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

In a sample of 276 Japanese adult patient attenders at two primary care clinics affiliated with the Department of Hygiene and Preventive Medicine at the Okayama University Medical School major depression was diagnosed in 5.8% and minor depression in 7.2% of patients studied. Functional impairment was significantly more severe in patients with either major or minor depression than in those not affected. None of the 36 patients with major or minor depression had received a diagnosis of depression or had been given antidepressant therapy. Possible explanations for the marked underdiagnosis of depression and lack of specific antidepressant therapy in these patients include severe stigma associated with a diagnosis of mental disorders, focus of the mental health system on hospitalization with consequent trivialization of mental problems in ambulatory patients, and the extraordinarily high work load of primary care doctors.
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PMID:Depressive disorders in Japanese primary care patients. 789 62

The Self-Appraisal Questionnaire (J. C. Coyne & M. M. Calarco, 1995) was used to examine how primary care and psychiatric outpatients with recent or past major depression appraised their prospects and structured their lives. They were compared with nondistressed and distressed primary care patients. Both depressed groups scored higher than the nondistressed patients for Lack of Energy, Management of Burden on Others, Need to Maintain a Balance in Life, Fear of Taking Risks, Imposition of Limitations on Life, and Sense of Stigma. The distressed group fell between the depressed psychiatric and the nondistressed groups, and generally did not differ from the depressed primary care group. Past depression did not explain differences associated with more recent depression and distress. Distress entails a need to manage its effects on others, but depression in psychiatric patients may produce a more profound reorganization of self-concept, relationships, and coping.
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PMID:Effects of recent and past major depression and distress on self-concept and coping. 950 41

Depression tends not to be accurately identified and treated in primary care settings. Women of color are especially likely to use these settings for mental health issues but are less likely to be diagnosed appropriately. A study was conducted within four Florida primary care clinics serving primarily low-income families. Participants included 321 women (Black, 22%, Hispanic, 23.5%, White, 38.6%) who completed a confidential questionnaire while waiting to be seen by clinic staff. Ten percent reported recent major depression, with 26.7% indicating depressive symptoms during the past two years. Depressed women were significantly more likely to report physical violence during the past year. Respondents turned primarily to family, friends, and medical clinics for their depression. They found turning to clinic staff to be helpful and described psychosocial interventions as useful. Members of all ethnic/racial groups reported barriers to seeking help, including perceived separation between mental health and general health and stigma. Implications are discussed in terms of appropriate community education and screening procedures.
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PMID:Women's help-seeking patterns for depression. 1048 27

Major depression is a widespread, often chronic disorder affecting the individual, his or her family, and society as a whole. It incurs tremendous social and financial costs in the form of impaired relationships, lost productivity, and lost wages. Although chronic major depression is eminently treatable, it continues to be undertreated and underrecognized. This is particularly true in primary care settings, where physicians are usually the first to encounter chronic depression but are seldom trained to distinguish depression from other medical illnesses with similar symptoms. In addition, because of the stigma attached to depression, patients often characterize their symptoms as part of a physical illness or fail to report them to a clinician at all. This article discusses the epidemiology of depression, its impact and burden on society, and its special character (including diagnosis and treatment) as a chronic illness.
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PMID:The societal costs of chronic major depression. 2212

Stigma attached to individuals with schizophrenia may be derived from its diagnostic label. Two forms of a questionnaire were distributed to 189 Japanese university students. Each questionnaire contains case vignettes of schizophrenia and major depression. In one form, the students were told at the close of each vignette the diagnostic label assigned to that case (the label group) whereas in another form, they were not done so (the control group). The students were also asked to rate negative image of the case in four items each. The label group was significantly higher than the control group in three of the four negative image items for the vignette of schizophrenia. They did not differ in any of the negative image items for the vignette of depression. This suggests that the label of schizophrenia (the Japanese translation Seishin-bunretsu-byou) has stigmatizing effect. We discussed these findings in the light of the implications of a relabeling, and argued for a change of name.
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PMID:Labeling effect of Seishin-bunretsu-byou, the Japanese translation for schizophrenia: an argument for relabeling. 1143 10

Labeling theory suggests that applying disease labels to behavior may serve to medicalize deviance and produce stigma. In contrast, attribution theory suggests that this practice may evoke sympathetic responses. Female undergraduates (N = 221) read vignettes describing an older parent exhibiting inappropriate behavior in a social situation, with diagnostic label (Alzheimer's disease, major depression, no label), personal congruence of the behavior (congruent, incongruent, no information), and parent gender manipulated across participants. Participants rated their emotional responses, attributions, and willingness to help. The Alzheimer's disease label, and to a lesser extent the major depression label, produced more sympathy toward the parent, less blame, and greater willingness to help, indicating that the provision of these labels may facilitate compassionate attitudes and enhanced caregiving toward older adults. However, participants reported greater anger and higher personality attributions toward fathers than mothers, suggesting that the influence of parent gender on potential caregivers' reactions warrants further attention.
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PMID:Diagnostic attributions versus labeling: impact of Alzheimer's disease and major depression diagnoses on emotions, beliefs, and helping intentions of family members. 1144 11

Despite the widespread notion of the bucolic life in the country, major depressive disorder (MDD) is common among impoverished women in the rural South. Women with MDD seldom get treated because of the paucity of treatment available, the inability to pay for services because of no insurance, and the distance they must travel to reach care. Even if treatment was available, impoverished rural Southern women are unlikely to seek services because of cultural and social prohibitions. These include incongruence between the biomedical model of MDD and sociocultural explanations for its causes and manifestations, stigma, and traditional viewpoints of women that keep them isolated and invisible. Innovative treatment strategies must be devised for these women that are based on local views of MDD and its treatment, and people and monetary resources available in poor rural economies. Needed research with this population include ethnographic studies to gain understanding of the cultural factors associated with MDD and its treatment and evaluation of outreach, and other novel paradigms of rural service delivery including the use of nonprofessional personnel. Although the problems of treatment and research with this population are daunting, there is an opportunity for imagination, innovation, and creativity in devising local solutions to local problems.
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PMID:No comfort in the rural South: women living depressed. 1264 82

The purpose of this study was to explore the relationship between perceived stigma and being in treatment for depression and current depression severity. Face-to-face interviews were conducted with a convenience sample of depressed subjects from a Veterans Administration outpatient mental health clinic (N = 54) and never-depressed subjects from a Veterans Administration primary care clinic (N = 50). Depression severity was measured using the 9-item Primary Care Evaluation of Mental Disorders depression measure. Stigma was measured using the 5-item Stigma Scale for Receiving Psychological Help modified for depression treatment. Statistical analyses included Spearman correlation and multivariate regression. In the correlation analysis, being in treatment for depression compared with never experiencing depression was associated with significantly higher levels of perceived stigma (p <.001). In separate multivariate models controlling for significant univariate correlates, greater depression severity (p <.001) and meeting criteria for current major depression (p <.001) were significant predictors of perceived stigma. Greater depression severity appears to be a strong predictor of perceived stigma.
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PMID:Relationship between perceived stigma and depression severity. 1506 Apr 1

Small differences in implementation of screening and the associated burden on clinicians and patients could have substantial effects on the sustainability of screening in routine primary care. Therefore, we investigated the psychometric properties of single items and two-item combinations of the "WHO-5 Well Being Index" (WHO-5) and compared the obtained characteristics to those of the original version as well as to another proposed two-item screener (developed from PRIME-MD and BPHQ, respectively). Screening and diagnostic interview data from 431 primary care patients were analysed. Main outcome measures were sensitivity, specificity and AUC values. All test characteristics were assessed using the diagnoses derived from the Composite International Diagnostic Interview (CIDI) as the criterion standard.Single-item screening questions proved rather inadequate. However, only marginal differences in performance were found between two questions and the longer screening instrument with respect to major depression, dysthymia and "any depressive disorder". There were no statistically significant differences between these AUC values and most other test characteristics assessed. The results suggest that screening could be reduced to two questions with a potential advantage in terms of ease of administration and scoring and decreased staff and patient burden and perhaps a reduced stigma associated with a positive screening score.
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PMID:Screening for depression in primary care: will one or two items suffice? 1530 89

Depressive disorders are very common in clinical practice, with approximately 11.3 of all adults afflicted during any a year. Saffron is the world's most expensive spice and apart from its traditional value as a food additive, recent studies indicate several therapeutic effects for saffron. It is used for depression in Persian traditional medicine. Our objective was to compare the efficacy of hydro-alcoholic extract of Crocus sativus (stigma) with fluoxetine in the treatment of mild to moderate depression in a 6-week double-blind, randomized trial. Forty adult outpatients who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition for major depression based on the structured clinical interview for DSM-IV and with mild to moderate depression participated in the trial. In this double-blind, single-center trial and randomized trial, patients were randomly assigned to receive capsules of saffron 30 mg/day (BD) (Group 1) and capsule of fluoxetine 20 mg/day (BD) (Group 2) for a 6-week study. Saffron at this dose was found to be effective similar to fluoxetine in the treatment of mild to moderate depression (F = 0.13, d.f. = 1, P = 0.71). There were no significant differences in the two groups in terms of observed side effects. The results of this study indicate the efficacy of Crocus sativus in the treatment of mild to moderate depression. A large-scale trial is justified.
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PMID:Hydro-alcoholic extract of Crocus sativus L. versus fluoxetine in the treatment of mild to moderate depression: a double-blind, randomized pilot trial. 1570 66


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