Internalized Stigma and Quality of Life in Patients With Alcohol Use Disorder: A Cross-Sectional Study From Gujarat, India

Abstract

Substance use disorders (SUDs) contribute to one-fifth of all disability-adjusted life years caused by psychiatric illnesses. They have a high treatment gap. Stigma affects the lives of people with SUDs and is shown to impede the pursuit of valued life goals and recovery from addiction. We studied stigma and QOL in patients with Alcohol Use disorders (AUD). Participants between 18 and 65 years with a clinical diagnosis of AUD were included (inpatients and outpatients). Demographic and clinical data were recorded using a semi-structured questionnaire. ISMIS & WHOQOL-Bref questionnaires were used to assess internalized stigma and quality of life. Of the 141 participants, 89(63.10%) patients had severe self-stigma, 31(22.10%) patients had moderate self-stigma, and 21(14.90) patients had mild self-stigma. In ISMIS, stigma due to alienation (3.22) was higher than social withdrawal, discrimination, stereotype, and stigma resistance. In the WHOQOL-Bref questionnaire, the mean score of social domain (9.45) was the lowest compared to the other domains of the quality of life scale. A significant association was found between the education and the duration of substance use with ISMI grades with people with up to 10th standard education (p-value - 0.002*), living in urban areas (p-value - 0.022*), and ten or more years of substance use (p-value - 0.00002). The various domains of quality of life generally negatively correlated with the internalized stigma score, suggesting that a greater degree of self-stigma is associated with poorer quality of life.