umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Studies on the perception of mental illness and epilepsy in Tehran, Iran: a study in stigma and discrimination
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

Stigma and discrimination because of medical conditions is a global phenomenon. Epilepsy and mental illness belong to the most stigmatizing disorders world-wide. Culture, religion, education, life-style influences the perception of stigma. There are two aspects of stigma of special interest for this thesis; internalized stigma, which is the perception of a person suffering from a condition and the public perception of this disorder. This study investigates both aspects of stigma because of mental illness and epilepsy. Internalized stigma of mental illness and epilepsy are also studied in Umea, Sweden, with the same instrument as in Iran in order to look at the cultural influence.

Methods

Paper 1 and 2 on internalized stigma because of mental disorders and epilepsy in Tehran:

These studies are cross-sectional with 138 persons with mental illness recruited from three different hospitals in Tehran and 130 persons with epilepsy from one neurologic clinic in Tehran and the Iran epilepsy association. Internalized stigma because of mental illness was measured using ISMI (Internalized Stigma of Mental Illness) questionnaire and because of epilepsy with the same instrument adapted for epilepsy (ISEP). ISMI/ISEP contains 29 items measured by a 4-point Likert scale. An open-ended question about the experiences of discrimination was added.

Paper 3 and 4 on public attitudes towards mental disorders and epilepsy in Tehran:

These two studies were performed with 800 individuals randomly chosen from households in four districts of Iran (north, south, east and west). In Paper 3 on attitudes and knowledge of mental illness a modified version of a questionnaire developed for the World Association program to reduce discrimination and stigma because of schizophrenia was used. In Paper 4 on awareness of and attitudes towards epilepsy a questionnaire originally developed by Caveness and Gallup in United States as early as 1949 was used and since used in many studies all over the world.

Paper 5 and 6 comparing internalized stigma because of mental disorders and epilepsy in Tehran and Umea:

These two studies included patients suffering from mental disorders (N=163) and epilepsy (N=93) recruited from the university hospital in Umea, Sweden. The same questions as used in Paper 1 and 2 were applied.

Results

The experience of stigma because of mental disorders was high in the Iranian sample. The Swedish sample generally reported lower levels of experienced stigma than the Iranian except for items covering self-blame and feelings of alienation. As regards epilepsy the Iranian sample reported quite a high level of experienced stigma compared to the Swedish sample. Generally the patients with epilepsy reported lower levels of experienced stigma compared to patients with mental illness in the two settings. Attitudes towards mentally ill persons in Tehran were at the same levels as in western high income countries. The knowledge about and attitudes towards persons with epilepsy was also generally at the same level as found in other European studies expect for a much lower acceptance as regards accepting a person with epilepsy to marry someone in the family.

Conclusion

Stigma because of mental illness and epilepsy is a reality even in Iran, which is an Islamic setting in spite of the teachings of the Koran to show mercy with people who suffer from different ailments and rather well developed health services. The levels of experienced stigma is higher in Iran compared to Sweden, but still there is quite a lot of stigma because of mental illness even in Sweden in spite of several national efforts to reduce stigma. The lower levels of stigma because of epilepsy in both settings and especially in Sweden, is suggested to be the consequence of effective treatments available for epilepsy compared to the less successful treatments available for mental illness. The differences in internalized stigma reported and the public perceptions of stigma because of both mental illness and epilepsy between Iran and Sweden is suggested partly a consequence of the different cultural settings, Sweden being an extremely individualistic society compared to the more collectivistic Iranian society.

Place, publisher, year, edition, pages
Umeå: Umeå University , 2013. , 43 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1604
Keyword [en]
Stigma, mental illness, epilepsy, Iran, Tehran, Sweden
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:umu:diva-81703ISBN: 978-91-7459-744-8 (print)OAI: oai:DiVA.org:umu-81703DiVA: diva2:658182
Public defence
2013-11-14, Föreläsningssal A, Psykiatriska kliniken, Byggnad 23, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2013-10-24 Created: 2013-10-21 Last updated: 2013-10-24Bibliographically approved
List of papers
1. Internalized stigma of mental illness in Tehran, Iran
Open this publication in new window or tab >>Internalized stigma of mental illness in Tehran, Iran
2011 (English)In: Stigma Research and Action, ISSN 2210-5174, Vol. 1, no 1, 11-17 p.Article in journal (Refereed) Published
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-81697 (URN)10.5463/sra.v1i1.10 (DOI)
Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2017-12-06Bibliographically approved
2. Self-perception of stigma in persons with epilepsy in Tehran, Iran
Open this publication in new window or tab >>Self-perception of stigma in persons with epilepsy in Tehran, Iran
2013 (English)In: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 28, no 2, 163-167 p.Article in journal (Refereed) Published
Abstract [en]

Epilepsy is one of the most stigmatizing medical conditions worldwide. It could be argued that the problem of stigma and discrimination might be different in an Islamic culture. A cross-sectional study of 130 patients with epilepsy was performed using the Internalized Stigma of Mental Illness (ISMI) questionnaire that was adapted for epilepsy. The questionnaire contained 29 items on a 4-point scale in addition to an open-ended question about experience of discrimination. An average score above the midpoint (2.5) is suggested to indicate a high level of stigma. Approximately 23.7% of the patients reported a score above the midpoint. Unemployment and low education were significantly associated with a high level of internalized stigma. Although epilepsy can be effectively treated, patients in Tehran still experience much stigma. For this reason, strategies for reducing self-perception of stigma should be included in a treatment plan.

(C) 2013 The Authors. Published by Elsevier Inc. All rights reserved.

Keyword
Epilepsy, Stigma, Iran, Perceived discrimination
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-79231 (URN)10.1016/j.yebeh.2013.04.009 (DOI)000321429100006 ()
Available from: 2013-09-16 Created: 2013-08-13 Last updated: 2017-12-06Bibliographically approved
3. Community study on attitudes to and knowledge of mental illness in Tehran
Open this publication in new window or tab >>Community study on attitudes to and knowledge of mental illness in Tehran
(English)In: Stigma Research and Action, ISSN 2210-5174Article in journal (Refereed) Accepted
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-81698 (URN)
Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2017-12-06Bibliographically approved
4. Public awareness and attitudes towards epilepsy in Tehran, Iran
Open this publication in new window or tab >>Public awareness and attitudes towards epilepsy in Tehran, Iran
2013 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 6, 1-5 p.Article in journal (Refereed) Published
Abstract [en]

Background: Epilepsy is a prototypical, stigmatised disorder. Numerous studies have been conducted regarding the public perception of epilepsy, but they are primarily from high-income western countries; few studies have taken place in low-to middle-income countries with a traditional culture and a religious orientation. Objective: The public knowledge and attitudes towards epilepsy in Tehran, Iran, is studied. Design: A survey of 800 subjects ranging from 18 to 85 years was randomly chosen from households in Tehran in 2009. The questionnaire used was based on the Caveness and Gallup's studies conducted in the United States in 1949 and it has been used in numerous similar studies all over the world. The mean age of the participants was 37.5 years and 46.7% were female. Pearson's Chi-squared test was used for subgroup analyses. Results: The majority of subjects cited brain disorders as a cause of epilepsy, while 17% indicated the will of God as the cause. Most individuals were willing to work with a person with epilepsy, allow their children to play with a child with epilepsy, and allow people with epilepsy to use public transportation (78-82%). However, only 28% were willing to accept the marriage of a family member to someone with epilepsy. Conclusion: The knowledge and attitudes towards epilepsy are similar to those in Europe, with the exception of a much lower acceptance regarding marriage to a person with epilepsy. However, the low acceptance for marrying someone with epilepsy reveals the remaining misconceptions about the nature of epilepsy in Iran, despite the high educational level in the studied population. Therefore, informational efforts must be employed to change the perception of epilepsy.

Place, publisher, year, edition, pages
CoAction Publishing, 2013
Keyword
epilepsy, attitudes, knowledge, stigma, Iran
National Category
Psychiatry Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-81700 (URN)10.3402/gha.v6i0.21618 (DOI)
Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2017-12-06Bibliographically approved
5. Internalized stigma of mental illness in Sweden and Iran: a comparative study
Open this publication in new window or tab >>Internalized stigma of mental illness in Sweden and Iran: a comparative study
2013 (English)In: Open Journal of Psychiatry, ISSN 2161-7325, E-ISSN 2161-7333, Vol. 3, no 4, 370-374 p.Article in journal (Refereed) Published
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-81702 (URN)10.4236/ojpsych.2013.34039 (DOI)
Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2017-12-06Bibliographically approved
6. On the experience of stigma by persons with epilepsy in Sweden and Iran: a comparative study
Open this publication in new window or tab >>On the experience of stigma by persons with epilepsy in Sweden and Iran: a comparative study
2013 (English)In: Seizure, ISSN 1059-1311, E-ISSN 1532-2688, Vol. 22, no 9, 748-751 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim of this paper is to compare the experience of stigma by persons with epilepsy in Sweden and Iran.

METHOD: An adapted version of the Internalized Stigma of Mental Illness Scale was completed by 130 persons with epilepsy in Tehran and 93 patients at a neurology clinic in Sweden.

RESULTS: The Swedish subjects reported a significantly lower level of experienced stigmatization than the Iranian patients, which we think is an effect of a more individualized medical treatment and a longer experience of health education in the Swedish society.

CONCLUSION: Improved seizure control, legislative measures and health education are major contributory factors for stigma reduction in a society as regards epilepsy and probably also other medical conditions.

Place, publisher, year, edition, pages
Saunders Elsevier, 2013
Keyword
Epilepsy, Internalized stigma, Iran; Perceived stigma, Sweden
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-81696 (URN)10.1016/j.seizure.2013.05.016 (DOI)23796412 (PubMedID)
Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2017-12-06Bibliographically approved

Open Access in DiVA

Ghanean_H(1243 kB)1542 downloads
File information
File name FULLTEXT01.pdfFile size 1243 kBChecksum SHA-512
3ac2be6b5f178035a788cd67a616feef0fa046aca97f51666398ea008b8c5a56786509183a44bb2170bac80f93794ee95beedc7eb86d29e116466add45b572fc
Type fulltextMimetype application/pdf

Authority records BETA

Ghanean, Helia

Search in DiVA

By author/editor
Ghanean, Helia
By organisation
Psychiatry
Psychiatry

Search outside of DiVA

GoogleGoogle Scholar
Total: 1542 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 705 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf