Experienced discrimination and internalized stigma among people infected with SARS-CoV-2 and surviving COVID-19: Association with anxiety, depression, and insomnia symptoms

Abstract

People surviving COVID-19 may experience social stigma related to their condition even after clinical recovery. This study aimed to: (1) investigate COVID-19-related experienced discrimination and internalized stigma, and (2) explore their association with symptoms of anxiety, depression, and insomnia. We conducted an online survey of people who survived COVID-19. Perception of stigma was assessed using the COVID-19 Experienced Discrimination Scale and the COVID-19 Internalized Stigma Scale. Depression, anxiety, and insomnia were assessed using, respectively, the Patient Health Questionnaire-9, the General Anxiety Disorder Scale-7, and the Insomnia Severity Index. Multivariable logistic regression analyses for each psychopathological domain were performed. A total of 579 participants participated in this study. Overall, 25% reported some degree of experienced discrimination, and 23% reported some degree of internalized stigma. Adjusted odds ratio showed that scoring higher on internalized stigma related significantly to higher symptoms of depression (2.14; 95% confidence interval [CI], 1.35–3.39), anxiety (2.30; 95% CI, 1.48–3.59), and insomnia (2.54; 95% CI, 1.64–3.95), whereas experienced discrimination was associated to anxiety (1.55; 95% CI, 1.06–2.28) and insomnia (1.82; 95% CI, 1.24–2.69). Experiences of social stigmatization are frequent among people surviving COVID-19 and seem to be associated with levels of psychological disturbances. Further research is required to elucidate the direction of these relationships to implement effective treatment strategies.