The general impact of self-stigma of mental illness on adult patients with depressive disorders: a systematic review.

BACKGROUND: Mental illness stigma is often common among mentally ill patients. This stigma can come from others or the patients themselves, which is called 'self-stigma'. The present study explored the widespread impacts of self-stigma on adult patients with depression. Additionally, this review compared the severity of self-stigma levels among psychiatric disorders and to review and update thoughts about self-stigma of depression. METHODS: An etiology and risk systematic review was conducted using the Joanna Briggs Institute (JBI) approach as a guideline. The search process was performed via research databases including MEDLINE, EMBASE and CINAHL. The inclusion criteria are studies include participants diagnosed with depressive disorders, both genders, participants' exposure to mental illness self-stigma, participants' experience of self-stigma consequences and any geographical site or clinical settings are included, the type of the included studies must be observational studies. The included studies were limited to the English language studies that were published from 2016 and onwards. Patients with depression under the age of eighteen and patients diagnosed with multiple mental illnesses were excluded. The JBI critical appraisal checklist were adopted to assess the risk of bias. RESULTS: In December 2022, a comprehensive search yielded eight cross-sectional studies that were included in this systematic review, involving a total of 783 patients diagnosed with depression, and 28 studies were excluded for not fulfilling the inclusion criteria of the review. The findings were extracted and synthesized through textual narrative synthesis into three main categories negatively affected by self-stigma of depression. These are: (1) the impact on the quality of life, (2) the impact on self-esteem and (3) the impact on self-worth. Moreover, in regard to the comparison of self-stigma levels among psychiatric disorders, self-stigma for people with schizophrenia was higher than self-stigma of depression. CONCLUSION: Self-stigma of depression has negatively impacted multiple aspects of the patient's life. Thus, the review brings the following recommendations: increase community awareness, educate the healthcare providers, include the topic of mental illness stigma in academic curriculums. The main limitation of the review is the limited number of included studies. TRIAL REGISTRATION: The research proposal for this review has been registered to Prospero (ID number: CRD42022366555).

Simultaneous Multiple Thromboembolic Events in a Postpartum Patient.

We report the case of a postpartum patient who presented to the emergency department in status epilepticus. She was initially treated for eclampsia; however, she was subsequently found to have simultaneous cerebral venous thrombosis (CVT) and pulmonary embolism (PE). While thromboembolic events may be seen frequently in the postpartum period, the combination of CVT and PE is an unusual occurrence. Although a challenging diagnosis, the emergency physicians played a critical role in the early recognition and rapid treatment of CVT in this case.