{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T23:14:54Z","timestamp":1793056494763,"version":"4.5.0"},"reference-count":41,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Soc Psychiatry"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Bipolar disorder (BD) is a complex mood disorder among the leading causes of disability worldwide. Internalized stigma refers to the awareness of negative stereotypes adopted by society and the agreement with these judgments, often associated with impaired functionality and social adaptation. Studies examining internalized stigma and related factors in BD are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>Our study aimed to evaluate the associations between internalized stigma and sociodemographic, marital, and clinical characteristics of individuals with BD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>One hundred and eighteen individuals with BD followed up at a specialized affective disorders unit were included. Participants\u2019 data were collected via follow-up documents and clinical interviews. The Internalized Stigma of Mental Illness Scale (ISMIS) was administered to assess internalized stigma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean ISMIS total score was 56.50. Being unemployed (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.012,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u20090.208), shorter BD duration (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u2009\u22120.302), presence of inter-episode residual symptoms (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.004,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u20090.248), and higher depressive scores (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.001,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u20090.275) predicted increased internalized stigma. Younger age (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.002,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u2009\u22120.264), being female (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.007,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u20090.226), absence of mania dominance (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.019,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u20090.190), and higher depressive scores (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.002,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u20090.260) predicted alienation scores. The presence of inter-episode residual symptoms predicted both stereotype endorsement (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u20090.320) and perceived discrimination (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      =\u20090.358). Younger age (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.001,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      =\u2009\u22120.281) and a total number of depressive episodes (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.015,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u20090.212) also predicted perceived discrimination. Shorter BD duration (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.005,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u2009\u22120.238), absence of seasonality (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.047,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u20090.169), and higher depressive scores (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.001,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u20090.320) predicted social withdrawal, while a history of hospitalization (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.033,\n                      <jats:italic toggle=\"yes\">B<\/jats:italic>\n                      \u2009=\u20090.203) predicted stigma resistance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Considering that internalized stigma is increased in earlier stages of BD, as well as in individuals with inter-episode residual symptoms, it might be important to implement effective psychosocial practices for internalized stigma, which might be modifiable through targeted interventions in the earlier periods. Therefore, a multidimensional and holistic approach toward internalized stigma may positively contribute to the functionality and quality of life of patients with BD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00207640251366717","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T12:25:44Z","timestamp":1757507144000},"page":"451-464","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Internalized Stigma Among Individuals With Bipolar Disorder: Associations With Sociodemographic and Clinical Characteristics From a Specialized Affective Disorders Unit"],"prefix":"10.1177","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9667-4525","authenticated-orcid":false,"given":"Selin","family":"Tanyeri Kayahan","sequence":"first","affiliation":[{"name":"Psychiatry Department, Ege University School of Medicine, \u0130zmir, Turkey"},{"name":"Psychiatry Clinic, Republic of T\u00fcrkiye Ministry of Health Yalva\u00e7 State Hospital, Isparta, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0645-7098","authenticated-orcid":false,"given":"Simavi","family":"Vahip","sequence":"additional","affiliation":[{"name":"Psychiatry Department, Ege University School of Medicine, \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"issue":"4","key":"e_1_3_2_2_1","first-page":"251","article-title":"Hamilton Depresyon Derecelendirme Olcegi (HDDO)\u2019nin gecerligi, guvenirligi ve klinikte kullan\u0131m\u0131","volume":"4","author":"Akdemir A.","year":"1996","unstructured":"Akdemir A., Orsel S., Dag I., Turkcapar H., Iscan N., Ozbay H. 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