Stigma: a core factor on predicting functionality in bipolar disorder.
OBJECTIVE
Extant literature indicates that bipolar disorder (BD) is associated with significant poor psychosocial functioning. However, the relationship between functioning and demographic and clinical variables is unclear. The aim of this study is to investigate the predictors of functioning such as demographic and clinical variables, social support, self-perceived stigma, and insight in remitted patients with BD.


METHODS
Eighty patients with a diagnosis of BD, complete remission according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition were included in the final assessment. Bipolar Disorder Functioning Questionnaire, Beck Depression Inventory, Young Mania Rating Scale, Internalized Stigma of Mental Illness Scale, Multidimensional Scale of Perceived Social Support, and Schedule for Assessing the Three Components of Insight were used. Student t test, Pearson correlation analyses, and linear regression analyses were used to assess the pathways effecting on functioning.


RESULTS
The 3 predictors of functioning were severity of depression, perceived social support, and internalized stigmatization. Severity of depression is considered the strongest predictor, whereas internalized stigmatization has a core role in predicting functioning. Clinical variables such as years of education and number of hospitalization probably have indirect effects on functioning.


CONCLUSIONS
Interventions that oppose stigmatization and consideration of mild depressive symptoms will positively affect functioning in remitted patients with BD.
Department of Psychiatry, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey. cemcerit@yahoo.com
Cem
C
Cerit
Arzu
A
Filizer
Ümit
Ü
Tural
Ali Evren
AE
Tufan
D000203:Activities of Daily Living; D000328:Adult; D001364:Awareness; D001714:Bipolar Disorder / Q000523:psychology / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008960:Models, Psychological; D012649:Self Concept; D012917:Social Adjustment; D057545:Social Stigma; D012944:Social Support; D014421:Turkey