Trial document




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  DRKS00017281

Trial Description

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Title

Interview and questionnaire study on self-stigmatisation in addiction disorders and depressive disorders - how does this relate to previous experience, social environment and abstinence motives?

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Trial Acronym

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URL of the Trial

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Brief Summary in Lay Language

Stigmatisation is an important reason that prevents people with mental illness from going into professional treatment. In society, mental disorders such as schizophrenia, depression and addiction are stigmatised, with alcohol addicts experiencing the most stigmatisation. People who suffer from alcohol addiction often also suffer from depression. Stigmatisation has a negative impact on self-esteem, self-efficacy expectations, quality of life, social relationships, seeking help, adherence to treatment and the course of the disease. So far, there are few research-based approaches to reduce self-stigmatization (e.g. "I am responsible for my mental disorder"). Therefore, it is important to promote the development of such disorders.

The following hypotheses will be tested:
1. people with alcohol dependence and depressive disorder show a higher degree of self-stigmatisation than alcohol addicts without depressive disorder
2. there is a negative link between self-stigmatisation and self-esteem, quality of life, social support, treatment motivation and abstinence confidence.
3. there is a positive link between self-stigmatisation with previous traumatisation experiences, depression, and abstinence.
4. there are connections between consumption variables (e.g. severity of dependency) and self-stigmatisation.

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Brief Summary in Scientific Language

Stigmatisation is one of the most important barriers for people with mental illness to seek professional treatment. Over the past decades, no significant change in the stigmatization of mentally ill people in the general population has been observed. In society, psychological disorders such as schizophrenia, depression and addiction are strongly stigmatised. However, the public stigmatisation of these three disorders differs greatly, with people with addictions, especially alcohol dependence, experiencing the greatest stigmatisation (Rehm, Methers, Popoca, 2009; Schomerus, 2011). For example, they are seen much more often as responsible for their own illness. The stigmatisation of addictions in particular has hardly changed in the last two decades (Schomerus, Matschinger, Lucht, Angermeyer, 2014). In addition, depression and alcohol dependence are highly comorbid and it can be assumed that about 50% of people with addiction disorders also suffer from depression and that about 30% of people with depression have a comorbid substance-related mental disorder (Zimmerman M, Chelminski I, McDermut W., 2002). One effect of public stigmas is the internalisation of the stigmas, or in the presence of several stigmatised conditions of the different stigmata. This self-stigmatisation has a negative effect on self-esteem, self-efficacy expectation, quality of life, social relationships, behaviour in seeking help, adherence to treatment and the course of the disease (Büchter & Messer, 2017). So far, only a few approaches for interventions to reduce self-stigmatisation in mental illnesses are available and these have been less successful (Büchter & Messer, 2017). In addition, these interventions are rarely evidence-based (Guruge, Wang, Jayasuriya-Illesinghe, & Sidani, 2017) and are predominantly directed at patients with schizophrenia (Wood, Byrne, Varese, & Morrison, 2016). Therefore, it is necessary to examine the above relationships in order to promote the development of evidence-based interventions to reduce self-stigmatization in dependency diseases.
In order to provide a better evidence base for future interventions to reduce self-stigmatisation, the following hypotheses will be tested, which were generally confirmed in mental disorders but still provided contradictory or insufficient evidence in alcohol dependence:
1. People with alcohol dependence and depressive disorder show a higher degree of self-stigmatisation than people with alcohol dependence without depressive disorder
2. There is a negative correlation between self-stigmatisation and self-esteem, quality of life, social support, treatment motivation and abstinence confidence.
3. There is a positive correlation between self-stigmatization and previous traumatization experiences, depression, and abstinence desire.
4. There are connections between consumption variables and self-stigmatisation.

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Organizational Data

  •   DRKS00017281
  •   2019/05/24
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  •   yes
  •   Approved
  •   2019-651N, Medizinische Ethik-Kommission II Medizinische Fakultät Mannheim der Universität Heidelberg
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Secondary IDs

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Health Condition or Problem studied

  •   F10.2 -  Mental and behavioural disorders due to use of alcohol; Dependence syndrome
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Interventions/Observational Groups

  •   patients with alcohol dependency and comorbid depression

    are being assessed within one session during their inpatient or outpatient Treatment in an specialized addiction Treatment centre. Assessments are covering patients social Networks (Soziale Netzwerkanalyse - social network-Analysis), alcohol- and drug-use (Form90), self-stigmatisation (SSAD, SSMI), Trauma-experience (CTQ), Quality of life (WHO-QOL-BREF), Self-esteem (Rosenberg-scale), Abstinence-self-efficacy (AASE), Treatment- and Abstinence-motivation (open questions). Results will be compared to the results of the comparison Group without comorbid depression
  •   patients with alcohol dependency without comorbid depression

    are being assessed within one session during their inpatient or outpatient Treatment in an specialized addiction Treatment centre. Assessments are covering patients social Networks (Soziale Netzwerkanalyse - social network-Analysis), alcohol- and drug-use (Form90), self-stigmatisation (SSAD, SSMI), Trauma-experience (CTQ), Quality of life (WHO-QOL-BREF), Self-esteem (Rosenberg-scale), Abstinence-self-efficacy (AASE), Treatment- and Abstinence-motivation (open questions). Results will be compared to the results of the Group with comorbid depression
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Characteristics

  •   Non-interventional
  •   Observational study
  •   Non-randomized controlled trial
  •   Open (masking not used)
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  •   Other
  •   Other
  •   Parallel
  •   N/A
  •   N/A
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Primary Outcome

As primary endpoints we define the expression of the respective internalized stigmata in persons with alcohol dependence with and without comorbid depression.

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Secondary Outcome

In order to test the hypothetical relationships, quality of life, self-esteem, motivation for treatment, confidence in abstinence, social support and motives for abstinence are recorded as additional variables.

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Countries of Recruitment

  •   Germany
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Locations of Recruitment

  • Medical Center 
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Recruitment

  •   Planned
  •   2019/05/10
  •   200
  •   Monocenter trial
  •   National
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Inclusion Criteria

  •   Both, male and female
  •   18   Years
  •   65   Years
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Additional Inclusion Criteria

diagnosis of alcohol dependence and Informed Consent must be in writing ("Written Informed Consent")

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Exclusion Criteria

• Withdrawal of the declaration of consent
• Not sufficient knowledge of written and spoken German
• schizophrenia or acute psychotic disorder
• dementia
• Serious somatic disease that would interfere with questioning
• Acute suicidal tendency
• Acute intoxication
• Acute withdrawal symptoms

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Addresses

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    • Zentralinstitut für Seelische Gesundheit Mannheim
    • Mr.  Dr.  Ulrich  Frischknecht 
    • J5
    • 68159  Mannheim
    • Germany
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    • Zentralinstitut für Seelische Gesundheit Mannheim
    • Mr.  Dr.  Ulrich  Frischknecht 
    • J5
    • 68159  Mannheim
    • Germany
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    • Zentralinstitut für Seelische Gesundheit Mannheim
    • Mr.  Dr.  Ulrich  Frischknecht 
    • J5
    • 68159  Mannheim
    • Germany
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Sources of Monetary or Material Support

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    • Zentralinstitut für Seelische Gesundheit Mannheim
    • Mr.  Dr.  Ulrich  Frischknecht 
    • J5
    • 68159  Mannheim
    • Germany
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Status

  •   Recruiting planned
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Trial Publications, Results and other Documents

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