Internalized stigmatization in borderline personality disorder and attention deficit hyperactivity disorder in comparison to bipolar disorder

Andréanne Filion Quenneville; Déborah Badoud; Rosetta Nicastro; Françoise Jermann; Sophie Favre; Anne-Lise Kung; Sebastian Euler; Nader Perroud; Hélène Richard-Lepouriel

doi:10.1016/j.jad.2019.10.053

Internalized stigmatization in borderline personality disorder and attention deficit hyperactivity disorder in comparison to bipolar disorder

J Affect Disord. 2020 Feb 1:262:317-322. doi: 10.1016/j.jad.2019.10.053. Epub 2019 Oct 30.

Authors

Andréanne Filion Quenneville¹, Déborah Badoud², Rosetta Nicastro², Françoise Jermann², Sophie Favre², Anne-Lise Kung³, Sebastian Euler⁴, Nader Perroud⁵, Hélène Richard-Lepouriel²

Affiliations

¹ Division of Psychiatric Specialties, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland; Department of Psychiatry, University of Montreal, Montreal, Canada. Electronic address: andreanne.filion.quenneville@umontreal.ca.
² Division of Psychiatric Specialties, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland.
³ Department of Psychiatry, University of Geneva, Geneva, Switzerland.
⁴ University Hospital Zurich, Department of Consultation Psychiatry and Psychosomatics, Zurich, Switzerland.
⁵ Division of Psychiatric Specialties, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland; Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.

PMID: 31733922
DOI: 10.1016/j.jad.2019.10.053

Abstract

Introduction: Internalized stigma constitutes a major concern in mental health illness. It has numerous repercussions on patients, including poor self-esteem, higher illness severity, poor adherence to care and reduced global functioning. The goal of this study was to compare internalized stigma between three diagnoses frequently seen in psychiatric practice: Borderline personality disorder (BPD), Attention deficit-hyperactivity disorder (ADHD) and Bipolar disorder (BD).

Methods: A total of 244 French-speaking patients were recruited in a specialized psychiatric center at University Hospitals of Geneva, Switzerland. 39 patients had a diagnosis of BPD, 136 had ADHD and 69 had BD. Every subjects completed the Internalized Stigma of Mental Illness (ISMI) scale, which is the most widely used scale employed to measure of internalized stigma. One way ANOVA analysis with adjustment on age and gender was done to compare the three groups (BPD, ADHD, BD).

Results: Participants with BPD reported higher ISMI score than subjects with ADHD and BD. BD experienced more internalized-stigma than ADHD. Higher ISMI score was also associated with higher severity of the respective disorder, poorer quality of life and unemployment.

Limitations: Limitations of this research include the small sample, especially in BPD group. A disequilibrium between male and female subjects can also impact our results. Observational nature of our study mean that we can only make correlation between variables and not infer causality. Finally, other confounding factors not taken into account in this study may have had influence on stigma.

Conclusions: Our findings are coherent with recent literature on BPD reporting high level of distress and of stigmatization. This has serious consequences on provided care and need to be address by mental health professionals to assure the optimal service to this population.

Publication types

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

MeSH terms

Adult
Attention Deficit Disorder with Hyperactivity / psychology*
Bipolar Disorder / psychology*
Borderline Personality Disorder / psychology*
Defense Mechanisms*
Female
Humans
Male
Middle Aged
Quality of Life
Social Stigma*
Switzerland