Skip to main content

Advertisement

SpringerLink
Log in

The experiences of bipolar patients’ families regarding stigma coping strategies in Tehran: a qualitative study

  • Published:
Current Psychology Aims and scope Submit manuscript

Abstract

Stigma and its consequences are an important issue in bipolar disorder patients and their families. Therefore, this study aims to explore the experiences of bipolar patients’ families regarding stigma and coping strategies in Tehran. We conducted a qualitative study in a psychiatric hospital in Tehran, Iran in 2021. The study participants included bipolar patients and their families, as well as mental health professionals selected through a targeted sampling method. Data were collected using individual semi-structured interviews, field attendance, and note-taking. The Data was analysed by the content analysis method with an inductive approach, and the themes were extracted. The criteria of credibility, dependability, conformability, and transferability were included to support the accuracy and robustness of the data.

Of the study participants (n = 27), 4 were bipolar patients, 20 bipolar patient’s family members and 3 were mental health care professionals. Data analysis resulted in 1326 primary codes classified into 20 subcategories and 7 main categories and we concluded that bipolar patients’ families use a variety of strategies to cope with stigma, including awareness, request for assistance, personal development, treatment adherence and responding to patient demand are helpful and some of them such as surrender and impulsivity have adverse results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data Availability

The data that support the findings of this study are available on request from the first author. The data are not publicly available due to privacy or ethical restrictions.

References

  • Arici, C., Cremaschi, L., Dobrea, C., Vismara, M., Grancini, B., Benatti, B., & Altamura, A. C. (2018). Differentiating multiple vs single lifetime suicide attempters with bipolar disorders: A retrospective study. Comprehensive Psychiatry, 80, 214–222.

    Article  PubMed  Google Scholar 

  • Aziz, H., Akhtar, S. W., & Hasan, K. Z. (1997). Epilepsy in pakistan: Stigma and psychosocial problems. A population-based epidemiologic study. Epilepsia, 38(10), 1069–1073.

    Article  PubMed  Google Scholar 

  • Bassirnia, A., Briggs, J., Kopeykina, I., Mednick, A., Yaseen, Z., & Galynker, I. (2015). Relationship between personality traits and perceived internalized stigma in bipolar patients and their treatment partners. Psychiatry Research, 230(2), 436–440.

    Article  PubMed  Google Scholar 

  • Baumann, A. E. (2007). Stigmatization, social distance and exclusion because of mental illness: The individual with mental illness as a ‘stranger’. International Review of Psychiatry, 19(2), 131–135.

    Article  PubMed  Google Scholar 

  • Becker, G., & Arnold, R. (1986). Stigma as a social and cultural construct. The dilemma of difference (pp. 39–57). Springer.

  • Bonsu, A. S., & Salifu Yendork, J. (2019). Community-based mental health care: Stigma and coping strategies among professionals and family caregivers in the eastern region of Ghana. Issues in Mental Health Nursing, 40(5), 444–451.

    Article  PubMed  Google Scholar 

  • Bruni, A., Carbone, E. A., Pugliese, V., Aloi, M., Calabrò, G., Cerminara, G., & De Fazio, P. (2018). Childhood adversities are different in schizophrenic spectrum disorders, bipolar disorder and major depressive disorder. BMC Psychiatry, 18(1), 391.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cardano, M. (2020). Defending qualitative research: Design, analysis, and textualization. Routledge.

  • Carvalho, A. F., Firth, J., & Vieta, E. (2020). Bipolar disorder. New England Journal of Medicine, 383(1), 58–66.

    Article  PubMed  Google Scholar 

  • Dubey, I., Arivazhagan, K., Sharma, S., Sreeraj, V., & Uvais, N. (2020). Perceived Stigma towards Psychiatric Illnesses in Mental Health Trainees. A Cross-Sectional Study.

  • Durgu, N., & Dulgerler, S. (2020). The meaning of recovery: The lived experience of patients with bipolar disorder in Turkey.Issues in Mental Health Nursing,1–8.

  • Ellison, N., Mason, O., & Scior, K. (2013). Bipolar disorder and stigma: A systematic review of the literature. Journal of Affective Disorders, 151(3), 805–820.

    Article  PubMed  Google Scholar 

  • Ellison, N., Mason, O., & Scior, K. (2015). Public beliefs about and attitudes towards bipolar disorder: Testing theory based models of stigma. Journal of Affective Disorders, 175, 116–123.

    Article  PubMed  Google Scholar 

  • Goffman, E. (2003). Stigma. Praha: Sociologické nakladatelství (SLON).

  • Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105–112.

    Article  PubMed  Google Scholar 

  • Green, M., Lino, B., Hwang, E. J., Sparks, A., James, C., & Mitchell, P. (2011). Cognitive regulation of emotion in bipolar I disorder and unaffected biological relatives. Acta Psychiatrica Scandinavica, 124(4), 307–316.

    Article  PubMed  Google Scholar 

  • Grover, S., Aneja, J., Hazari, N., Chakrabarti, S., & Avasthi, A. (2019). Stigma and its correlates among caregivers of patients with bipolar disorder. Indian Journal of Psychological Medicine, 41(5), 455–461.

    Article  PubMed  PubMed Central  Google Scholar 

  • Guan, Z., Huang, C., Wiley, J. A., Sun, M., Bai, X., & Tang, S. (2020). Internalized stigma and its correlates among family caregivers of patients diagnosed with schizophrenia in Changsha, Hunan, China. Journal of Psychiatric and Mental Health Nursing, 27(3), 224–236.

    Article  PubMed  Google Scholar 

  • Guba, E. G., & Lincoln, Y. S. (1994). Competing paradigms in qualitative research. Handbook of Qualitative Research, 2(163–194), 105.

    Google Scholar 

  • Hormazábal-Salgado, R., & Poblete‐Troncoso, M. (2020). Living with bipolar disorder in Chile: A qualitative study. International Journal of Mental Health Nursing, 29(3), 488–497.

    Article  PubMed  Google Scholar 

  • Javed, A., Lee, C., Zakaria, H., Buenaventura, R. D., Cetkovich-Bakmas, M., Duailibi, K., & Azeem, M. W. (2021). Reducing the stigma of mental health disorders with a focus on low-and middle-income countries. Asian Journal of Psychiatry, 58, 102601.

    Article  PubMed  Google Scholar 

  • Kaltenboeck, A., Winkler, D., & Kasper, S. (2016). Bipolar and related disorders in DSM-5 and ICD-10. CNS Spectrums, 21(4), 318–323.

    Article  PubMed  Google Scholar 

  • Latifian, M., Raheb, G., Abdi, K., & Alikhani, R. (2022a). The bipolar patients’ family experiences of the outcomes of encountering stigma in Tehran: A qualitative study. International Journal of Social Psychiatry, 00207640221113748.

  • Latifian, M., Raheb, G., Uddin, R., Abdi, K., & Alikhani, R. (2022b). The process of stigma experience in the families of people living with bipolar disorder: A grounded theory study. BMC Psychology, 10(1), 1–12. https://doi.org/10.1186/s43057-022-00080-9.

    Article  Google Scholar 

  • Latifian, M., Raheb, G., Abdi, K., Alikhani, R., & Shariful Islam, S. M. (2022c). The effectiveness of psychoeducation in improving attitudes towards psychological disorders and internalized stigma in the family members of bipolar patients: A quasi-experimental study. PsyCh Journal.

  • Latifian, M., Abdi, K., Raheb, G., Islam, S. M. S., & Alikhani, R. (2023). Stigma in people living with bipolar disorder and their families: A systematic review. International Journal of Bipolar Disorders, 11(1), 1–20.

    Article  Google Scholar 

  • Mehra, A., Kumar, A., Grover, S., Chakrabarti, S., & Avasthi, A. (2020). Relationship of stigma with burden and coping among caregivers of patients with severe mental disorders. Indian Journal of Social Psychiatry, 36(1), 11–18.

    Article  Google Scholar 

  • Mohamadi, M., Mohtashami, J., & Arab Khangholi, Z. (2021). Stigma towards patients with mental disorders. Iranian Journal of Systematic Review in Medical Sciences, 1(1), 61–72.

    Google Scholar 

  • Monnapula-Mazabane, P., & Petersen, I. (2021). Mental health stigma experiences among caregivers and service users in South Africa: a qualitative investigation. Current Psychology, 1–13.

  • Morgan, A. J., Wright, J., & Reavley, N. J. (2021). Review of australian initiatives to reduce stigma towards people with complex mental illness: What exists and what works? International Journal of Mental Health Systems, 15(1), 1–51.

    Google Scholar 

  • Nejad, Z. K., Aghdam, A. M., Hassankhani, H., & Sanaat, Z. (2016). The effects of a patient-caregiver education and follow-up program on the breast cancer caregiver strain index.Iranian Red Crescent Medical Journal, 1(3).

  • Ocisková, M., Praško, J., Kamarádová, D., Látalová, K., Kurfürst, P., Dostálová, L., & Ticháčková, A. (2014). Self-stigma in psychiatric patients–standardization of the ISMI scale. Neuroendocrinology Letters, 35(7), 624–632.

    PubMed  Google Scholar 

  • Peters, E. M., & Bowen, R. (2018). Irritability in a mixed sample of patients with unipolar and bipolar II depression predicts responsiveness to lamotrigine. Personalized Medicine in Psychiatry, 7, 27–30.

    Article  Google Scholar 

  • Phelan, J. C., Bromet, E. J., & Link, B. G. (1998). Psychiatric illness and family stigma. Schizophrenia Bulletin, 24(1), 115–126.

    Article  PubMed  Google Scholar 

  • Ranjbar, M., Seyed Fatemi, N., Hamooleh, M., Esmaeeli, M., N., & Haghani, S. (2020). Correlation of stigma with self-compassion in patients with bipolar disorder. Iran Journal of Nursing, 32(122), 1–12.

    Article  Google Scholar 

  • Rezayat, F., Mohammadi, E., Fallahi-khoshknab, M., & Sharifi, V. (2019). Experience and the meaning of stigma in patients with schizophrenia spectrum disorders and their families: A qualitative study. Japan Journal of Nursing Science, 16(1), 62–70.

    Article  PubMed  Google Scholar 

  • Richard-Lepouriel, H., Aubry, J. M., & Favre, S. (2021). Is Coping with Stigma by Association Role-Specific for Different Family Members? A Qualitative Study with Bipolar Disorder Patients’ Relatives. Community Mental Health Journal, 1–14.

  • Richardson, T., & White, L. (2019). The impact of a CBT-based bipolar disorder psychoeducation group on views about diagnosis, perceived recovery, self-esteem and stigma. The Cognitive Behaviour Therapist, 12, e43.

    Article  Google Scholar 

  • Sadeghi, K., & Rezaiee (2003). Comparison of mental illness stigma in the families of patients with depressive disorder, bipolar disorder and schizophrenia. Cognitive Science News, 5(2), 25–16.

    Google Scholar 

  • Sadock, B. J., & Sadock, V. (2003). Comprehensive textbook of psychiatry. IV (4th).

  • Sharif, L., Basri, S., Alsahafi, F., Altaylouni, M., Albugumi, S., Banakhar, M., & Wright, R. J. (2020). An exploration of family caregiver experiences of burden and coping while caring for people with mental disorders in Saudi Arabia—A qualitative study. International Journal of Environmental Research and Public Health, 17(17), 6405.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sharma, H., Sharma, B., & Sharma, D. B. (2017). Burden, perceived stigma and coping style of caregivers of patients with schizophrenia and bipolar disorder. International Journal of Health Science and Research, 7(11), 84–94.

    Google Scholar 

  • Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., & Henderson, C. (2016). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet, 387(10023), 1123.

    Article  Google Scholar 

  • Yin, M., Li, Z., & Zhou, C. (2020). Experience of stigma among family members of people with severe mental illness: A qualitative systematic review. International Journal of Mental Health Nursing, 29(2), 141–160.

    Article  PubMed  Google Scholar 

  • Zhang, Z., Sun, K., Jatchavala, C., Koh, J., Chia, Y., Bose, J., & Ho, R. (2020). Overview of stigma against psychiatric illnesses and advancements of anti-stigma activities in six asian societies. International Journal of Environmental Research and Public Health, 17(1), 280.

    Article  Google Scholar 

Download references

Acknowledgements

The present study is extracted from a research project (ethics code: IR.USWR.REC.1399.249) at the Psychosis Research Center of the University of Social Welfare and Rehabilitation Sciences. We would like to appreciate the full cooperation of the university officials, the staff of Razi Psychiatric Hospital, as well as the patients and their families who participated in this study.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

    Maryam Latifian, Ghoncheh Raheb & Rosa Alikhani

  2. Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

    Kianoush Abdi

  3. Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia

    Sheikh Mohammed Shariful Islam

Authors
  1. Maryam Latifian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kianoush Abdi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ghoncheh Raheb
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sheikh Mohammed Shariful Islam
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rosa Alikhani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kianoush Abdi.

Ethics declarations

Conflict of Interest

The authors declare no conflict of interest.

Informed Consent

Conscious consent was obtained from all participants. Regarding the patients, their legal guardian was informed.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Supplementary Material 2

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Latifian, M., Abdi, K., Raheb, G. et al. The experiences of bipolar patients’ families regarding stigma coping strategies in Tehran: a qualitative study. Curr Psychol 43, 4179–4190 (2024). https://doi.org/10.1007/s12144-023-04620-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12144-023-04620-2

Keywords

Search

Navigation