title: Public Stigma towards Older Adults with Depression: Findings from the São Paulo-Manaus Elderly in Primary Care Study.
abstract: This study investigates three domains of public stigma (perceived negative reactions, perceived discrimination, and dangerousness) against older adults with depression. The sample comprised of older adults registered with primary care clinics (n = 1,291) and primary health care professionals (n = 469) from São Paulo and Manaus, Brazil. Participants read a vignette describing a 70-year-old individual (Mary or John) with a depressive disorder and answered questions measuring stigma. The prevalence of the three stigma domains was between 30.2 and 37.6% among older participants from São Paulo and between 27.6 and 35.4% among older participants from Manaus. Older adults from both cities reported similar prevalence of perceived stigma. Key factors associated with stigmatizing beliefs among older participants were reporting depressive symptoms, having physical limitations, and identifying the case of the vignette as a case of mental disorder. Among health professionals, the prevalence of the three stigma domains was between 19.8 and 34.8% in São Paulo and 30.2 and 44.6% in Manaus. The key factor associated with stigma among primary health care professionals was city, with consistently higher risk in Manaus than in São Paulo. Findings confirm that public stigma against older adults in Brazil is common. It is important to educate the public and primary health care providers in Brazil on stigma related to mental illness in order to reduce barriers to adequate mental health treatment.
authors.affiliation: Laboratory of Psychopathology and Psychiatric Therapeutics (LIM-23), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcia
authors.initials: M
authors.lastname: Scazufca
authors.affiliation: Laboratory of Psychopathology and Psychiatric Therapeutics (LIM-23), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
authors.forename: Maria Clara
authors.identifier: http://orcid.org/0000-0003-2595-9579
authors.initials: MC
authors.lastname: P de Paula Couto
authors.affiliation: Laboratory of Psychopathology and Psychiatric Therapeutics (LIM-23), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.|Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts, United States of America.
authors.forename: Hsiang
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts, United States of America.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kester
authors.affiliation: Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Patrícia Emília
authors.initials: PE
authors.lastname: Braga
authors.affiliation: Anhanguera University of São Paulo (UNIAN), São Paulo, Brazil.
authors.forename: Érica T P
authors.initials: ÉT
authors.lastname: Peluso
authors.affiliation: Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Sérgio L
authors.initials: SL
authors.lastname: Blay
authors.affiliation: Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: R Menezes
authors.affiliation: Open University of the Third Age, Amazonas State University, Manaus, Amazonas, Brazil.
authors.forename: Euler
authors.initials: E
authors.lastname: E Ribeiro
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D001938:Brazil; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology; D058007:Physicians, Primary Care / Q000523:psychology; D011320:Primary Health Care / Q000941:ethics; D057545:Social Stigma