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Measuring discrimination experienced by people with a mental illness: replication of the short-form DISCUS in six world regions

2023-07Journal article Open access
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dc.contributor.authorBrohan, Elaine
dc.contributor.authorThornicroft, Graham
dc.contributor.authorRüsch, Nicolas
dc.contributor.authorLasalvia, Antonio
dc.contributor.authorCampbell, Megan M.
dc.contributor.authorYalçınkaya-Alkar, Özden
dc.contributor.authorLanfredi, Mariangela
dc.contributor.authorOchoa, Susana
dc.contributor.authorÜçok, Alp
dc.contributor.authorTomás, Catarina
dc.contributor.authorFadipe, Babatunde
dc.contributor.authorSebes, Julia
dc.contributor.authorFiorillo, Andrea
dc.contributor.authorSampogna, Gaia
dc.contributor.authorPaula, Cristiane Silvestre
dc.contributor.authorValverde, Leonidas
dc.contributor.authorSchomerus, Georg
dc.contributor.authorKlemm, Pia
dc.contributor.authorOuali, Uta
dc.contributor.authorCastelein, Stynke
dc.contributor.authorAlexová, Aneta
dc.contributor.authorOexle, Nathalie
dc.contributor.authorGuimarães, Patrícia Neves
dc.contributor.authorSportel, Bouwina Esther
dc.contributor.authorChang, Chih-Cheng
dc.contributor.authorLi, Jie
dc.contributor.authorShanthi, Chilasagaram
dc.contributor.authorReneses, Blanca
dc.contributor.authorBakolis, Ioannis
dc.contributor.authorEvans-Lacko, Sara
dc.date.accessioned2024-02-23T14:29:41Z
dc.date.available2024-02-23T14:29:41Z
dc.date.issued2023-07
dc.descriptionFinancial support: IB is supported by the NIHR Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and by the NIHR Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. GT is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South London at King’s College London NHS Foundation Trust, and by the NIHR Asset Global Health Unit award. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. GT also receives support from the National Institute of Mental Health of the National Institutes of Health under award number R01MH100470 (Cobalt study). GT is supported by the UK Medical Research Council in relation to the Emilia (MR/S001255/1) and Indigo Partnership (MR/R023697/1) awards. JL is supported by the programme of community mental health service model in Guangzhou (20161A031002), which was supported by the Health and Family Planning Commission of Guangzhou Municipality.pt_PT
dc.description.abstractBackground The Discrimination and Stigma Scale (DISC) is a patient-reported outcome measure which assesses experiences of discrimination among persons with a mental illness globally. Methods This study evaluated whether the psychometric properties of a short-form version, DISC-Ultra Short (DISCUS) (11-item), could be replicated in a sample of people with a wide range of mental disorders from 21 sites in 15 countries/territories, across six global regions. The frequency of experienced discrimination was reported. Scaling assumptions (confirmatory factor analysis, inter-item and item-total correlations), reliability (internal consistency) and validity (convergent validity, known groups method) were investigated in each region, and by diagnosis group. Results 1195 people participated. The most frequently reported experiences of discrimination were being shunned or avoided at work (48.7%) and discrimination in making or keeping friends (47.2%). Confirmatory factor analysis supported a unidimensional model across all six regions and five diagnosis groups. Convergent validity was confirmed in the total sample and within all regions [ Internalised Stigma of Mental Illness (ISMI-10): 0.28-0.67, stopping self: 0.54-0.72, stigma consciousness: -0.32-0.57], as was internal consistency reliability (α = 0.74-0.84). Known groups validity was established in the global sample with levels of experienced discrimination significantly higher for those experiencing higher depression [Patient Health Questionnaire (PHQ)-2: p < 0.001], lower mental wellbeing [Warwick-Edinburgh Well-being Scale (WEMWBS): p < 0.001], higher suicidal ideation [Beck Hopelessness Scale (BHS)-4: p < 0.001] and higher risk of suicidal behaviour [Suicidal Ideation Attributes Scale (SIDAS): p < 0.001]. Conclusions The DISCUS is a reliable and valid unidimensional measure of experienced discrimination for use in global settings with similar properties to the longer DISC. It offers a brief assessment of experienced discrimination for use in clinical and research settings. Copyright © The Author(s), 2022. Published by Cambridge University Press.pt_PT
dc.description.sponsorshipKing's College London NHS Foundation Trust; NIHR ARC; NIHR Applied Research Collaboration South London; National Institutes of Health; National Institute of Mental Health; South London and Maudsley NHS Foundation Trust; King's College Hospital NHS Foundation Trust; Manchester Biomedical Research Centre; Medical Research Council; National Institute for Health Research; Guangzhou Municipal Health and Family Planning Commission; NIHR Imperial Biomedical Research Centrept_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBrohan E. et al (2023). Measuring discrimination experienced by people with a mental illness: replication of the short-form DISCUS in six world regions. Psychological Medicine, 53, 3963–3973. https:// doi.org/10.1017/S0033291722000630pt_PT
dc.identifier.doihttps://doi.org/10.1017/S0033291722000630pt_PT
dc.identifier.issn00332917
dc.identifier.pmc10317801
dc.identifier.pmid35351228
dc.identifier.urihttp://hdl.handle.net/10400.8/9478
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherCambridge University Presspt_PT
dc.relation.publisherversionhttps://www.cambridge.org/core/journals/psychological-medicine/article/measuring-discrimination-experienced-by-people-with-a-mental-illness-replication-of-the-shortform-discus-in-six-world-regions/563387E20AA7B2A1D392E953E7D4C20Bpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectDISCUSpt_PT
dc.subjectDiscriminationpt_PT
dc.subjectGlobal mental healthpt_PT
dc.subjectPsychometricspt_PT
dc.subjectStigmapt_PT
dc.titleMeasuring discrimination experienced by people with a mental illness: replication of the short-form DISCUS in six world regionspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage3973pt_PT
oaire.citation.issue9pt_PT
oaire.citation.startPage3963pt_PT
oaire.citation.titlePsychological Medicinept_PT
oaire.citation.volume53pt_PT
person.familyNameTomás
person.givenNameCatarina
person.identifier.ciencia-idD11A-6DEE-6E34
person.identifier.orcid0000-0003-3713-3352
person.identifier.scopus-author-id56597693100
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationc0b7f00c-1469-4022-8f58-246ba6eb6c90
relation.isAuthorOfPublication.latestForDiscoveryc0b7f00c-1469-4022-8f58-246ba6eb6c90

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