Volume 26, Issue 2 (Summer 2020)                   IJPCP 2020, 26(2): 240-256 | Back to browse issues page


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Rezvanifar F, Shariat S V, Amini H, Rasoulian M, Shalbafan M. A Scoping Review of Questionnaires on Stigma of Mental Illness in Persian. IJPCP 2020; 26 (2) :240-256
URL: http://ijpcp.iums.ac.ir/article-1-3087-en.html
1- Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran.
2- Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran.
3- Department of Psychiatry, Roozbeh Psychiatry Hospital, Tehran University of Medical Sciences, Tehran, Iran.
4- Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran. , shalbafan.mr@iums.ac.ir
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1. Introduction
atients with mental illness generally face two major issues related to their disorder: they should deal with not only different signs and symptoms of their disorders (including anxiety, delusion, hallucination, etc.) but also with the concurrent social stigma of mental illness. The families of the patients with mental illness usually feel embarrassed and guilty about the disorder of their relative and would also experience similar social isolation and stigma. 
Despite the progress in the treatment of mental disorders in recent decades, the social stigma of mental illness still exists and affects the patients with mental illness and their families as well as mental health personnel. For appropriate planning for the needs of the patients with mental illness, it is necessary to study different aspects of stigma in various sub-populations. 
To adequately address the need for precise assessment of the social stigma of mental illness, we need valid and reliable assessment tools. Due to the limited access to questionnaires to assess the social stigma of mental illness in Persian, we planned to review all of the assessment tools related to the social stigma of mental illness, which have been designed in Iran or translated into Persian.
2. Methods
We searched for both Persian and English sources. We searched the English databases, including PubMed, Google Scholar, Scopus, and PsycINFO, along with the Persian databases, including IranMedex, Scientific Information Database, Irandoc, and Magiran. We did not limit our searches for a specific period. For English databases, we combined three keywords of “Stigma” OR its related words, “Mental Health” OR its related words, and “Iran” OR the related words using the AND operator. For Persian databases we used only the Persian equivalent terms for “stigma” and no Boolean search was used. 
Our search yielded 289 articles and 248 theses. Only 25 articles and 7 theses met our inclusion criteria of studying stigma, using a questionnaire in English and Persian. After removing shared questionnaires, we found 21 distinct stigma questionnaires. Then, we emailed the corresponding authors of all of the articles, and informing them about our study asked them to send us a copy of the questionnaire and surveys that they used in their study. We also asked their permission to publish the full text of their questionnaire as an appendix to our article. Finally, we gathered the whole data on 19 questionnaires.
3. Results
Twenty-one questionnaires and surveys were used to assess 'stigma' in the Persian language that included: Social Distance Item, Perceived Dangerousness of Mental Patients Item, The Attribution Questionnaire, The Level of Familiarity Scale, Attitudes toward Seeking Professional Psychological Help, Knowledge and Attitude about Patients with Mental Disorders and Epilepsy, Experience of Caregiving Inventory, Internalization of Stigma for Mothers of Children with Disability, Opening Minds Scale for Health Care Providers, Perceived Stigma of Mental Illness in Nurses, Opinion about Mental Illness, Depression Stigma Scale, Stigma Scale, The Parents Internalized Stigma of Mental Illness Scale, Family Caregiver’s Stigma toward Patients with Mental Illness, Opening Minds Scale for Health Care Providers, Stigma in Patients with Mental Disorders, Perceived Stigma Questionnaire, Cognitive Appraisal of Stigma-related Stress, Rejection Sensitivity Questionnaire and Perceived Stigma Scale-Revised. We could not find the Persian version of the Rejection Sensitivity Questionnaire and Perceived Stigma Scale.
4. Discussion 
Most of the questionnaires and surveys of the social stigma of mental illness in Persian were translated version from other languages except four questionnaires that have been originally developed and validated in Persian. These four questionnaires include the Internalization of Stigma for Mothers of Children with Disability, Family Caregiver’s Stigma toward Patients with Mental Illness, Perceived Stigma Questionnaire, and Perceived Stigma of Mental Illness in Nurses. Only two questionnaires assessed the stigma of mental illness within the general population (Knowledge and Attitude about Patients with Mental Disorders and Epilepsy, Opinion about Mental Illness). However, eight questionnaires are available to assess the stigma of mental illness in caregivers or family members of patients with mental disorders. 
There are ten questionnaires for assessment of stigma of mental illness in health care providers, and medical and nursing students as future care providers. Few questionnaires and surveys are available in Persian for assessment of stigma in patients themselves. In the world literature, most of the questionnaires have been developed to assess stigma in the general population and then in patient. However, most of the questionnaires and surveys studied in Iran are related to care providers and students and then related to caregivers or family members of the patients. Limited questionnaires are available for assessment of stigma in general population and patients.  Furthermore, we did not find any questionnaires for assessment of stigma in children and adolescents. Most of the questionnaires and surveys that are being used in Persian are translations from an English questionnaire. Interestingly, some of the questionnaires are used for a different target population than the original questionnaire without clear justifications. 
Ethical Considerations
Compliance with ethical guidelines

For all reviewed questionnaires, necessary permissions were obtained from their authors. Because of the type of article (Review), there was no need for obtaining ethical approval.
Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 
Authors contributions
Conceptulization and design: Farahnaz Rezvanifar, Seyed Vahid Shariat, and Mohammadreza Shalbafan; Data collection: Farahnaz Rezvanifar, Mohammadreza Shalbafan, and Maryam Rasoulian; Initial draft preparation: Farahnaz Rezvanifar and Homayoun Amini; Editing & review: All authors.
Conflicts of interest
The authors declared no conflict of interest.


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Type of Study: Rewie | Subject: Psychiatry and Psychology
Received: 2019/09/9 | Accepted: 2020/02/12 | Published: 2020/07/1

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