Abstract
BACKGROUND: While stigma surrounding mental illness continues to affect management, there are hardly any studies reflecting any change following psychiatric admission. We aimed to examine how self-stigma changes during treatment in an inpatient setting and how it relates to improvements in symptoms and functioning. METHODS: We analyzed stigma, depression, anxiety, stress, insight, well-being, functioning, and disability in 100 consecutive patients at admission and discharge in a psychiatric hospital in Kerala. RESULTS: At admission, 34.5% (confidence interval [CI]: 24.5-45.7) of patients reported self-stigma, which decreased to 23.2% (CI: 15.1-32.9) at discharge; the stigma score decreased from 17.1 ± 6.6 to 14.9 ± 4.7 (p < .005). However, stigma levels did not change between admission and discharge for most (68.3%) patients; 87.5% had minimal stigma, with no scope for further reduction. In a minority (7.3%), stigma severity increased. Stigma correlated positively with depression, anxiety, functioning, and insight, and negatively with age and well-being at admission; and at discharge, positively with stress. Patients reporting stigma had higher depression, anxiety, insight, and poorer well-being both at admission and discharge. CONCLUSIONS: Most patients had a lower level of stigma; average stigma severity decreased during psychiatric admission; however, in a minority, it increased. While usual care was beneficial, the effectiveness of a proactive approach to stigma reduction warrants further study.