M Lanfredi1, S Zoppei2, C Ferrari3, C Bonetto2, T Van Bortel4, G Thornicroft5, L Knifton6, N Quinn6, G Rossi7, A Lasalvia2. 1. Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy. Electronic address: mlanfredi@fatebenefratelli.it. 2. Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy. 3. IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy. 4. Cambridge Institute of Public Health, University of Cambridge, Cambridge, United Kingdom. 5. Health Service and Population Research Department, Institute of Psychiatry, King's College London, Institute of Psychiatry, London, United Kingdom. 6. Centre for Health Policy, University of Strathclyde, Glasgow, United Kingdom. 7. Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy.
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.
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.
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