ABSTRACT
BACKGROUND: Psychiatric stigma has potentially controversial effects on patients health-related behaviors. It appears that both stigmatization and motivation in psychiatric patients are heterogeneous and multi-dimensional, and that the relationship between stigma and treatment motivation may be more complex than previously believed. AIM: To determine psychiatric stigma subtypes as they relate to treatment motivation among inpatients with various mental disorders. METHODS: Sixy-three psychiatric inpatients were examined by the Treatment Motivation Assessment Questionnaire (TMAQ) and the Russian version of Internalized Stigma of Mental Illness scale (ISMI). K-Means cluster and dispersion analysis were conducted. RESULTS: Cluster 3 (25 subjects) was the least stigmatized. Cluster 1 (18 subjects) showed an explicit stigma. Cluster 2 (20 subjects) showed an implicit stigma that took the form of the lowest treatment motivation compared to other clusters. Implicitly stigmatized patients, in contrast to explicitly stigmatized individuals, showed a decline in 3 out of 4 TMAQ factors (Mean dif.=1.051.67). CONCLUSION: Cooperation with doctors, together with reliance on ones own knowledge and skills to cope with the disorder, might be the way to overcome an internalized stigma for patients with mental disorders.
ABSTRACT
Background: The overload of healthcare systems around the world and the danger of infection have limited the ability of researchers to obtain sufficient and reliable data on psychopathology in hospitalized patients with coronavirus disease 2019 (COVID-19). The relationship between severe acute respiratory syndrome with the coronavirus 2 (SARS-CoV-2) infection and specific mental disturbances remains poorly understood. Aim: To reveal the possibility of identifying the typology and frequency of psychiatric syndromes associated with acute COVID-19 using cluster analysis of discrete psychopathological phenomena. Materials and Methods: Descriptive data on the mental state of 55 inpatients with COVID-19 were obtained by young-career physicians. Classification of observed clinical phenomena was performed with k-means cluster analysis of variables coded from the main psychopathological symptoms. Dispersion analysis with p level 0.05 was used to reveal the clusters differences in demography, parameters of inflammation, and respiration function collected on the basis of the original medical records. Results: Three resulting clusters of patients were identified: (1) persons with anxiety; disorders of fluency and tempo of thinking, mood, attention, and motor-volitional sphere; reduced insight; and pessimistic plans for the future (n = 11); (2) persons without psychopathology (n = 37); and (3) persons with disorientation; disorders of memory, attention, fluency, and tempo of thinking; and reduced insight (n = 7). The development of a certain type of impaired mental state was specifically associated with the following: age, lung lesions according to computed tomography, saturation, respiratory rate, C-reactive protein level, and platelet count. Conclusion: Anxiety and/or mood disturbances with psychomotor retardation as well as symptoms of impaired consciousness, memory, and insight may be considered as neuropsychiatric manifestations of COVID-19 and should be used for clinical risk assessment.
ABSTRACT
Introduction: Individuals with affective and anxiety disorders are among those most vulnerable to the negative effects of the COVID-19 pandemic. Aim: This study aims to analyze the determinants of stress levels and protective behavioral strategies associated with the COVID-19 pandemic in Russian-speaking people with affective or anxiety disorders (AADs). Materials and Methods: In this cross-sectional online survey, the psychological distress and behavioral patterns of respondents with self-reported AAD (n = 1,375) and without disorders (n = 4,278) were evaluated during three periods of restrictive measures in Russia (March-May 2020). Distress levels were verified using the Psychological Stress Measure (PSM-25). Results: Stress levels among respondents with AAD were higher at all study periods than for those with no mental disorder (Cohen's d 0.8-1.6). The stress level increased (Cohen's d = 0.4) in adolescents (16-18 years) with AAD and remained the same in those without disorders; in youths (19-24 years) with and without disorders, an increase (Cohen's d = 0.3) and a decrease (Cohen's d = 0.3) in the stress were observed, correspondingly; the stress in adults (25-44 years) with disorders did not change and decreased in those without disorders (Cohen's d = 0.4). Individuals with bipolar disorders demonstrated lower stress than individuals with depressive (Cohen's d = 0.15) and anxiety disorders (Cohen's d = 0.27). Respondents with depressive and bipolar disorders employed fewer protective measures simultaneously and were less likely to search for information about COVID-19. Conclusion: The presence of affective or anxiety disorders is associated with a more acute response to the COVID-19 pandemic. Apparently, the type of mental disorder influenced stress levels and protective behavior patterns.