Supplementary Material for: Self-Perceived Stigmatization in Female Patients with Anorexia Nervosa - Results from an Explorative Retrospective Pilot Study of Adolescents

Background: The stigma of mental illness has been identified as an important barrier to treatment and recovery. Previous research reported the stigmatization of individuals with eating disorders by both health professionals and the general public. The aim of this pilot study was to empirically assess the previous stigmatization and discrimination experiences of young female patients with anorexia nervosa (AN) using a retrospective explorative approach. Methods: An in-house questionnaire that was developed to survey experiences of stigmatization was mailed to 75 former adolescent patients with AN. The mean time of assessment after discharge was 5.6 ± 1.2 years. The patients were asked to respond anonymously. The response rate was approximately 48% (n = 36). Results: Feelings that society held negative stereotypes of individuals with AN, concrete experiences of stigmatization and discrimination, and rejection by peers were reported. A remarkable degree of self-stigmatization, as indexed by high rates of agreement to stigmatizing statements, was detected. Approximately one third of the participants reported delayed initiation of treatment due to fear of stigmatization and discrimination. Conclusion: Stigmatization plays a decisive role in young patients with AN and impacts their motivation to seek professional help and engage in treatment. Clinicians should be aware of the stigmatization related to eating disorders and its burden for affected patients.

背景：精神疾病病耻感（stigma）已被明确为阻碍治疗与康复的关键障碍。既往研究证实，卫生专业人员与普通公众均会对进食障碍（eating disorders）患者实施污名化行为。本试点研究旨在采用回顾性探索方法，对青年女性神经性厌食症（anorexia nervosa, AN）患者既往经历的污名化与歧视经历进行实证评估。
方法：本研究研发了用于调查污名化经历的自制问卷，将其邮寄给75名曾为青少年的AN患者。受试者出院后至本次评估的平均间隔时长为5.6±1.2年，要求所有受试者匿名作答，最终回收率约为48%（n=36）。
结果：受试者报告称感知到社会对AN患者持有负面刻板印象，存在明确的污名化、歧视经历以及同伴排斥现象。通过对污名化相关表述的高认同率可发现，受试者存在显著程度的自我病耻感。约三分之一的参与者表示，因惧怕污名化与歧视而延迟了治疗启动。
结论：污名化对青年AN患者具有决定性影响，会削弱其寻求专业帮助与参与治疗的动机。临床医师应充分认识到进食障碍相关污名化及其对患者造成的沉重负担。