Stigma Resistance and Its Associated Factors among People with Bipolar Disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.

Background: Stigma resistance is the capacity to cope and remain unaffected by mental illness stigmatization. In bipolar patients, having low stigma resistance may result in a higher internalized stigma, low self-esteem, and poor treatment outcome. In Ethiopia, the prevalence of stigma resistance among bipolar patients is not well known. Therefore, this study is aimed at assessing the prevalence of stigma resistance and its associated factors among bipolar patients at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.

Method: An institutional-based cross-sectional study was conducted from May 8^th to June 14^th, 2016, at Amanuel Mental Specialized Hospital. The study participants were selected using a systematic random sampling technique. The stigma resistance subscale of the internalized stigma of mental illness was used to measure stigma resistance. Bivariable and multivariable logistic regression was computed to identify factors associated with stigma resistance. Accordingly, variables with P values of less than 0.05 were considered as statistically significant predictors of stigma resistance with a 95% confidence interval.

Results: In this study, 418 participants completed the interview with a response rate of 98.8%. The prevalence of low stigma resistance was 56.9% (95%CI = 51.9-61.6%). Being unemployed (AOR = 1.65; 95%CI = 1.35-1.87), high internalized stigma (AOR = 3.04; 95%CI = 1.83-5.05) and low self-esteem (AOR = 2.13; 95%CI = 1.72-6.76) were significantly associated with low stigma resistance. Conclusions and Recommendation. More than half of the bipolar patients attending the Amanuel Mental Specialized Hospital had low stigma resistance. Therefore, stigma reduction programs have focused on improving self-esteem and reducing internalized stigma to increase their stigma resistance. Mental health information dissemination regarding community support and reengagement of people with bipolar disorder is highly recommended.