Attitude toward Depression in Thai Population
Objectives : This study aimed to examine the attitudes toward depression in each region of
Thailand and the factors associated with each attitude.
Methods : This cross-sectional descriptive study was conducted in Thai population aged
18 year and over. The Depression Stigma Scale was first translated into Thai, and then
distributed via Google Form. This cross-sectional descriptive study was conducted in Thai
population aged 18 and above. The questionnaire was translated into Thai and distributed
online via Google Form. It was divided into two sections: the first section surveyed demographic
data such as age, sex, hometown and years of education, and the second section was the
Depression Stigma Scale, which was further divided into two parts – personal stigma for
depression and perceived stigma for depression. Then, the demographic characteristics were
analyzed, and the score differences between each region compared. The correlations between
correlating socio-demographic data and the scores of each question item were compared
using multivariate regression analysis.
Results : The total number of respondents was 977, of which the majority was women (80.2%),
living in the central region of Thailand (51.59%). It was found that perceived stigma for
depression was higher than personal stigma. Each region was different in terms of the content
of attitudes and stigmas, and the highest level of stigma was found in the western region.
Higher levels of negative stigma were associated with male gender, younger age, no experience
with patients with mental illnesses, and higher educational level.
Conclusion : The contents of the public relation campaigns should be adapted to suit the
culture and beliefs in each region, and the target groups should be men, younger people,
people with no experience or familiarity with patients with mental illnesses, and people with
higher educational level.
Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock’s synopsis of psychiatry. 11th ed. 2015: 356-7.
Spijker J, Graaf R, Bijl RV, Beekman AT, Ormel J, Nolen WA. Functional disability and depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Acta Psychiatr Scand 2004; 110: 208-214.
Üstün T, Ayuso-Mateos J, Chatterji S, Mathers C, Murray C. Global burden of depressive disorders in the year 2000. Br J Psychiatry 2004; 184: 386-92.
Depression [Internet]. Who.int. 2019 [cited June 8, 2018]. Available from: https://www.who.int/ news-room/fact-sheets/detail/depression
Kongsuk T., Kittirattanapaiboon P., Kenbuboha K., Sukawaha S., Leejongpermpoon J. The prevalence of major depressive disorders in Thailand: results from the Epidemiology of Mental Disorders National Survey 2008. [Accessed June 13, 2013]. Available from: http:// www.dmh.go.th/downloadportal/Morbidity/ Depress2551.pdf.
Report on healthcare access in patients with depression:: [Internet]. Thaidepression.com. 2018 [cited June 9, 2018]. Available from: http://www.thaidepression.com/www/report/ main_report/
Goldman LS, Nielsen NH, Champion HC, Awareness, diagnosis and treatment of depression. J Gen Intern Med 1999; 14: 569-80.
Bramesfeld A, Grobe T, Schwartz FW. Who is treated, and how, for depression? An analysis of statutory health insurance data in Germany. Soc Psychiatry Psychiatr Epidemiol 2007; 42: 740-6.
Harman JS, Edlund MJ, Fortney JC., 2004. Disparities in the adequacy of depression treatment in the United States. Psychiatr Serv 2004; 55: 1379-85.
Prins M, Verhaak P, Smolders M, Laurant M, van der Meer K, Spreeuwenberg P et al. Patient Factors Associated with Guideline-concordant Treatment of Anxiety and Depression in Primary Care. J Gen Intern Med 2010; 25: 648-55.
Wang P, Aguilar-Gaxiola S, Alonso J, Angermeyer M, Borges G, Bromet E, et al. Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Lancet 2007; 370(9590): 841-50.
Goldney RD, Fisher LJ. Have Broad-Based Community and Professional Education Programs Influenced Mental Health Literacy and Treatment Seeking of those with Major Depression and Suicidal Ideation?. Suicide LifeThreat Behav 2008; 38: 129-42.
Jorm AF. Mental health literacy. Br J Psychiatry 2000; 177: 396-401.
Goldney R, Fisher L, Wilson D. Mental health literacy: an impediment to the optimum treatment of major depression in the community. Journal of Affective Disorders. 2001; 64(2-3): 277-284.
Angermeyer MC, Dietrich S. Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatr Scand 2006; 113: 163-79.
Jorm AF, Barney LJ, Christensen H, Highet NJ, Kelly CM, Kitchener BA. Research on mental health literacy: what we know and what we still need to know. Aust N Z J Psychiatry 2006; 40: 3-5.
Thornicroft G. Shunned: discriminating against people with mental illness. Oxford: Oxford University Press; 2006.
Mann CE, Himelein MJ. Factors Associated With Stigmatization of Persons With Mental Illness. Psychiatr Serv 2004; 55: 185-7.
Aromaa E, Tolvanen A, Tuulari J, Wahlbeck K. Predictors of stigmatizing attitudes towards people with mental disorders in a general population in Finland. Nord J Psychiatry 2011; 65: 125-32.
Wang J, Lai D. The relationship between mental health literacy, personal contacts and personal stigma against depression. J Affect Disord 2008; 110(1-2): 191-6.
Griffiths KM, Christensen H, Jorm A. Predictors of depression stigma. BMC Psychiatry 2008; 8: 25.
Angermeyer MC, Holzinger A, Matschinger H. Mental health literacy and attitude towards people with mental illness: A trend analysis based on population surveys in the eastern part of Germany. Eur Psychiatry 2009; 24: 225-32.
Mehta N, Kassam A, Leese M, Butler G, Thornicroft G. Public attitudes towards people with mental illness in England and Scotland, 1994-2003. Br J Psychiatry 2009; 194: 278-84.
Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K, et al. Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 2013; 381(9860): 55-62.
Calear AL, Griffiths KM, Christensen H. Personal and perceived depression stigma in Australian adolescents: Magnitude and predictors. J Affect Disord 2011; 129(1-3): 104-8.
Eisenberg D, Downs MF, Golberstein E, Zivin K. Stigma and Help Seeking for Mental Health Among College Students. Med Care Res Rev 2009; 66: 522-41.
Barney LJ, Griffiths KM, Jorm A, Christensen H. Stigma about Depression and its Impact on Help-Seeking Intentions. Aust N Z J Psychiatry 2006; 40: 51-4.
Coppens E, Van Audenhove C, Scheerder G, Arensman E, Coffey C, Costa S, et al. Public attitudes toward depression and help-seeking in four European countries baseline survey prior to the OSPI-Europe intervention. J Affect Disord 2013; 150: 320-9.
Yokoya S, Maeno T, Sakamoto N, Goto R, Maeno T. A Brief Survey of Public Knowledge and Stigma Towards Depression. J Clin Med Res 2018; 10: 202-9.
Griffiths K, Christensen H, Jorm A, Evans K, Groves C. Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression. Br J Psychiatry 2004; 185: 342-9.
WHO | Process of translation and adaptation of instruments [Internet]. Who.int. 2019 [cited October 7, 2019]. Available from: https://www. who.int/substance_abuse/research_tools/ translation/en/
The jamovi project (2019). jamovi (Version 0.9) [Computer Software]. Retrieved from https:// www.jamovi.org
Griffiths K, Nakane Y, Christensen H, Yoshioka K, Jorm A, Nakane H. Stigma in response to mental disorders: a comparison of Australia and Japan. BMC Psychiatry 2006; 6: 21.
Peluso É, Blay S. Public stigma in relation to individuals with depression. J Affect Disord 2009; 115: 201-6.
Sun Y, Chen G, Wang L, Li N, Srisurapanont M, Hong J, et al. Perception of Stigma and Its Associated Factors Among Patients With Major Depressive Disorder: A Multicenter Survey From an Asian Population. Front Psychiatry 2019; 10: 321.
Knodel J, Saengtienchal C, Sittitrai W. Living arrangements of the elderly in Thailand: Views of the populace. J Cross-Cult Gerontol 1995; 10: 79-111.
Abas M, Punpuing S, Jirapramukpitak T, Guest P, Tangchonlatip K, Leese M, et al. Rural-urban migration and depression in ageing family members left behind. Br J Psychiatry 2009; 195: 54-60.
Ingersoll-Dayton B, Saengtienchai C, Kespichayawattana J, Aungsuroch Y. Measuring psychological well-being: insights from Thai elders. Gerontologist 2004; 44: 596-604.
Cook TM, Wang J. Descriptive epidemiology of stigma against depression in a general population sample in Alberta. BMC Psychiatry 2010; 10: 29.