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1. Measuring discrimination experienced by people with a mental illness: replication of the short-form DISCUS in six world regions.

Author

Brohan, Elaine, Thornicroft, Graham, Rüsch, Nicolas, Lasalvia, Antonio, Campbell, Megan M., Yalçınkaya-Alkar, Özden, Lanfredi, Mariangela, Ochoa, Susana, Üçok, Alp, Tomás, Catarina, Fadipe, Babatunde, Sebes, Julia, Fiorillo, Andrea, Sampogna, Gaia, Paula, Cristiane Silvestre, Valverde, Leonidas, Schomerus, Georg, Klemm, Pia, Ouali, Uta, and Castelein, Stynke

Subjects
PSYCHIATRIC diagnosis, MENTAL depression risk factors, SUICIDE risk factors, FRIENDSHIP, WELL-being, RESEARCH evaluation, DISCRIMINATION (Sociology), RESEARCH methodology evaluation, RESEARCH methodology, WORK, BECK Hopelessness Scale, HEALTH outcome assessment, SOCIAL stigma, PSYCHOMETRICS, AVOIDANCE (Psychology), CRONBACH'S alpha, SUICIDAL ideation, FACTOR analysis, QUESTIONNAIRES, RESEARCH funding, MENTAL illness, CONSCIOUSNESS
Abstract

Background: The Discrimination and Stigma Scale (DISC) is a patient-reported outcome measure which assesses experiences of discrimination among persons with a mental illness globally. Methods: This study evaluated whether the psychometric properties of a short-form version, DISC-Ultra Short (DISCUS) (11-item), could be replicated in a sample of people with a wide range of mental disorders from 21 sites in 15 countries/territories, across six global regions. The frequency of experienced discrimination was reported. Scaling assumptions (confirmatory factor analysis, inter-item and item-total correlations), reliability (internal consistency) and validity (convergent validity, known groups method) were investigated in each region, and by diagnosis group. Results: 1195 people participated. The most frequently reported experiences of discrimination were being shunned or avoided at work (48.7%) and discrimination in making or keeping friends (47.2%). Confirmatory factor analysis supported a unidimensional model across all six regions and five diagnosis groups. Convergent validity was confirmed in the total sample and within all regions [ Internalised Stigma of Mental Illness (ISMI-10): 0.28–0.67, stopping self: 0.54–0.72, stigma consciousness: −0.32–0.57], as was internal consistency reliability (α = 0.74–0.84). Known groups validity was established in the global sample with levels of experienced discrimination significantly higher for those experiencing higher depression [Patient Health Questionnaire (PHQ)-2: p < 0.001], lower mental wellbeing [Warwick-Edinburgh Well-being Scale (WEMWBS): p < 0.001], higher suicidal ideation [Beck Hopelessness Scale (BHS)-4: p < 0.001] and higher risk of suicidal behaviour [Suicidal Ideation Attributes Scale (SIDAS): p < 0.001]. Conclusions: The DISCUS is a reliable and valid unidimensional measure of experienced discrimination for use in global settings with similar properties to the longer DISC. It offers a brief assessment of experienced discrimination for use in clinical and research settings. [ABSTRACT FROM AUTHOR]

Published
2023
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2. Measuring discrimination experienced by people with a mental illness: replication of the short-form DISCUS in six world regions

Author

Brohan, Elaine, primary, Thornicroft, Graham, additional, Rüsch, Nicolas, additional, Lasalvia, Antonio, additional, Campbell, Megan M., additional, Yalçınkaya-Alkar, Özden, additional, Lanfredi, Mariangela, additional, Ochoa, Susana, additional, Üçok, Alp, additional, Tomás, Catarina, additional, Fadipe, Babatunde, additional, Sebes, Julia, additional, Fiorillo, Andrea, additional, Sampogna, Gaia, additional, Paula, Cristiane Silvestre, additional, Valverde, Leonidas, additional, Schomerus, Georg, additional, Klemm, Pia, additional, Ouali, Uta, additional, Castelein, Stynke, additional, Alexová, Aneta, additional, Oexle, Nathalie, additional, Guimarães, Patrícia Neves, additional, Sportel, Bouwina Esther, additional, Chang, Chih-Cheng, additional, Li, Jie, additional, Shanthi, Chilasagaram, additional, Reneses, Blanca, additional, Bakolis, Ioannis, additional, and Evans-Lacko, Sara, additional

Published
2022
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3. Discrimination in the workplace, reported by people with major depressive disorder: a cross-sectional study in 35 countries

Author

Brouwers, E. P M, Mathijssen, J., Van Bortel, T., Knifton, L., Wahlbeck, K., Van Audenhove, C., Kadri, N., Chang, Ch, Goud, B. R., Ballester, D., Tófoli, L. F., Bello, R., Jorge-Monteiro, M. F., Zäske, H., Milacic, I., Uçok, A., Bonetto, C., Lasalvia, A., Thornicroft, G., Van Weeghel, J., Thornicroft, Graham, Van Bortel, Tine, Treacy, Samantha, Brohan, Elaine, Ando, Shuntaro, Rose, Diana, Wahlbeck, Kristian, Aromaa, Esa, Nordmyr, Johanna, Nyqvist, Fredrica, Herberts, Carolina, Lewis, Oliver, Russo, Jasna, Karsay, Dorottya, Maglajlic, Rea, Lasalvia, Antonio, Zoppei, Silvia, Cristofalo, Doriana, Bonetto, Chiara, Goldie, Isabella, Knifton, Lee, Quinn, Neil, Sartorius, Norman, Van Audenhove, Chantal, Scheerder, Gert, Tambuyzer, Else, Hristakeva, Valentina, Germanov, Dimitar, Roelandt, Jean Luc, Bacle, Simon Vasseur, Daumerie, Nicolas, Caria, Aude, Zaske, Harald, Gaebel, Wolfgang, Economou, Marina, Louki, Eleni, Peppou, Lily, Geroulanou, Klio, Harangozo, Judit, Sebes, Julia, Csukly, Gabor, Rossi, Giuseppe, Lanfredi, Mariangela, Pedrini, Laura, Germanavicius, Arunas, Markovskaja, Natalja, Valantinas, Vytis, Van Weeghel, Jaap, Boumans, Jenny, Willemsen, Eleonoor, Plooy, Annette, Duarte, Teresa, Monteiro, Fatima Jorge, Teodorescu, Radu, Radu, Iuliana, Pana, Elena, Hurova, Janka, Leczova, Dita, Svab, Vesna, Konecnik, Nina, Reneses, Blanca, Lopez-Ibor, Juan J., Palomares, Nerea, Bayon, Camila, Uçok, Alp, Karaday, Gulsah, Glozier, Nicholas, Cockayne, Nicole, Tófoli, Luís Fernando, Costa, Maria Suely Alves, Milev, Roumen, Garrah, Teresa, Tackaberry, Liane, Stuart, Heather, Margetic, Branka Aukst, Groiæ, Petra Folnegovic, Wenigova, Barbora, Pavla, Elepova, Radwan, Doaa Nader, Johnson, Pradeep, Goud, Ramakrishna, Nandesh, N., Jayaram, Geetha, Suzuki, Yuriko, Akiyama, Tsuyoshi, Matsunaga, Asami, Bernick, Peter, James, Bawo, Ola, Bolanle, Owoeye, Olugbenga, Oshodi, Yewande, Abdulmalik, Jibril, Chee, Kok Yoon, Ali, Norhayati, Kadri, Nadia, Belghazi, Dounia, Anwar, Yassine, Khan, Nashi, Kausar, Rukhsana, Vidojevic, Ivona Milacic, Sumathipala, Athula, Chang, Chih Cheng, Nacef, Fethi, Ouali, Uta, Ouertani, Hayet, Jomli, Rabaa, Ouertani, Abdelhafidh, Kaaniche, Khadija, Bello, Ricardo, Ortega, Manuel, Melone, Arturo, Andréina, María, Marco, Francisco, Ríos, Arturo, Rodríguez, Ernesto, Laguado, Arianna, Van Bortel, Tine [0000-0003-0467-6393], Apollo - University of Cambridge Repository, Tranzo, Scientific center for care and wellbeing, and Arbeid & Gezondheid

Subjects
Male, OCCUPATIONAL & INDUSTRIAL MEDICINE, discrimination, human development index, stigma, work, Social stigma, Cross-sectional study, Social Stigma, HN, 0302 clinical medicine, 030212 general & internal medicine, Workplace, media_common, General Medicine, Middle Aged, Mental Health, Major depressive disorder, Female, Developed country, Prejudice, Adult, Employment, medicine.medical_specialty, media_common.quotation_subject, Stigma (botany), OCCUPATIONAL &amp, Affect (psychology), behavioral disciplines and activities, 03 medical and health sciences, mental disorders, medicine, Humans, Psychiatry, Depressive Disorder, Major, Depressive Disorder, business.industry, Research, Major, medicine.disease, Mental health, 030227 psychiatry, Cross-Sectional Studies, Logistic Models, Multivariate Analysis, Unemployment, INDUSTRIAL MEDICINE, business
Abstract

Objective: Whereas employment has been shown to be beneficial for people with Major Depressive Disorder (MDD) across different cultures, employers’ attitudes have been shown to be negative towards workers with MDD. This may form an important barrier to work participation. Today, little is known about how stigma and discrimination affect work participation of workers with MDD, especially from their own perspective. We aimed to assess, in a working age population including respondents with MDD from 35 countries: (1) if people with MDD anticipate and experience discrimination when trying to find or keep paid employment; (2) if participants in high, middle and lower developed countries differ in these respects; and (3) if discrimination experiences are related to actual employment status (ie, having a paid job or not).Method: Participants in this cross-sectional study (N=834) had a diagnosis of MDD in the previous 12 months. They were interviewed using the Discrimination and Stigma Scale (DISC-12). Analysis of variance and generalised linear mixed models were used to analyse the data.Results: Overall, 62.5% had anticipated and/or experienced discrimination in the work setting. In very high developed countries, almost 60% of respondents had stopped themselves from applying for work, education or training because of anticipated discrimination. Having experienced workplace discrimination was independently related to unemployment.Conclusions: Across different countries and cultures, people with MDD very frequently reported discrimination in the work setting. Effective interventions are needed to enhance work participation in people with MDD, focusing simultaneously on decreasing stigma in the work environment and on decreasing self-discrimination by empowering workers with MDD.

Published
2016

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