Estigma e discriminação entre adultos com transtornos psiquiátricos

• Autor(a) principal: Silva, Leonidas Valverde da
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações do Mackenzie
• Texto Completo: http://dspace.mackenzie.br/handle/10899/22770
• topic: estigma; transtornos psiquiátricos; fatores associados; CNPQ::CIENCIAS HUMANAS::PSICOLOGIA; CNPQ::CIENCIAS HUMANAS::EDUCACAO; CNPQ::CIENCIAS DA SAUDE

Stigma associated with others psychiatric disorders is an obstacle to mental health care. It contributes to limiting access to services, employment, habitation and other social rights. From that perspective, this research aimed to know the production of studies in the field of mental health stigma in Brazil and identify the predictors of stigma and discrimination experiences lived by people with psychiatric disorders, such as sociodemographic (education, gender, age, employment status) and clinical factors (type of diagnosis and presence of suicidal ideation). Regarding the methodological aspects, this dissertation was divided into two studies: 1) a literature review about stigma related to psychiatric disorders on Brazilian population; and 2) an empirical study of quantitative cross-sectional design. In the literature review, were selected 20 articles extracted from the PubMed and Scielo databases using the descriptors “stigma”, “mental health” and “Brazil”. Inclusion criteria were studies with empirical data on stigma related to mental health; Brazilian samples/participants; and published in Portuguese, English or Spanish. In the cross-sectional empirical study, the sample consisted of 100 people aged between 18 and 60 years and of both genders. Participants were diagnosed with depression, anxiety, bipolar disorder and schizophrenia and were users of the Psychiatric Outpatient Clinic of the State Public Servant Hospital. It was used the Abbreviated Discrimination and Stigma Scale (DISCUS), as well as items from other brief questionnaires with multiple questions covering: a) clinical aspects (type of diagnosis; presence/absence of suicidal ideation); b) sociodemographic profile, gender, age, education level and employment status); c) personal characteristics such as self-esteem and emotional well-being. Statistical analysis followed: 1) verification of the normality of quantitative variables according to the Kolmogorov-Smirnov test; 2) use of the correlation test between two interval variables with normal distribution using Pearson's parametric test and Spearman's nonparametric test for variables without normal distribution; 3) use of the T test for independent variables with two categories; and 4) in independent variables with three or more categories, the nonparametric ANOVA analysis of variance. In the review study it was found that, in general, research work of stigma in mental health conducted in Brazil sought to: 1) investigate models of intervention against stigma, among which stand out the educational and contact model; 2) understand the beliefs and attitudes of the general public, students and health professionals towards people with mental health problems; and 3) understand the experiences of stigma in the life of individuals with psychiatric disorders. In the empirical study, the descriptive results revealed a higher frequency of stigma/discrimination experiences in the workplace, friendships and interpersonal relationships. From the multivariate linear regression model, it was observed that the variables education, diagnosis of anxiety, bipolarity and depression (related to schizophrenia) and suicidal ideation had independent effects on the stigma/discrimination experiences. This model was statistically significant (p<0.001) and the variables that make up the final model explained the largest proportion of stigma variance (R² = 20.27%). As general conclusions, it was observed that the two studies conducted in this dissertation (literature review and empirical/cross-sectional) revealed that education has a relevant role in the perception of stigmatizing situations and that negative stereotypes, type of diagnosis and Suicidal ideation can negatively interfere with the lives of people with mental health problems. Further studies are suggested to identify other variables that affect the lives of people with psychiatric disorders, such as socioeconomic and ethnic issues, in order to develop and implement intervention policies to reduce stigma related to psychiatric disorders.