Computational psychiatry approach to stigma subtyping in patients with mental disorders: explicit and implicit internalized stigma

BACKGROUND: Psychiatric stigma has potentially controversial effects on patients health-related behaviors. It appears that both stigmatization and motivation in psychiatric patients are heterogeneous and multi-dimensional, and that the relationship between stigma and treatment motivation may be more complex than previously believed. AIM: To determine psychiatric stigma subtypes as they relate to treatment motivation among inpatients with various mental disorders. METHODS: Sixy-three psychiatric inpatients were examined by the Treatment Motivation Assessment Questionnaire (TMAQ) and the Russian version of Internalized Stigma of Mental Illness scale (ISMI). K-Means cluster and dispersion analysis were conducted. RESULTS: Cluster 3 (25 subjects) was the least stigmatized. Cluster 1 (18 subjects) showed an explicit stigma. Cluster 2 (20 subjects) showed an implicit stigma that took the form of the lowest treatment motivation compared to other clusters. Implicitly stigmatized patients, in contrast to explicitly stigmatized individuals, showed a decline in 3 out of 4 TMAQ factors (Mean dif.=1.051.67). CONCLUSION: Cooperation with doctors, together with reliance on ones own knowledge and skills to cope with the disorder, might be the way to overcome an internalized stigma for patients with mental disorders