Comparing discrimination among people with schizophrenia, affective and anxiety disorders. A multilevel study in five European countries

Antonio Lasalvia; Chiara Bonetto; Elisabetta Miglietta; Domenico Giacco; Pablo Nicaise; Vincent Lorant; Jacek Moskalewicz; Marta Welbel; Michael Bauer; Andrea Pfennig; Mirella Ruggeri; Stefan Priebe

doi:10.1016/j.jad.2020.10.002

Comparing discrimination among people with schizophrenia, affective and anxiety disorders. A multilevel study in five European countries

J Affect Disord. 2021 Jan 15:279:191-202. doi: 10.1016/j.jad.2020.10.002. Epub 2020 Oct 6.

Authors

Affiliations

¹ UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy; Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy. Electronic address: antonio.lasalvia@univr.it.
² Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
³ Unit for Social and Community Psychiatry (World Health Organisation Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK; Unit for Mental Health and Wellbeing, Division of Health Sciences, University of Warwick, Coventry, United Kingdom.
⁴ Institute of Health and Society IRSS, Université Catholique de Louvain, Ecole de Santé Publique, Clos Chapelle-aux-champs, 30 bte 30.15 - 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
⁵ Department of Studies on Alcohol and Drug Dependence, Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957, Warsaw, Poland.
⁶ Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Universitätsklinikum Carl Gustav Carus, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Fetscherstraße 74, 01307, Dresden, Germany.
⁷ UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy; Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
⁸ Unit for Social and Community Psychiatry (World Health Organisation Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK.

PMID: 33059222
DOI: 10.1016/j.jad.2020.10.002

Abstract

Background: Most research on mental illness stigma has involved people with psychosis; less information is available for people with affective and anxiety disorders. We aimed to compare experienced and anticipated discrimination among people with schizophrenia, and affective and anxiety disorders.

Methods: People with schizophrenia (n=773), affective (n=1010) and anxiety disorders (n=372) were recruited during psychiatric admission across 5 EU countries. The Discrimination and Stigma Scale (DISC-12) was used. Multivariate mixed effect logistic regression models with a random effect for hospital and country were performed to explore patient characteristics associated with experienced and anticipated discrimination.

Results: With anxiety disorders, there were more reports of experiences of discrimination in social life (35%), intimate relationships (23.5%), and physical healthcare (19%); in schizophrenia, in relations with neighbours (23.6%) and mental health staff (21.7%); and in affective disorders, in parental role (22.8%). In multivariate analyses, anxiety was associated with increased likelihood of experiencing discrimination in police interactions (OR=1.675; p=0.038) and physical healthcare (OR=1.816; p=0.003), and reduced likelihood when starting a family (OR=0.474; p=0.01) as compared with schizophrenia. Affective (OR=1.367; p=0.004) and anxiety disorders (OR=1.354; p=0.034) were associated with increased likelihood of concealing a diagnosis compared with schizophrenia.

Limitations: As patients with affective and anxiety disorders were recruited from hospital inpatient units, their experiences may not be representative of all people with these disorders.

Conclusions: In a sample of people receiving inpatient treatment, experienced and anticipated discrimination are perceived, at least in some life domains, as more of a burden for people with affective and anxiety disorders than those with schizophrenia.

Keywords: affective disorders; anxiety disorders; discrimination; multi-site studies; multilevel analysis; schizophrenia; stereotypes; stigma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anxiety Disorders / epidemiology
Europe
Humans
Mental Health
Schizophrenia* / epidemiology
Social Stigma