Computational psychiatry approach to stigma subtyping in patients with mental disorders: explicit and implicit internalized stigma.

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.

Determinants of Stress Levels and Behavioral Reactions in Individuals With Affective or Anxiety Disorders During the COVID-19 Pandemic in Russia.

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.

Behavioral and Emotional Reactions of the Russian Population to the Beginning of the COVID-19 Pandemic: An On-Line Survey Results.

BACKGROUND: The study aimed to identify the patterns of adaptive and behavioral strategies in different population groups, also to evaluate their association with the infection prevention strategies and the distress during the COVID-19 pandemic. METHODS: The data were obtained from the on-line survey of 1958 respondents (mean age 31±12 years) from March 30, 2020 to April 5, 2020. 578 respondents reported a history of affective disorders; 884 respondents - a history of somatic disease. The level of anxiety distress was evaluated with the Psychological Stress Measure (PSM-25). The analysis of variance was used for statistics. p<0.05 was considered significant. The effect sizes (ES) were evaluated according to Cohen's d and Cramer's V criteria. RESULTS: The average PSM-25 score corresponded to moderate stress intensity. An increased level of psychological stress was associated with the young age of the respondents, the history of affective disorders and somatic diseases, the compliance with self-isolation, the practice of social distancing, and the use of sanitizer. Concerns about the availability of protective equipment were specifically associated with the self-isolation compliance (ES=0.1); the combination of concerns about the contagiousness of the virus (ES=0.12) and the inaccessibility of daily medications (ES=0.11) - with the principles of social distance. Moreover, the concerns about the lack of specific treatment, the danger to one's own life, the contagiousness of the virus, and the lack of protective equipment were associated with the protective behavior resulting in increased hand hygiene. The history of affective disorders was rarely associated with wearing masks and gloves, but more often - with the use of self-isolation strategies. CONCLUSIONS: The psychological reactions of the population during the COVID-19 pandemic are specifically associated with adaptive behavior in the process of anti-epidemic measures. Respondents with affective disorders experienced specific patterns of anxiety about coronavirus infection in combination with high rates of psychological stress.

Stress and Stigmatization in Health-Care Workers during the COVID-19 Pandemic.

BACKGROUND: The health-care workers showed the highest risks of the adverse psychological reactions from the COVID-19 pandemic. AIM: This study aimed to evaluate the structure and severity of psychological distress and stigmatization in different categories of health-care workers during the COVID-19 pandemic. MATERIALS AND METHODS: This study included two phases of online survey in 1800 Russian-speaking health-care workers (March 30 - April 5 and May 4 - May 10, 2020). The Psychological Stress Scale (PSM-25) and modified Perceived Devaluation-Discrimination scale (Cronbach's α = 0.74) were used. Dispersion analysis was performed with P = 0.05, Cohen's d, and Cramer's V calculated (effect size [ES]). RESULTS: The psychological stress levels decreased in the second phase (ES = 0.13), while the stigma levels (ES = 0.33) increased. Physicians experienced more stress compared with nurses and paramedical personnel (ES = 0.34; 0.64), but were less likely to stigmatize SARS-CoV-2-infected individuals (ES = 0.43; 0.41). The increasing probability of contact with infected individuals was associated with higher levels of psychological stress (probable contact ES = 0.48; definite contact ES=0.97). The highest rates of contacts with COVID-19 patients were reported by physicians (χ2 = 123.0; P = 0.00, Cramer's V = 0.2), the youngest (ES = 0.5), and less experienced medical workers (ES = 0.33). CONCLUSION: Direct contact with coronavirus infection is associated with a significant increase in stress among medical personnel. The pandemic compromises the psychological well-being of the youngest and highly qualified specialists. However, the stigmatizing reactions are not directly associated with the risks of infection and are most prevalent among nurses and paramedical personnel.