Deconstructing stigma as a barrier to treating DGBI: Lessons for clinicians.
Jordyn H FeingoldDouglas A DrossmanPublished in: Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society (2021)
Stigma, defined as social devaluation based on negative stereotypes toward a particular population, is prevalent within health care and is a common phenomenon in disorders of gut-brain interaction (DGBI). Characteristically, DGBI including functional dyspepsia (FD) lack a structural etiology to explain symptoms, have high psychiatric co-morbidity, and respond to neuromodulators traditionally used to treat psychopathology. As a result, these disorders are frequently and wrongly presumed to be psychiatric and carry a great deal of stigma. Stigma has profound adverse consequences for patients, including emotional distress, medication non-adherence, barriers to accessing care, and increased symptoms. The basis for stigma dates back to the 17th Century concept of mind-body dualism. Patients and health care providers need to understand the factors that promote stigma and methods to ameliorate it. In this minireview, we address the data presented in Yan et al.'s (Neurogastroenterol Motil, 2020, e13956). We offer concrete solutions for clinicians to mitigate the impact of stigma to optimize treatment adherence and clinical outcomes for patients with DGBI.
Keyphrases
- mental health
- healthcare
- mental illness
- hiv aids
- social support
- end stage renal disease
- chronic kidney disease
- palliative care
- newly diagnosed
- prognostic factors
- depressive symptoms
- type diabetes
- emergency department
- patient reported outcomes
- machine learning
- electronic health record
- physical activity
- adipose tissue
- sleep quality
- antiretroviral therapy
- intellectual disability
- hiv infected
- autism spectrum disorder
- metabolic syndrome
- affordable care act
- replacement therapy
- social media