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

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. Objectives In 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. Methods Fifty-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. Results From 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. Conclusions This 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 Interest None Declared

Introduction: Despite its well-known acute and long-term harmful effects on a person's mental health and well-being, alcohol remains the most commonly used psychoactive substance among adolescents after tobacco products in many countries.Objectives: We aimed at studying the prevalence of alcohol use, and identify associated factors in Tunisian high school adolescents.Methods: We used national data from the 2021-Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD).Based on a clustered two-stage stratification sampling method, a representative sample of teenagers aged 16 to 18 years, was selected.Data collection was performed using a self-administered standardized questionnaire, assessing socio-demographic characteristics and risky behaviours, and including questions about alcoholic beverages patterns of use.Binary logistic regression model was used to assess associated factors and adjusted Odds Ratios (AORs) were presented with 95% confidence intervals (CI).Cspro software was used for data entry and all statistical analysis were performed with STATA software.Results: A total of 6201 adolescents with a mean age of 16.8 years and a sex ratio female/male of 1.5 were enrolled.Lifetime prevalence of alcoholic beverages consumption was 8.0%, 95% CI [7.0, 9,1] (n=6196).The prevalence of alcohol consumption during the previous year and month were 5.1 % and 1.7% respectively.Cocktails and beer were the most frequently consumed beverages.Prevalence of alcohol use was significantly associated with tobacco, cannabis and e-cigarettes use (AOR 9.5, 6.0 and 1.9 respectively; p≤10 -3 ), a higher frequency of nights spent away from home, school absenteeism for non-medical reasons and enrolment in the private sector.Alcohol intoxication was reported by 2.9% of respondents during their lifetime.Early onset was reported by 17.2% of respondents for alcohol use and 10.1% for alcohol intoxication.Conclusions: Although the prevalence of alcohol use was relatively low among Tunisian adolescents compared to European adolescents, early onset-indicating an increased risk of developing an alcohol use disorder-warrant the implementation of primary prevention interventions through mental health promotion and life skill trainings to halt these trends and avert the raising burden of morbidity and mortality attributable to alcohol use.

EPV0506
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 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.Objectives: In 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.Methods: Fifty-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.
Results: From the study sample, 66.7% were male, with mean age of 44.8AE11.0 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.Conclusions: This 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 selfesteem among patient with SMI will likely improve their quality of life, besides improving their clinical and functional outcomes.

EPV0507
The prevalence of psychiatric disorders in patients with Multiple Sclerosis in Saudi Arabia: A cross-sectional multi-centered study Introduction: Multiple sclerosis is considered one of the leading causes of neurological non-traumatic disability among young people.Given the chronic progressive nature of the disease, psychiatric disorders are more prevalent among those patients as reported in the literature; however, the data in Saudi Arabia is lacking.
Objectives: The study aimed to estimate the prevalence of psychiatric disorders among MS patient in Saudi Arabia.Methods: This was a cross-sectional multi-centered study, including patients with multiple sclerosis.Participants were interviewed and asked to fill a validated survey that consisted of demographics, Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) questionnaire.Descriptive statistics were performed, and the analysis were made using Chi-square, Fisher's exact, and ANOVA tests as appropriate.Results: A total of 192 participants were included in the study.Based on a cutoff score of > 10 in the GAD-7 and PHQ-9 scales, the prevalence of anxiety was 26.1% (n-50), with majority of the participants having minimal anxiety (40%); meanwhile, the prevalence of depression was 42.7% (n=82), and most of them had mild depression (30%).[table 1, image 1 and 2] Females participants significantly scored higher in GAD-7 and PHQ-9 compared to males (p-value= 0.0376 and 0.1134, respectively).[table 2 and 3] In addition, no significant association was detected between functional disability (EDSS score) and the prevalence of anxiety and depression.