Internalized stigma: One of the main factors responsible for the psychosocial burden of melasma?

Abstract

Background Internalized stigma is the acceptance of negative stereotypes about the disease created by society and withdrawing self from society with emotions such as worthlessness and shame. Aims This study aimed to investigate the internalized stigma state of patients with melasma, and to identify the factors affecting the internalized stigma. Methods A total of 55 melasma patients were included. The sociodemographic and clinical characteristics of the patients were recorded. Melasma Severity Index, the Turkish version of the Melasma Quality of Life Scale (MelasQoL-TR), and Internalized Stigma Scale (ISS) were used. Besides, patients answered the Perceived Health Status (PHS) and the General Health Questionnaire 12 scales (GHQ-12) surveys. Results The mean ISS total score was found as 49.49 +/- 13.15. Cronbach's alpha coefficient for the whole scale was calculated as 0.92 for melasma patients. There was a significant correlation between the ISS total score and MelasQoL-TR (r = 0.608,P < .001). Besides, statistically significant positive correlations were also found between the overall scores of ISS and GHQ-12 (r = 0.578,P < .001). Linear regression analysis revealed that the most important determinant of internalized stigma was MelasQoL-TR (beta = 0.313,P < .001). Conclusions This study demonstrates that patients with melasma internalize the negative stereotype judgments of the society about the disease. High levels of internalized stigma are related to poor quality of life and psychological illnesses. Therefore, internalized stigma may be one of the main factors responsible for the psychosocial burden of melasma.