic review.
ConclusionsShared psychotic disorder is an uncommon variant of delusional disorder. Genetic and psychological factors may play an etiological role. This particular case involved 4 people, 3 family members and a close friend. Shared psychotic disorder is a diagnosis in transition, this report allows an update on changes brought in by DSM-5.
Psychogenic stuttering: A case and review
- A. Almada, R. Simões, M. Constante, P. Casquinha, M.J. Heitor
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, pp. S386-S387
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Introduction
Stuttering is a speech disorder characterized by involuntary repetition, prolongation or cessation of a sound. This dysfluency may be developmental or acquired. Acquired dysfluency can be classified as neurogenic or psychogenic.
ObjectivesThis case report aims to describe and discuss a case of psychogenic stuttering, providing an updated review on this disorder.
MethodsIn and outpatient interviews were performed by Neurology and Psychiatry. Investigation to exclude organic causes included lab exams, electrocardiogram, electroencephalography, computed tomography scan and magnetic resonance imaging. A literature review in Science Direct database, with the keywords “psychogenic stuttering”, was also conducted.
ResultsA 63-year-old man was admitted to the Beatriz Ângelo Hospital with an acute stuttering. Speech was characterized by the repetition of initial or stressed syllables, little affected by reading out loud or singing. Comprehension, syntaxes and semantic were not compromised, as weren’t sensory and motor abilities. During admission, stuttering characteristics changed. Multiple somatic complaints and stress prior to the onset and bizarre secondary behaviors were also detected. Work-up didn’t show an organic etiology for that sudden change. An iatrogenic etiology was considered, as sertraline and topiramate were started for depression 1 month before. However, the stuttering pattern, the negative results, the psychological and the social life events suggested a psychogenic etiology.
ConclusionsPsychogenic stuttering finds its origin in psychological or emotional problems. It is best classified as a conversion reaction. The differential diagnosis between psychogenic and neurological stuttering can be challenging.
Disclosure of interestThe authors have not supplied their declaration of competing interest.