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Personal and perceived stigma in relation to diverse domains of quality of life among patients with major depressive disorder having residual symptoms: a hospital-based cross-sectional study in Thailand

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Abstract

Purpose

Depression is a debilitating disease with residual symptoms that negatively impact patients’ quality of life (QoL). Stigma is associated with poor QoL; however, knowledge regarding stigma subtypes and each QoL domain concerning residual depression is limited. We aimed to investigate the association of residual depression symptoms with QoL and stigma among patients with major depressive disorder (MDD).

Methods

This cross-sectional study was conducted at an outpatient clinic among patients with MDD (March–July 2022). We administered the Thai version of the Patient Health Questionnaire-9, World Health Organization Quality of Life Brief, and Mental Health Consumers’ Experience of Stigma to assess patients’ levels of depression, QoL, and personal and perceived stigma, respectively. We performed correlational and logistic regression analyses to evaluate the association of demographics, QoL, stigma, and stress with residual depression.

Results

Of 384 patients with MDD (median age = 39.5, females = 73.2%), 54.4% had residual depression. Among those with residual depression, depression was negatively correlated with QoL (ρ = – 0.58, p < 0.001) and positively correlated with stigma (ρ = 0.24, p < 0.001). The risk of residual depression decreased as the QoL score increased (adjusted OR per 1-point increase 0.93 [0.91, 0.96], p < 0.001); residual depression was significantly associated with personal stigma.

Conclusion

Stigma and QoL exhibit an inverse relationship. Physical-, psychological-, and environmental-health domains of QoL and personal stigma are key contributing factors to residual MDD symptoms. Improvement of QoL and stigma requires further theoretical research and should be of concern in clinical practice. Longitudinal studies on relatively diverse populations and subsyndromal symptoms are needed.

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Data availability

The qualitative data used and analyzed during this study cannot be made publicly available for confidentiality reasons but can be made available, on request, from the corresponding author.

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Acknowledgements

The authors acknowledge the participants for their willingness to offer information; the psychiatric clinic’s nursing staff for providing space at the clinic as well as facilitating several operational aspects of the study; and the team’s research assistants, Nisan Werachattawan and Kreuwan Jongborwanwiwat, for their support. This article was proofread and edited by the International Affairs Department of the Faculty of Medicine, Prince of Songkla University.

Funding

This work was supported by the Faculty of Medicine, Prince of Songkla University, Thailand. However, the funders played no role in the study’s design, data collection, analysis, decision to publish, or manuscript preparation.

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Author notes

  1. Warut Aunjitsakul

    Present address: Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand

Authors and Affiliations

  1. Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand

    Jarurin Pitanupong

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  1. Jarurin Pitanupong
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Contributions

JP: Conceptualization, Methodology, Investigation, Writing—Original Draft, Project administration, and Funding acquisition. WA: Methodology, Formal analysis, Investigation, Data Curation, Writing—Review & Editing, Visualization, and Project administration. All authors approved the final manuscript.

Corresponding author

Correspondence to Warut Aunjitsakul.

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Conflict of interest

We confirm that all methods were carried out under the relevant guidelines and regulations. The authors declare no conflict of interests.

Ethics approval and consent to participate

This study was approved by the Ethics Committee of the Faculty of Medicine, Prince of Songkla University (REC: 64-569-3-1), who waived the requirement for informed consent as the patients could not be identified throughout the research process. All stages of the research were conducted in full compliance with the Declaration of Helsinki and Ethical Statements of the Ethics Committee of the Faculty of Medicine, Prince of Songkla University.

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Pitanupong, J., Aunjitsakul, W. Personal and perceived stigma in relation to diverse domains of quality of life among patients with major depressive disorder having residual symptoms: a hospital-based cross-sectional study in Thailand. Qual Life Res 33, 399–409 (2024). https://doi.org/10.1007/s11136-023-03527-6

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