Skip to main content
    • Aa
    • Aa

Perceptions of self-stigma and its correlates among older adults with depression: a preliminary study

  • Perla Werner (a1), Ifat Stein-Shvachman (a1) and Jeremia Heinik (a2)

Background: Depression is common in old age and is often associated with stigma. However, to date, little is known about self-stigma (internalization of stigmatic beliefs) in depressed older people despite its importance and consequences. The aim of this study was to examine self-stigma and its correlates in depressed older people.

Methods: Phone interviews were conducted with 54 persons diagnosed with major depression (78% female, average age = 74) from a psychogeriatric clinic in the central area of Israel. Self-stigma was assessed using an adapted version of the Internalized Stigma of Mental Health (ISMI) scale. Symptoms of depression were assessed using the short form of the Geriatric Depression Scale (GDS). Self-esteem was measured using Rosenberg's Self Esteem Scale. Information regarding sociodemographic and psychiatric health characteristics was also collected.

Results: Self-stigma was relatively moderate with 10% to 20% of the participants reporting self-stigma. Those who reported higher levels of self-stigma were younger than those who did not report it. Income and education were lower in persons who reported high levels of stigmatization. Persons who reported stigmatization scored higher on the GDS and reported lower self-esteem than those without stigmatization.

Conclusions: This study represents an effort to examine the correlates of self-stigma in depressed older people. Since self-stigma exists among older adults, further studies are required to extend this body of knowledge.

Corresponding author
Correspondence should be addressed to: Perla Werner, Ph.D., Professor and Dean, Faculty of Social Welfare and Health Sciences, University of Haifa, Mt. Carmel, Haifa 31905, Israel. Phone: +972-4-8249565; Fax: +972-4-8240573. Email:
Hide All
L. J. Barney , K. M. Griffiths , A. F. Jorm and H. Christensen (2006). Stigma about depression and its impact on help-seeking intentions. Australia and New Zealand Journal of Psychiatry, 40, 1, 5154.

M. Berge and M. Ranney (2005). Self-esteem and stigma among persons with schizophrenia: implications for mental health. Care Management Journal, 6, 139144.

L. Blankertz (2001). Cognitive components of self esteem for individuals with severe mental illness. American Journal of Orthopsychiatry, 71, 457465.

H. B. Bosworth , C. I. Voils , G. G. Potter and D. C. Steffens (2008). The effects of antidepressant medication adherence as well as psychosocial and clinical factors on depression outcome among older adults. International Journal of Geriatric Psychiatry, 23, 129134.

Z. Z. Cernovsky , J. A. Landmark , H. Merskey and M. Husni (2004). Clinical correlates of insight in schizophrenia. Psychological Reports, 95, 821827.

C. A. de Mendoca Lima , I. Levav , L. Jacobsson and W. Rutz (2003). Stigma and discrimination against older people with mental disorders in Europe. International Journal of Geriatric Psychiatry, 18, 679682.

J. K. Djerner (2006). Prevalence and predictors of depression in populations of elderly: a review. Acta Psychiatrica Scandinavica, 113, 372387.

K. M. Fung , H. W. Tsang , P. W. Corrigan , C. S. Lam and W. M. Cheung (2007). Measuring self-stigma of mental illness in China and its implications for recovery. International Journal of Social Psychiatry, 53, 408418.

K. M. Fung , H. W. H. Tsang and P. W. Corrigan (2008). Self-stigma of people with schizophrenia as predictor of their adherence to psychosocial treatment. Psychiatric Rehabilitation Journal, 32, 95104.

K. M. Griffiths , H. Christensen and A. Jorm (2008). Predictors of depression stigma. BMC Psychiatry, 8, 2537.

S. K. Kahng and C. T. Mowbray (2005). What affects self-esteem of persons with psychiatric disabilities: the role of causal attribution of mental illnesses. Psychiatric Rehabilitation Journal, 28, 354361.

J. W. Kanter , L. C. Rusch and M. J. Brondino (2008). Depression self-stigma: a new measure and preliminary findings. Journal of Nervous and Mental Disease, 196, 663670.

S. L. Kivelä and K. Pahkala (2001). Depressive disorder as a predictor of physical disability in old age. Journal of the American Geriatrics Society, 49, 290296.

H. Kunikata , Y. Mino and K. Nakajima (2005). Quality of life of schizophrenic patients living in the community: the relationships with personal characteristics, objective indicators and self esteem. Psychiatry and Clinical Neuroscience, 59, 163169.

K. Ladin (2008). Risk of late-life depression across 10 European Union countries: deconstructing the education effect. Journal of Aging and Health, 20, 653670.

E. Licht-Strunk , H. W. J. van Marwijk , T. Hoekstra , J. W. R. Twisk , de M. Haan and A. T. F. Beekman (2009). Outcome of depression in later life in primary care: longitudinal cohort study with three years’ follow-up. BMJ, 338, 449466.

B. G. Link , E. L. Struening , S. Neese-Todd , S. Asmussen and J. C. Phelan (2001). The consequences of stigma for the self esteem of people with mental illnesses. Psychiatric Services, 52, 16211626.

J. A. Luchsinger , L. S. Honig , M. X. Tang and D. P. Devanand (2008). Depressive symptoms, vascular risk factors, and Alzheimer's disease. International Journal of Geriatric Psychiatry, 23, 922928.

M. Luppa , S. Heinrich , M. C. Angermeyer , H. H. Konig and S. G. Riedel-Heller (2008). Healthcare costs associated with recognized and unrecognized depression in old age. International Psychogeriatrics, 20, 12191229.

C. G. Lyketsos , M. Steinberg , J. T. Tschanz (2000). Mental and behavioral disturbances in dementia: findings from The Cache County Study on Memory in Aging. American Journal of Psychiatry, 157, 708714.

P. H. Lysaker , J. Tsai , P. Yanos and D. Roe (2008). Associations of multiple domains of self-esteem with four dimensions of stigma in schizophrenia. Schizophrenia Research, 98, 194200.

R. S. Mackin and P. A. Arean (2007). Cognitive and psychiatric predictors of medical treatment adherence among older adults in primary care clinics. International Journal of Geriatric Psychiatry, 22, 5560.

K. M. Mehta , K. Yaffe , K. M. Langa , L. Sand , M. A. Whooley and K. E. Corinsky (2003). Additive effects of cognitive function and depressive symptoms on mortality in elderly community-living adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 58, 461467.

F. C. Papadopoulos (2005). Prevalence and correlates of depression in late life: a population based study from a rural Greek town. International Journal of Geriatric Psychiatry, 20, 350357.

J. M. Pyne , E. J. Kue , P. J. Schroeder , J. C. Fortney , M. Edlund and G. Sullivan (2004). Relationship between perceived stigma and depression severity. Journal of Nervous and Mental Disease, 192, 278283.

N. Rush , M. C. Angermeyer and P. W. Corrigan (2005). Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. European Psychiatry, 20, 529539.

E. A. Schlenk , J. Dumbar-Jacob and S. Engberg (2004). Medication non-adherence among older adults: a review of strategies and interventions for improvement. Journal of Gerontological Nursing, 30, 3343.

D. P. Schmitt and J. Allik (2005). Simultaneous administration of Rosenberg self-esteem scale in 53 nations: exploring the universal culture-specific features of global self-esteem. Journal of Personality and Social Psychology, 89, 623642.

J. A. Sirey (2001). Perceived stigma as predictors of treatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158, 479481.

H. W. H. Tsang , K. M. T. Fung and P. W. Corrigan (2006). Psychosocial treatment compliance scale for people with psychotic disorders. Australian and New Zealand Journal of Psychiatry, 40, 561569.

W. S. Tse and A. J. Bond (2004). The impact of depression on social skills: a review. Journal of Nervous and Mental Disease, 192, 260268.

J. Unützer , D. L Patrick , P. Diehr , G. Simon , D. Grembowski and W. Katon (2000). Quality adjusted life years in older adults with depressive symptoms and chronic medical disorders. International Psychogeriatrics, 12, 1533.

P. Werner , A. Aviv and Y. Barak (2008). Self stigma, self esteem and age in persons with schizophrenia. International Psychogeriatrics, 20, 174187.

C. Yen , C. Chen , Y. Lee , T. Tang , J. Yen and C. Ko (2005). Self-stigma and its correlates among outpatients with depressive disorders. Psychiatric Services, 56, 599601.

J. A. Yesevage (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 3749.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 10
Total number of PDF views: 39 *
Loading metrics...

Abstract views

Total abstract views: 269 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 17th October 2017. This data will be updated every 24 hours.