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Self-stigma as a mediator between social capital and empowerment among people with major depressive disorder in Europe: The ASPEN study

Published online by Cambridge University Press:  15 April 2020

M. Lanfredi ,
S. Zoppei ,
C. Ferrari ,
C. Bonetto ,
T. Van Bortel ,
G. Thornicroft ,
L. Knifton ,
N. Quinn ,
G. Rossi  and
A. Lasalvia
M. Lanfredi*
Affiliation:
Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
S. Zoppei
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
C. Ferrari
Affiliation:
IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
C. Bonetto
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
T. Van Bortel
Affiliation:
Cambridge Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
G. Thornicroft
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, Institute of Psychiatry, London, United Kingdom
L. Knifton
Affiliation:
Centre for Health Policy, University of Strathclyde, Glasgow, United Kingdom
N. Quinn
Affiliation:
Centre for Health Policy, University of Strathclyde, Glasgow, United Kingdom
G. Rossi
Affiliation:
Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
A. Lasalvia
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
*
*Corresponding author. Tel.: +39 03 03 50 15 04; fax: +39 03 03 50 15 92. E-mail address:[email protected] (M. Lanfredi).
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Abstract

Introduction:

Individual social capital has been recognized as having an important role for health and well-being. We tested the hypothesis that poor social capital increases internalized stigma and, in turn, can reduce empowerment among people with major depressive disorder (MDD).

Materials and methods:

This is a cross-sectional multisite study conducted on a sample of 516 people with MDD in 19 European countries. Structural Equation Models were developed to examine the direct and indirect effects of self-stigma and social capital on empowerment.

Results:

Social capital and self-stigma accounted for 56% of the variability in empowerment. Higher social capital was related to lower self-stigma (r = –0.72, P < 0.001) which, in turn, partially mediated the relationship between social capital and empowerment (r = 0.38, P < 0.001).

Conclusions:

Social capital plays a key role in the appraisal of empowerment, both directly and through the indirect effect mediated by self-stigma. In order to improve empowerment of people with MDD, we identify strategies to foster individual social capital, and to overcome the negative consequences related to self-stigma for attainment of life goals.

Keywords

Self-stigmaDepressionEmpowermentSocial capital
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 1 , January 2015 , pp. 58 - 64
Copyright
Copyright © Elsevier Masson SAS 2015

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