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. 2025 Jul 1;5(1):94.
doi: 10.1007/s44192-025-00237-y.

Self-stigma, insight and related factors among major depressive disorder, general anxiety disorder and obsessive-compulsive disorder patients: a cross-sectional study from Iran

Ayda Ayoubi  1 , Ali Amirkafi  2 , Seyed Vahid Shariat  1 , Sana Movahedi  1 , Mohammadreza Shalbafan  3   4
Affiliations

Self-stigma, insight and related factors among major depressive disorder, general anxiety disorder and obsessive-compulsive disorder patients: a cross-sectional study from Iran

Ayda Ayoubi et al. Discov Ment Health. .

Abstract

Background: Self-stigma toward psychiatric disorders is a major barrier to help-seeking and treatment adherence, significantly impacting patients' quality of life. Insight is one of the key factors influencing internalized stigma. Therefore, this study aims to assess the relationship between self-stigma and insight among patients with Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), and Obsessive-Compulsive Disorder (OCD).

Methods: A total of 140 participants included individuals diagnosed with MDD, GAD and OCD who had not experienced recurrent episodes over the past six months with convenience sampling. They were recruited from the outpatient clinics of the Tehran Psychiatry Institute and the Brain and Cognition Clinic in Tehran, Iran, between July 2021 and June 2022. Self-stigma was assessed using the Mental Illness Stigma Scale, a 34-item questionnaire in which higher scores indicate greater stigma. Insight was evaluated using three agree/disagree statements regarding self-identification as mentally ill, perceived need for psychiatric consultation, and perceived need for psychiatric medication.

Results: A total of 140 patients were included in the study. Of these, 89 (63.6%) considered themselves mentally ill, 126 (90%) acknowledged the need for psychiatric consultation, and 113 (80.7%) recognized the need for psychiatric medication. The mean stigma score was 64.5 ± 21.0. Patients who recognized the need for psychiatric consultation and medication had significantly higher stigma scores compared to those who did not (p = 0.002, d = 0.87 and p = 0.003 d = 0.66 respectively).

Conclusions: As one of the few studies examining the association between stigma and insight in patients with MDD, GAD and OCD, this research serves as a foundation for further exploration in this field. The current findings show that the recognition of need for psychiatric consultation as well as medication had significantly higher self-stigma compared to those who did not among participants.

Keywords: Generalized anxiety disorder; Insight; Major depressive disorder; Mental health; Obsessive compulsive disorder; Psychiatry; Social stigma.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Before the subjects entered the study, we gave them information about the questionnaires, data privacy, voluntary nature and benefits of participation; they were free to accept or retract their data, and it didn’t have any effect on their treatment process; finally, written consent was obtained from all of the participants. This study was conducted according to the declaration of Helsinki and subsequent revisions and approved by the Ethics Committee of the Iran University of Medical Sciences with the code IR.IUMS.FMD.REC.1399.885. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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