Family Affiliate Stigma and Patient Internalized/Anticipated Stigma in Bipolar Disorder: A Multicenter Dyadic Study

Area of Science:

• Psychiatry
• Clinical Psychology
• Sociology

Background:

• Bipolar disorder stigma is often viewed individually, but family systems can also be affected.
• Family members may experience affiliate stigma, and patient-relative stigma dimensions can coexist within dyads.
• Limited dyadic studies have concurrently assessed these stigma dimensions.

Purpose of the Study:

• To investigate the association between relatives' affiliate/family stigma and patients' internalized/anticipated stigma in bipolar disorder.
• To explore the relationship between stigma dimensions and illness burden indicators in patient-relative dyads.
• To examine dyadic associations using a newly developed questionnaire.

Main Methods:

• A multicenter study involving 184 adults with bipolar disorder and one adult relative each.
• Utilized the Turkish-language Patient-Relative Stigma Questionnaire for Bipolar Disorder (PRSQ-BD) for parallel patient and relative assessments.
• Employed linear mixed-effects models for dyadic analyses and negative binomial regression for illness burden indicators.

Main Results:

• Higher relatives' affiliate/family stigma correlated with increased patient internalized/anticipated stigma.
• Patients' public stigma beliefs were strongly associated with their internalized/anticipated stigma.
• Patient and relative stigma dimensions were linked to higher lifetime episode counts and hospitalizations.

Conclusions:

• Patient and relative stigma dimensions are interconnected within dyads and associated with illness burden in bipolar disorder.
• Findings suggest a dyadic relationship between family stigma and patient outcomes.
• Further research is needed to validate mechanisms and causal pathways due to the study's preliminary nature and cross-sectional design.