Intergenerational burden: deconstructing the dual impact of familial suicide in a specialized bipolar clinic, from clinical risk to internalized stigma
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: This study aimed to assess the level of internalized stigma in individuals with bipolar disorder (BD) during the euthymic phase and to examine its individual, familial, and clinical predictors. Method: Ninety-seven euthymic participants with BD, diagnosed according to DSM-5 criteria, were administered the Internalized Stigma of Mental Illness Scale (ISMI), Resilience Scale for Adults (RSA), and Rosenberg Self-Esteem Scale (RSES). Results: High levels of internalized stigma (ISMI mean ≥ 2.5) were found in 13.4% of participants. Multiple linear regression analysis showed that higher resilience (β = -0.39, p <.001) and higher educational attainment (β = -0.18, p = .029) were associated with lower internalized stigma, whereas a family history of death by suicide was associated with higher stigma (β = 0.20, p = .019). A greater number of mood episodes showed a borderline association with higher stigma (β = 0.18, p = .050). The overall model explained 52% of the variance in stigma scores. Limitations: The cross-sectional design and relatively small sample size are the primary limitations. Conclusions: Internalized stigma in BD was associated with a combination of individual, familial, and educational factors. The independent association of a family history of suicide underscores the importance of a systematic evaluation of such a family history in a clinical interview, suggesting that strengthening resilience and health literacy may represent vital targets for intervention.
Source: Frontiers in Psychiatry
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223023069