Background: Both stigma and psychological distress affect quality of life (QOL). The objectives of this study are to determine the effects of these two factors on QOL and to explore possible mediation between psychological distress and self-stigma in opioid-dependent individuals.
Methods: A total of 268 treatment-seeking opioid dependent individuals were interviewed using the brief version of the World Health Organization Quality of Life instrument (WHOQOL-BREF), the Self-Stigma Scale-Short (SSS-S), the Chinese Health Questionnaire-12 (CHQ-12), and the Opiate Treatment Index (OTI). Multiple linear regression models were constructed to determine if the SSS-S and CHQ-12 predict the WHOQOL-BREF scores, and a comparison of potential mediation effects of psychological distress was made (as assessed by the CHQ-12) between the SSS-S and the WHOQOL-BREF.
Results: The CHQ-12 score was predictive of the scores for the four domains and almost all facets of the WHOQOL-BREF except the item, “Dependence on medical aids.[sm1] ” The significant predictive effects of the SSS-S score on 14 of the 26 facets of the WHOQOL-BREF were reduced to 5, with three in the social domain, after the adjustment of the CHQ-12 score. Psychological distress completely mediated the relation between self-stigma and the physical, psychological, environmental domains, and partially mediated the relationship between self-stigma and the social QOL domains.
Conclusions: Psychological distress has a significant impact on the QOL of treated opioid users. It appears to be a core element in reducing the negative effects of self-stigma on aspects of QOL.
Key words: Opioid, self-stigma, quality of life, psychological distress.