Prevalence and associated factors of perceived stigma among medically ill patients on follow-up screened positive for depression in Ethiopia: facility-based cross-sectional study

Abstract

Background: Many people are familiar with the issues of stigma in mental health or HIV, but feeling stigma as an underlying factor for many medically ill-health conditions has not been examined.

Methods: Institution-based cross-sectional study was conducted on patients followed for medical illnesses and having depression. We recruited 384 participants and who were interviewed by nurses using face-to-face interviews and a systematic random sampling technique applied. We used a perceived devaluation and discrimination, a 12-item tool that is used to measure outcome perceived stigma. Variables were coded and entered Epi Info V.3.5.3 and exported to SPSS V.20 for analysis. Statistical analysis parameters, such as descriptive and multivariate logistic regression, were used for data analysis. Adjusted ORs (AORs) with a 95% CI and p value <0.05 were declared significance.

Result: The prevalence of perceived stigma on a patient who followed for medical illness screened positive for depression was found to be around 66.3%. In the multivariate logistic regression, patients with hypertension 61% less likely ((AOR=0.39, 95% CI (0.17 to 0.89)) to have perceived stigma than with asthma and cardiac patients, patients completed higher education 2.15 times ((AOR=2.15; 95% CI 1.05 to 4.40)) more likely to have perceived stigma than which cannot read and write. Patients who had the previous admission with medical illness 1-2 times were 3.52 more likely (AOR=3.52, 95% CI (2.14 to 5.78)) perceived stigma than those who had no hospital admission. Patients who had the previous admission three times with medical illness were 6.1 more likely (AOR=6.1, 95% CI (2.32 to 16.07)) to have perceived stigma than those who had no previous hospital admission.

Conclusion: The prevalence of perceived stigma among patients who had on follow-up for medical illnesses was high. Educational status, history of previous hospital admission were considerably associated with higher perceived stigma.

Keywords: depression & mood disorders; mental health; palliative care.