title: Connection between self-stigma, adherence to treatment, and discontinuation of medication.
abstract: BACKGROUND
  Self-stigma plays a role in many areas of the patient's life. Furthermore, it also discourages therapy. The aim of our study was to examine associations between self-stigma and adherence to treatment and discontinuation of medication in patients from various diagnostic groups.
  
  
  METHODS
  This cross-sectional study involved outpatients attending the Department of Psychiatry, University Hospital Olomouc, Czech Republic. The level of self-stigma was measured with the Internalized Stigma of Mental Illness and adherence with the Drug Attitude Inventory. The patients also anonymously filled out a demographic questionnaire which included a question asking whether they had discontinued their medication in the past.
  
  
  RESULTS
  We examined data from 332 patients from six basic diagnostic categories (substance abuse disorders, schizophrenia, bipolar disorders, depressive disorders, anxiety disorders, and personality disorders). The study showed a statistically significant negative correlation between self-stigma and adherence to treatment in all diagnostic groups. Self-stigma correlated positively and adherence negatively with the severity of disorders. Another important factor affecting both variables was partnership. Self-stigma positively correlated with doses of antidepressants and adherence with doses of anxiolytics. Self-stigma also negatively correlated with education, and positively with a number of hospitalizations and number of psychiatrists visited. Adherence was further positively correlated with age and age of onset of disorders. Regression analysis showed that self-stigma was an important factor negatively influencing adherence to treatment and significantly contributing to voluntary discontinuation of drugs. The level of self-stigma did not differ between diagnostic categories. Patients suffering from schizophrenia had the lowest adherence to treatment.
  
  
  CONCLUSIONS
  The study showed a significant correlation between self-stigma and adherence to treatment. High levels of self-stigma are associated with discontinuation of medications without a psychiatrist's recommendation. This connection was present in all diagnostic groups.
authors.affiliation: Department of Psychiatry, University Hospital Olomouc.
authors.forename: Dana
authors.initials: D
authors.lastname: Kamaradova
authors.affiliation: Department of Psychiatry, University Hospital Olomouc.
authors.forename: Klara
authors.initials: K
authors.lastname: Latalova
authors.affiliation: Department of Psychiatry, University Hospital Olomouc.
authors.forename: Jan
authors.initials: J
authors.lastname: Prasko
authors.affiliation: Department of Psychiatry, University Hospital Olomouc.
authors.forename: Radim
authors.initials: R
authors.lastname: Kubinek
authors.affiliation: Department of Psychiatry, University Hospital Olomouc.
authors.forename: Kristyna
authors.initials: K
authors.lastname: Vrbova
authors.affiliation: Department of Psychiatry, University Hospital Olomouc.
authors.forename: Barbora
authors.initials: B
authors.lastname: Mainerova
authors.affiliation: Department of Psychiatry, University Hospital Olomouc.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cinculova
authors.affiliation: Department of Psychiatry, University Hospital Olomouc.
authors.forename: Marie
authors.initials: M
authors.lastname: Ociskova
authors.affiliation: Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic.
authors.forename: Michaela
authors.initials: M
authors.lastname: Holubova
authors.affiliation: Department of Psychiatry, University Hospital Olomouc.
authors.forename: Jarmila
authors.initials: J
authors.lastname: Smoldasova
authors.affiliation: Department of Psychiatry, University Hospital Olomouc.
authors.forename: Anezka
authors.initials: A
authors.lastname: Tichackova
keywords: adherence; discontinuation of drugs; mental disorders; self-stigma