Self-stigma and treatment effectiveness in patients with anxiety disorders - a mediation analysis

Self-stigma and treatment effectiveness in patients with anxiety disorders - a mediation analysis

The goal of this study was to explore the impact of self-stigma on the treatment outcomes in patients with anxiety disorders and to find possible mediators of this relationship. Two hundred and nine patients with anxiety disorders, who were hospitalized in a psychotherapeutic department, attended th...

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Bibliographic Details
Published in:Neuropsychiatric disease and treatment Vol. 14; pp. 383 - 392
Main Authors: Ociskova, Marie, Prasko, Jan, Vrbova, Kristyna, Kasalova, Petra, Holubova, Michaela, Grambal, Ales, Machu, Klara
Format: Journal Article
Language:English
Published: New Zealand Dove Medical Press Limited 01-01-2018
Taylor & Francis Ltd
Dove Medical Press
Subjects:
Analysis
Anxiety
Anxiety disorders
Behavior
Behavior modification
Behavioral medicine
Care and treatment
Clinical outcomes
Cognitive-behavioral therapy
Drug therapy
Epidemiology
Mediation
Mental depression
Mental disorders
Original Research
Patients
Prejudice
Psychiatrists
Psychiatry
Psychopathology
Psychotherapy
self-stigma / anxiety disorders / treatment effectiveness / medication
Stigma
self-stigma
anxiety disorders
medication
treatment effectiveness
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Summary:The goal of this study was to explore the impact of self-stigma on the treatment outcomes in patients with anxiety disorders and to find possible mediators of this relationship. Two hundred and nine patients with anxiety disorders, who were hospitalized in a psychotherapeutic department, attended the study. The average age was 39.2±12.4 years; two-thirds were women. Most of the patients used a long-term medication. The participants underwent either cognitive behavioral therapy (CBT) or short psychodynamic therapy. The selection to the psychotherapy was not randomized. All individuals completed several scales - Beck Depression Inventory, the second edition (BDI-II), Beck Anxiety Inventory (BAI), Dissociative Experience Scale (DES), Sheehan Disability Scale (SDS), subjective Clinical Global Impression (subjCGI), and The Internalized Stigma of Mental Illness Scale (ISMI). A senior psychiatrist filled out the objective CGI (objCGI). The patients significantly improved in the severity of anxiety (BAI), depression (BDI-II), and overall severity of the mental disorder (objCGI). The self-stigma predicted a lower change of the objCGI, but not a change of the anxiety and depressive symptoms severity. Anxiety, depressive symptoms, dissociation, and disability were assessed as possible mediators of the relationship between the self-stigma and the treatment change. None of them were significant. Self-stigma lowers the effectiveness of the combined treatment of anxiety disorders. Future research should explore other possible mediators influencing this relationship.
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ISSN:1176-6328
1178-2021
1178-2021
DOI:10.2147/NDT.S152208