Relationship between internalized stigma and sleep in individuals with bipolar disorder

Aim: The aim of this study was to determine the relationship between internalized stigma and sleep in patients with bipolar disorder. Material and Method: This study was conducted with 35 individuals diagnosed with bipolar disorder in the euthymic period, in a cross-sectional, descriptive, and correlational design. In data collection, the Internalized Stigma of Mental Illness Scale (ISMI) and the Pittsburgh Sleep Quality Index (PSQI) were used. In the analysis of descriptive data, mean, standard deviation, minimum, maximum number, and percentage were used. Whether the scale scores and numerical variables showed normal distribution was examined using Kurtosis and Skewness. Because of the limited sample size and number of individuals in the groups, non-parametric tests were preferred. The relationship between the two scales was analyzed using the Pearson correlation test. For comparing the scales based on sociodemographic variables, the Mann-Whitney U test was used for binary variables, and the Kruskal-Wallis test was used for variables with three or more categories. Results: The mean age of the participants was 38.60 (9.72) years. A statistically significant moderate positive correlation was found between the duration of protective treatment and the mean total score on the PSQI for the participants. Additionally, it was determined that the mean total scores of the ISMI and PSQI were statistically different between the groups based on response to protective treatment. It was determined that the mean total ISMI scores were statistically significantly lower in those who received a poor response to protective treatment compared to those who received a moderate or good response. Similarly, it was found that the mean total PSQI scores were statistically significantly higher in those who received a poor response to protective treatment compared to those who received a good response. The PSQI and response to protective treatment were found to be statistically significant predictors of the ISMI (R2=0.52). Conclusion: In this study, it can be said that individuals diagnosed with bipolar disorder have poor sleep quality, experience a moderate level of internalized stigma, and there is a moderately positive relationship between sleep and stigma. It is recommended that mental health and psychiatric nurses develop psychotherapeutic interventions to reduce the stigma levels and improve the sleep quality of individuals diagnosed with bipolar disorder, and integrate them into the nursing care plan. Keywords: Bipolar Disorder, Sleep, Stigma, Internalized Stigma