Identifying core stigmatizing beliefs about depression: results from an item-level statistical approach

Abstract

Introduction. Stigma surrounding depression continues to be a major barrier to treatment, social inclusion, and recovery. While general attitudes toward mental illness have been widely studied, fewer investigations have focused on the specific beliefs that drive stigma toward individuals with depression in a low- and middle-income country (LMIC) in Eastern European settings, particularly in Moldova. Material and methods. A cross-sectional study was conducted with a sample of 460 participants from Moldova, who completed the Depression Stigma Scale. Each of the nine items reflected a different stigmatizing belief about depression. Descriptive statistics, including mean scores and standard deviations, were calculated for each item. An item-level comparative analysis was performed. Results. The highest stigma scores were recorded for items such as: “I would not employ someone if I knew they had been depressed”, “Depression is not a real medical illness”, and “Depression is a sign of personal weakness.” The lowest scores were observed for beliefs related to dangerousness and avoidance, including “People with depression are dangerous” and “It is best to avoid people with depression so you don’t become depressed yourself.” These results suggest that stigma in Moldova is predominantly characterized by doubts about the medical legitimacy of depression and concerns over professional roles, rather than fear-based or exclusionary attitudes. Conclusions. Anti-stigma interventions in LMICs, such as Moldova should prioritize improving public understanding of depression as a legitimate health condition and addressing discrimination in professional settings.