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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The term masturbation entered the English language in 1776 in the translation of Tissot's Treatise on the Diseases Produced by Onanism. Tissot linked semen conservation theory from antiquity with degeneracy theory and attributed degeneration and death from the social disease (syphilis and gonorrhea) to semen wastage not only in the social vice of promiscuity and prostitution, but also in the secret vice of masturbation. Nocturnal semen loss became designated as spermatorrhea, a new disease requiring treatment. In the nineteenth century the campaign against masturbation became a medical mania. It reached its apogee under John Harvey Kellogg, M.D., who invented Corn Flakes and other cereal and nut foods as meat substitutes to reduce all carnal desire and, hence, masturbation. The stigma on masturbation remains. It prohibits rational discourse on masturbation, and nourishes the perpetuation of fallacies regarding its effects. The imagery of a masturbation fantasy is also the imagery of the personal lovemap, which may be unorthodox, warped and distorted paraphilically. Masturbation might become societally endorsed as a public health policy to help contain the HIV epidemic of AIDS. Nonetheless, the President of the United States in 1995 dismissed his Surgeon General, Dr. Jocelyn Elders, for advocating so sane a policy.
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PMID:Safe sex in the era of AIDS. 749 73

Depression is encountered frequently in the primary care setting. Its appearance is dominated by the physical symptoms of the syndrome. This factor, when combined with the residual stigma that mitigates against acceptance of the diagnosis, probably accounts for how often the diagnosis is missed. The depressive illnesses are serious, disrupting occupational and social functioning to a significant degree. They are life-threatening for some in the short-term, but for many more over a lifetime, as depression is more often recurrent or chronic than a one time experience. With a psychiatric nomenclature now available that is user-friendly, screening tests that are available and easy to administer, and treatments that are successful, it is important that the physician learn to recognize and manage this common set of problems. Depression is typically co-morbid with serious medical illness, and often co-morbid with complicating emotional disorders. It may appear in a form that takes a bipolar course, including episodes of mania and hypomania. The physician in practice must decide which patients with depression he or she will treat, and who to refer for specialty care. The SSRI anti-depressants are usually the frontline treatment of choice. Bipolar, treatment-resistant, and difficult patients with co-morbid psychiatric illnesses should be referred to psychiatrists. It is valuable for the physician to have psychiatrists he or she knows to facilitate consultation, communication and coordination. The value of brief psychotherapy in the treatment of a depressive episode underlines the need for a psychiatrist with whom the physician can work collaboratively. The depressed patient presents the physician with a situation in which he or she can make a positive difference in the life of a person and his or her family. The need to model and teach the treatment of depression in primary care is evident, with the likelihood that this will be the arena in which these patients will continue to receive care.
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PMID:Depression comes in many disguises to the providers of primary care: recognition and management. 1090 22

The National Depressive and Manic-Depressive Association (National DMDA) is the largest patient-directed, illness-specific organization in the United States, representing the millions of people living with mood disorders. Recent National DMDA surveys have shown that people with mood disorders often have incorrect information about their illnesses, that misdiagnoses are frequent, that a significant physician/patient communication gap exists, and that noncompliance is widespread. For optimal recovery to occur, it is important that individuals receive correct information about their symptoms and treatments, that physicians and other healthcare providers understand mood disorders from a patient perspective, and that doctors and patients communicate fully throughout the course of treatment about symptoms, side effects, and other concerns. National DMDA plays an important role in the management of mood disorders by urging those who are undiagnosed or untreated to seek treatment; by providing accurate, easy-to-understand information; and by facilitating support groups in which patients and their families can discuss treatment and management of their illnesses. The organization encourages patients to play active roles in their treatment plans and to attend support groups, which have been shown to increase patient compliance and decrease the incidence of psychiatric hospitalization. According to the US Surgeon General, stigma is the number one barrier to mental health care, and National DMDA's evidence supports this. National DMDA works to combat stigma with education, advocacy, and patient self-help. Increased awareness and openness about mood disorders can lead to increased acceptance, which, in turn, can lead to more timely diagnosis and treatment.
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PMID:Mood disorders: diagnosis, treatment, and support from a patient perspective. 1239 65

Behavioral changes-both real and imagined-have formed a halo around epilepsy since antiquity. The myth of epilepsy as a curse has been largely vanquished in modern cultures, but the disorder remains a social stigma for many patients. In ancient Rome people with epilepsy were avoided for fear of contagion, in the Middle Ages they were hunted as witches, and in the first half of our century they were labeled deviants and their marriage and reproduction were restricted by eugenistic medical doctors. Religious conversion experiences can occur in temporal relationship to changes in seizure frequency. Many religious leaders may have had epilepsy. However, changes in religious sentiment are not characteristic of epilepsy patients. Recognized since the late 19th century, postictal psychosis has stimulated theories regarding the mechanism of mania and psychosis. Understanding the pathophysiology of behavioral changes in epilepsy may offer insight into the psychopathology of other diseases.
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PMID:Epilepsy and behavior: a brief history. 1260 25

Bipolar disorder (BD) has been related to heightened creativity, yet core questions remain unaddressed about this association. We used qualitative methods to investigate how highly creative individuals with BD understand the role of symptoms and treatment in their creativity, and possible mechanisms underpinning this link. Twenty-two individuals self-identified as highly creative and living with BD took part in focus groups and completed quantitative measures of symptoms, quality of life (QoL), and creativity. Using thematic analysis, five themes emerged: the pros and cons of mania for creativity, benefits of altered thinking, the relationship between creativity and medication, creativity as central to one's identity, and creativity's importance in stigma reduction and treatment. Despite reliance on a small sample who self-identified as having BD, findings shed light on previously mixed results regarding the influence of mania and treatment and suggest new directions for the study of mechanisms driving the creative advantage in BD.
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PMID:Creativity and Bipolar Disorder: Igniting a Dialogue. 2581 21

Internalized stigma of mental disorders has significant negative outcomes for patients with bipolar disorder and their families. The aim of this study is to evaluate the association between personality traits and internalized stigma of mental disorders in bipolar patients and their treatment partners. Five different questionnaires were utilized in this study: (1) Demographic data questionnaire, (2) Millon Clinical Multiaxial Inventory-III (MCMI-III) for personality traits, (3) Internalized Stigma of Mental Illness (ISMI) for stigma, (4) Self Report Manic Inventory (SRMI) for mania and (5) Center for Epidemiological Studies-Depression Scale (CES-D) for depression. The scores of personality traits were combined to create externalizing and internalizing personality trait scores. Results showed that patients with bipolar disorder and their treatment partners both experienced internalized stigma of mental health disorders. There was a significant positive correlation between internalized stigma and internalizing personality traits, but not externalizing traits. In a multi-variate regression analysis, internalizing personality trait score was found to be a significant predictor of internalized stigma. In conclusion, patients with bipolar disorder and their treatment partners perceive higher level of internalized stigma of mental disorders if they have internalizing personality traits.
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PMID:Relationship between personality traits and perceived internalized stigma in bipolar patients and their treatment partners. 2642 1

Impaired interpersonal, social, and occupational functioning is very often observed in patients with bipolar disorder, not only at the acute stages of the illness but in remission as well. This finding raises the question of multiple factors that might affect psychosocial functioning in bipolar patients, such as residual subsyndromal symptoms and neuropsychological deficits. Social cognition impairment, especially impaired Theory of Mind (ToM), might also play an important role in bipolar patients' every-day functioning, similarly to what was found in patients with schizophrenia. The present study aimed to investigate the potential effect of clinical and cognitive factors on the psychosocial functioning of patients with bipolar disorder during remission, assessing ToM along with a broad range of basic cognitive functions. Forty-nine patients with bipolar disorder type I in remission and 53 healthy participants were assessed in general intelligence, working memory, attention, speed processing, verbal learning and memory, and executive functions using a comprehensive battery of neuropsychological tests. The Faux Pas Recognition Test was used to assess ToM. The two groups were matched for gender, age and education level. The Hamilton Rating Scale for Depression (HDRS), the Young Mania Rating Scale (YMRS), and the Brief Psychiatric Rating Scale (BPRS) were also administered to the patients. Every-day functioning was assessed with the Global Assessment of Functioning (GAF). In order to examine the contribution of many factors in psychosocial functioning, we used hierarchical multiple regression analysis. Bipolar patients presented significant impairment compared to healthy participants in all the basic cognitive functions tested with the exception of verbal memory. Moreover, patients had significant poorer performance than healthy controls in overall psyand cognitive ToM but not in affective ToM as measured by Faux Pas. Psychosocial functioning in patient group was significantly correlated to symptom severity-especially depressive (p<0.001) and psychotic symptoms (p=0.001), history of psychotic episodes (p=0.031) and ToM, overall (p=0.001) as well as its cognitive (p=0.023) and affective (p=0.004) components. Only the contribution of ToM in psychosocial functioning remained significant in the final multiple regression model. The findings of the current study indicate that residual symptoms and cognitive dysfunctions, especially deficits in social cognition, negatively affect psychosocial functioning of remitted patients with bipolar disorder. Moreover, our results suggest that ToM may play a central role in these patients' functioning. ToM is a mediator of the relationship between other clinical or cognitive variables and functioning, while it has also significant effect on social skills independently of other factors. Therefore, specific therapeutic interventions targeting social cognitive dysfunction might improve functional outcome in bipolar disorder. Putative contribution of other clinical characteristics (comorbid personality disorders, substance abuse, anxiety) and psychosocial factors (stigma, self-stigma, lack of social network) in bipolar patients' functioning should be examined in future studies.
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PMID:Clinical and cognitive factors affecting psychosocial functioning in remitted patients with bipolar disorder. 2783 72

Posttraumatic stress disorder (PTSD) in young individuals is associated with an increased risk to develop psychosis or mania, and both trauma and PTSD rates are elevated in people with schizophrenia and other severe mental illnesses. However, less research has examined PTSD in people who have recently developed a first episode of psychosis (FEP). The present study is a secondary analysis of the baseline data collected for the National Institute of Mental Health Recovery After an Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) study to examine the rates of trauma and PTSD, and to explore the demographic and clinical correlates of PTSD in a representative sample of 404 persons with an FEP. Approximately 80% of the study sample reported experiencing at least one traumatic event during their lives, with females more likely to report childhood sexual abuse and spousal abuse than males. A total of 20 participants (5.0%) met criteria for a lifetime diagnosis of PTSD, while another 15 participants (3.7%) met subthreshold diagnostic criteria for PTSD. Significant correlations were found between lifetime PTSD and the Calgary Depression Scale, the Mental Health Recovery Measure, the Stigma Scale, and duration of untreated psychosis, with higher scores on each variable associated with a diagnosis of PTSD. The association between PTSD and more severe depression, as well as lower perceptions of personal recovery, suggest that PTSD may be an important target for treatment programs for persons recovering from an FEP. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Prevalence and correlates of PTSD in first episode psychosis: Findings from the RAISE-ETP study. 3134 88

Resistance to pharmacological agents is commonly encountered in the treatment of acute episodes of mania. In contemporary practice guidelines, electroconvulsive therapy (ECT), once a widely used standalone intervention for mania, is no longer considered a first-line treatment. Stigma, logistics, and ethical factors constrain ECT administration in this condition and lead to its underutilization. However, the past three decades have produced promising research regarding the use of ECT in mania. Randomized controlled trials, albeit in limited numbers, the adoption of ultrabrief ECT, examination of the safety and efficacy of combining ECT with pharmacological agents, including lithium, and use of ECT as a maintenance strategy have enhanced our understanding of how and when to utilize this intervention in mania. In this comprehensive review, the authors summarize the evidence regarding the efficacy and safety of ECT in mania, including related syndromes, such as delirious mania and mixed affective states. The impact of technical parameters, particularly the choice of treatment frequency, electrode placements, and pulse width, are discussed in the light of recent evidence.
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PMID:Electroconvulsive Therapy in Mania: A Review of 80 Years of Clinical Experience. 3316 75