Overlap and differences between internalised stigma and depression: A Delphi study

Two common consequences among persons with a physical health condition are internalised stigma associated with the physical illness and depression. Increased awareness and knowledge of both concepts might help professionals to better diagnose and deploy interventions that best suit the needs of people who experience these phenomena. Therefore, this study aimed to investigate to what extent and how internalised stigma and depression overlap. A Delphi study was conducted to create understanding and build consensus among experts. Over three survey rounds, experts in the field of stigma and depression (n = 24) were asked to determine whether signs/behaviours, symptoms/experiences, external factors and strategies or interventions were associated with internalised stigma, depression or both. Consensus was reached that internalised stigma and depression are common consequences of physical health conditions and are two separate but overlapping phenomena. The main difference between both were external factors, such as environmental (e.g. weather-driven mood fluctuations), or therapeutic (e.g. medication) aspects of depression. This study highlights the importance of raising awareness among professionals that internalised stigma and depression can co-occur, and that strategies and interventions are available for both. Improved awareness will lead to care that is more suitable to the individual's needs, therewith improving quality of life.