Measuring discrimination experienced by people with a mental illness: replication of the short-form DISCUS in six world regions
Por:
Brohan E, Thornicroft G, Rüsch N, Lasalvia A, Campbell MM, Yalçinkaya-Alkar Ö, Lanfredi M, Ochoa S, Üçok A, Tomás C, Fadipe B, Sebes J, Fiorillo A, Sampogna G, Paula CS, Valverde L, Schomerus G, Klemm P, Ouali U, Castelein S, Alexová A, Oexle N, Guimarães PN, Sportel BE, Chang CC, Li J, Shanthi C, Reneses B, Bakolis I and Evans-Lacko S
Publicada:
1 jul 2023
Ahead of Print:
1 mar 2022
Resumen:
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 (alpha = 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.
Filiaciones:
Brohan E:
Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Thornicroft G:
Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Rüsch N:
Department of Psychiatry II, Ulm University and BKH Günzburg, Günzburg, Germany
Lasalvia A:
Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
Campbell MM:
Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Department of Psychology, Rhodes University, Makhanda, South Africa
Yalçinkaya-Alkar Ö:
Department of Psychology, Ankara Yildirim Beyazit University, Ankara, Turkey
Lanfredi M:
Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
Ochoa S:
Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
Üçok A:
Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul, Turkey
Tomás C:
Department of Nursing Sciences, School of Health Sciences of Polytechnic Institute of Leiria, Leiria, Portugal
Center for Innovative Care and Health Technology (ciTechCare), Polytechnic Institute of Leiria, Leiria, Portugal
Center for Health Technology and Services Research (Innovation & Development in Nursing), University of Porto, Porto, Portugal
Fadipe B:
Department of Psychiatry, Lagos University Teaching Hospital, Lagos, Nigeria
Sebes J:
Psychosomatic and Psychotherapy-Rehabilitation Department, National Medical Rehabilitation Institute Szanatórium u. 19. 1121 Budapest, Budapest, Hungary
Fiorillo A:
Department of Psychiatry, University of Campania, L. Vanvitelli, Naples, Italy
Sampogna G:
Department of Psychiatry, University of Campania, L. Vanvitelli, Naples, Italy
Paula CS:
Developmental Disorder Program, Mackenzie Presbyterian University, São Paulo, Brazil
Valverde L:
Developmental Disorder Program, Mackenzie Presbyterian University, São Paulo, Brazil
Schomerus G:
Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany
Klemm P:
Department of Psychiatry, Medical Faculty, Greifswald University, Greifswald, Germany
Ouali U:
Department Psychiatry A, Razi Hospital La Manouba, Tunisia
Faculty of Medicine of Tunis, University Tunis El Manar, Tunisia
Castelein S:
Lentis Research, Lentis Psychiatric Institute, Groningen, The Netherlands
Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
Alexová A:
Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
Faculty of Social Sciences, Charles University, Prague, Czech Republic
Oexle N:
Department of Psychiatry II, Ulm University and BKH Günzburg, Günzburg, Germany
Guimarães PN:
Department of Mental and Public Health, Faculty of Medicine, State University of Montes Claros, Montes Claros, MG, Brazil
Sportel BE:
Department of Psychotic Disorders, GGZ Drenthe Mental Health Institute, Assen, The Netherlands
Chang CC:
Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
Department of Health Psychology, Chang Jung Christian University, Tainan, Taiwan
Li J:
The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
Shanthi C:
Department of Psychiatry, Government Medical College, Nizamabad, Telangana State, India
Reneses B:
Institute of Psychiatry and Mental Health, Institute of Biomedical Research (IdISSC), San Carlos University Hospital, Complutense University, Madrid, Spain
Bakolis I:
Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Evans-Lacko S:
Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
hybrid, Green Accepted, Green Submitted
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