Background:

Bipolar affective disorder (BPAD) is one of the most common severe mental illnesses that cause morbidity. Stigma can negatively influence the disease experience in patients with BPAD. Significant differences are observed in the attributes of stigma across the various sociocultural milieus. The current review was thus conducted to compile the evidence regarding the burden and correlates of various forms of stigma in BPAD in India.

Methods:

An exhaustive literature review was conducted in PubMed, MedIND, and Google Scholar to identify Indian studies conducted on stigma in BPAD. The broad themes in various forms of stigma were identified (qualitative analysis). Quantitative analysis of measures of stigma was done, calculating the effect size in BPAD and comparator groups (schizophrenia and anxiety disorders) using standardized mean difference.

Results:

Overall, 12 studies could be identified for qualitative analysis, and 5 were used for quantitative analysis. Overall, the current evidence points out that the stigma in BPAD is less than that in schizophrenia but more than that in anxiety disorders. Internalized stigma in BPAD is correlated with poor self-esteem, reduced community participation, and low quality of life. Caregivers of patients with BPAD also experience significant stigma.

Conclusions:

The review shows that stigma in BPAD is substantial. It also draws attention to the fact that the research regarding stigma in BPAD is lagging behind. This review also provides a platform to develop an intervention in the Indian scenario, where further research should be carried out.

中文翻译：

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双相情感障碍中的耻辱：印度研究的系统定量文献综述

 背景：

双相情感障碍（BPAD）是导致发病的最常见的严重精神疾病之一。耻辱感会对 BPAD 患者的疾病经历产生负面影响。在不同的社会文化环境中，耻辱属性存在显着差异。因此，当前的审查是为了汇编有关印度 BPAD 中各种形式的耻辱的负担和相关性的证据。

 方法：

PubMed、MedIND 和 Google Scholar 进行了详尽的文献综述，以确定印度针对 BPAD 污名进行的研究。确定了各种形式的耻辱的广泛主题（定性分析）。对耻辱测量进行定量分析，使用标准化均差计算 BPAD 和比较组（精神分裂症和焦虑症）的效应大小。

 结果：

总体而言，有 12 项研究可用于定性分析，5 项研究可用于定量分析。总体而言，目前的证据表明，BPAD 的耻辱感低于精神分裂症，但高于焦虑症。 BPAD 的内在耻辱与自尊心差、社区参与度降低和生活质量低相关。 BPAD 患者的护理人员也遭受着严重的耻辱。

 结论：

审查表明 BPAD 的耻辱感很严重。这也引起了人们对BPAD污名化研究的滞后这一事实的关注。本次审查还提供了一个针对印度情景制定干预措施的平台，应进行进一步的研究。