The Relationship Between Stigma and Mental Health in a Population of Individuals With COVID-19

Impact and Implications Results from this study suggest that, when treating individuals with COVID-19, particular attention should be paid to those with underlying mental health history and female gender because those individuals appear to be more at risk for experiencing stigma. This stigma could potentially lead to avoiding testing, treatments, or other health care services, including those related to prevention and treatment of COVID-19. Results from this study also indicate future research should include the longitudinal assessment of the association between stigma and mental health to determine the interaction over time, especially as COVID-19 continues to evolve. Purpose: Illness stigma has been observed across previous outbreaks including Ebola, SARS, HIV/AIDS, and now COVID-19. Although both the stigma of having COVID-19 as well as mental health impacts of COVID-19 have been studied, limited research exists regarding the relationship of stigma and mental health in this population. Thus, the primary purpose of the present study was to examine the relationship between stigma and mental health in adults with COVID-19. Method: Adult respondents with a diagnosis of COVID-19 (N = 632) completed an online questionnaire distributed between April 17, 2020, and April 18, 2021. The study measures included the Patient Health Questionnaire 8 (PHQ-8), the Generalized Anxiety Disorder 7-item (GAD-7), and the 8-Item Stigma Scale for Chronic Illness (SSCI-8) tailored to measure perceived stigmatization from a COVID-19 diagnosis. Results: Participants (mean age = 51) were mostly female (71%), White (73%), married (70%), obese (56%), and had a chronic health condition (56%). Female sex, education status, working from home or not working owing to COVID-19, previous mental health diagnosis, history of chronic illness, and being a current/former smoker were associated with higher stigma scores, whereas older age and Black race were associated with lower stigma scores. Conclusions: Greater stigma and psychological distress was observed in females with a previously diagnosed psychiatric illness and/or chronic health condition. Our findings suggest a disproportionate burden of mental health/psychiatric symptoms/sequelae, including stigma and PTSD, among COVID-19 survivors with a history of mental illness. Further studies are needed to fully characterize COVID-19 related stigma and subsequent mental health experiences.