{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T11:03:14Z","timestamp":1769166194233,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T00:00:00Z","timestamp":1601164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Internalized stigma is the acceptance of negative stereotypes about the disease created by society and withdrawing self from society with emotions such as worthlessness and shame.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aimed to investigate the internalized stigma state of patients with melasma, and to identify the factors affecting the internalized stigma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 55 melasma patients were included. The sociodemographic and clinical characteristics of the patients were recorded. Melasma Severity Index, the Turkish version of the Melasma Quality of Life Scale (MelasQoL\u2010TR), and Internalized Stigma Scale (ISS) were used. Besides, patients answered the Perceived Health Status (PHS) and the General Health Questionnaire 12 scales (GHQ\u201012) surveys.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean ISS total score was found as 49.49\u00a0\u00b1\u00a013.15. Cronbach's alpha coefficient for the whole scale was calculated as 0.92 for melasma patients. There was a significant correlation between the ISS total score and MelasQoL\u2010TR (r\u00a0=\u00a00.608, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Besides, statistically significant positive correlations were also found between the overall scores of ISS and GHQ\u201012 (r\u00a0=\u00a00.578, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Linear regression analysis revealed that the most important determinant of internalized stigma was MelasQoL\u2010TR (\u03b2\u00a0=\u00a00.313, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrates that patients with melasma internalize the negative stereotype judgments of the society about the disease. High levels of internalized stigma are related to poor quality of life and psychological illnesses. Therefore, internalized stigma may be one of the main factors responsible for the psychosocial burden of melasma.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.13697","type":"journal-article","created":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T16:08:53Z","timestamp":1601222933000},"page":"1182-1187","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Internalized stigma: One of the main factors responsible for the psychosocial burden of melasma?"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3121-5816","authenticated-orcid":false,"given":"Birg\u00fcl","family":"\u00d6zkesici Kurt","sequence":"first","affiliation":[{"name":"Clinic of Dermatology Ad\u0131yaman University Training and Research Hospital Ad\u0131yaman Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esra","family":"\u0130nan Do\u011fan","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Ad\u0131yaman University Faculty of Medicine Ad\u0131yaman Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikail","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Osmaniye Community Health Center Tuberculosis Dispensary Osmaniye Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erkan","family":"Alpsoy","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereolaogy Akdeniz University Faculty of Medicine Antalya Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1995.01690240119022"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2003.05419.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/0378-6323.168937"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546630601028778"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1077-7229(98)80006-0"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-017-0773-2"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.4274\/turkderm.54521"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.13841"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.174024"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2006.07591.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0837"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546630802287553"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2006.01.049"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2003.08.008"},{"key":"e_1_2_8_16_1","first-page":"163","article-title":"Reliability and validity of the Turkish version of the internalized stigma of mental illness scale","volume":"18","author":"Ersoy MA","year":"2007","journal-title":"Turk Psikiyatri Derg"},{"key":"e_1_2_8_17_1","unstructured":"BruinAD PicavetHSJ NossikovA World Health Organization.Regional Office for E. 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