Objective To systematically evaluate the relevant factors of stigma in patients with depression, and to provide evidence for the development of targeted intervention measures in clinical practice.

Methods PubMed, Web of Science, Embase, The Cochrane Library, CNKI, VIP, WanFang Data, and SinoMed databases were electronically searched to collect observational studies on the relevant factors of stigma in patients with depression from inception to June 16, 2026. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was performed using Stata 18.0 software to calculate pooled correlation coefficients (r) and 95% confidence intervals (CI).

Results A total of 33 studies were included, covering 9 countries and regions, involving 4,985 participants, and 25 relevant factors were extracted. Meta-analysis results showed that factors positively correlated with self-stigma included depression severity [r=0.368, 95%CI (0.281, 0.490)], marital status [r=0.108, 95%CI (0.044, 0.173)], living situation [r=0.328, 95%CI (0.120, 0.509)], number of hospitalizations [r=0.357, 95%CI (0.205, 0.491)], negative coping style [r=0.327, 95%CI (0.127, 0.501)], and number of daily medication types [r=0.283, 95%CI (0.162, 0.396)], all results were statistically significant (P < 0.05). Factors negatively correlated with self-stigma included education level [r=-0.211, 95%CI (-0.355, -0.074)], social support [r=-0.561, 95%CI (-0.971, -0.298)], self-efficacy [r=-0.566, 95%CI (-0.691, -0.408)], positive coping style [r=-0.200, 95%CI (-0.285, -0.112)], family income level [r=-0.167, 95%CI (-0.323, -0.003)], social support utilization [r=-0.701, 95%CI (-0.889, -0.313)], self-esteem [r=-0.493, 95%CI (-0.588, -0.385)], and quality of life [r=-0.548, 95%CI (-0.632, -0.451)], all results were statistically significant (P < 0.05).

Conclusion Self-stigma in patients with depression is associated with multiple factors. Social support, social support utilization, self-efficacy, quality of life, and self-esteem show relatively strong associations with self-stigma. Clinicians should identify relevant factors early and implement targeted preventive measures to reduce the level of self-stigma in patients with depressive disorder.

1. HerrmanH, PatelV, KielingC, et al. Time for united action on depression: a Lancet-World Psychiatric Association Commission[J]. Lancet, 2022, 399(10328): 957-1022. doi：10.1016/s0140-6736(21)02141-3

2. World Health Organization. Depression and other common mental disorders: global health estimates[EB/OL]. (2017)[2026-01-15]. https://iris.who.int/handle/10665/254610.

3. HuangY, WangY, WangH, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study[J]. Lancet Psychiatry, 2019, 6(3): 211-224. doi：10.1016/s2215-0366(18)30511-x

4. CorriganP. How stigma interferes with mental health care[J]. Am Psychol, 2004, 59(7): 614-625. doi：10.1037/0003-066x.59.7.614

5. DuN, ChongESK, WeiD, et al. Prevalence, risk, and protective factors of self-stigma for people living with depression: a systematic review and Meta-analysis[J]. J Affect Disord, 2023, 332: 327-340. . doi：10.1016/j.jad.2023.04.013

6. 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(4): 297-299.ZengXT, LiuH, ChenX, et al. Meta-analysis series 4: quality assessment tools for observational studies[J]. Chinese Journal of Evidence-Bases Cardiovascular Medicine, 2012, 4(4): 297-299.

7. RupinskiMT, DunlapWP. Approximating Pearson product-moment correlations from Kendall's tau and Spearman's rho[J]. EPM, 1996, 56(3): 419-429. doi：10.1177/0013164496056003004

8. BorensteinM, HedgesLV, HigginsJPT, et al. Introduction to Meta-analysis, 2nd ed[M]. Hoboken: John Wiley & Sons, 2021: 18-19. doi：10.1002/9781119558378

9. LenhardW, LenhardA. Computation of effect sizes[EB/OL]. (2017-10)[2026-01-15]. https://www.psychometrica.de/effect_size.html. doi：10.1093/oxfordhb/9780198733522.013.36

10. CohenJ. Statistical power analysis for the behavioral sciences, 2nd ed[M]. Hillsdale: Lawrence Erlbaum Associates, 1988: 79-81. doi：10.2307/2290095

11. Çalık ŞentürkHN, BildikT. Internalized stigma in adolescents with major depressive disorder and their parents: associations with functioning, help-seeking, beliefs, and social support[J]. Int J Soc Psychiatry, 2026, 72(6): 1734-1746. doi：10.1177/00207640261424410

12. KitakamiCS, TigumanGMB, VieiraMEB, et al. Factors associated with stigma and beliefs about psychotropics among the Japanese ancestry population diagnosed with depression in Brazil[J]. J Immigr Minor Health, 2025, 27(1): 74-84. doi：10.1007/s10903-024-01635-0

13. 李海燕, 温淑媛, 陈喜梅, 等. 抑郁症患者病耻感水平现状及其相关影响因素分析[J]. 中国当代医药, 2024, 31(8): 118-121.LiHY, WenSY, ChenXM, et al. Analysis of the current status of stigma levels in patients with depression and its related influencing factors[J]. China Modern Medicine, 2024, 31(8): 118-121.

14. YadavJ, MishraS, NischalA, et al. Relationship between stigma, self-esteem and quality of life among patients with depression at a tertiary care unit of North India: a cross-sectional study[J]. Minerva Psychiatry, 2023, 64(2): 226-232. doi：10.23736/s2724-6612.21.02246-6

15. 王哲. 抑郁倾向用户病耻感对在线健康社区参与行为影响机制研究[D]. 武汉: 华中科技大学, 2023.WangZ. Study on the influence mechanism of depressive tendency user stigma on online health community participation behavior[D]. Wuhan: Huazhong University of Science and Technology, 2023.

16. 冯丽, 黄月萍, 郑桂彬. 抑郁症患者病耻感现状及其影响因素[J]. 中国医学创新, 2022, 19(33): 90-93.FengL, HuangYP, ZhengGB. Current status and influencing factors of stigma in patients with depression[J]. Medical Innovation of China, 2022, 19(33): 90-93.

17. 曹晓慧. 抑郁症患者病耻感水平的因素分析[J]. 航空航天医学杂志, 2022, 33(1): 105-108.CaoXH. Analysis of factors affecting stigma level in patients with depression[J]. Journal of Aerospace Medicine, 2022, 33(1): 105-108.

18. 刘同巍, 裴欢, 张超峰. 抑郁症患者病耻感与抑郁情绪、社会支持及家庭功能的关系[J]. 临床护理杂志, 2021, 20(6): 2-5. doi：10.3969/j.issn.1671-8933.2021.06.001LiuTW, PeiH, ZhangCF. The relationship between stigma and depression,social support and family function in patients with depression[J]. Journal of Clinical Nursing, 2021, 20(6): 2-5. doi：10.3969/j.issn.1671-8933.2021.06.001

19. 李德重, 岳阳, 孙连峰, 等. 抑郁症患者病耻感现状及影响因素分析[J]. 国际精神病学杂志, 2021, 48(6): 1001-1003.LiDZ, YueY, SunLF, et al. The status and influencing factors of stigma of depression patients[J]. Journal of International Psychiatry, 2021, 48(6): 1001-1003.

20. WoonLS, KhooSI, BaharudinA, et al. Association between insight and internalized stigma and other clinical factors among patients with depression: a cross-sectional study[J]. Indian J Psychiatry, 2020, 62(2): 186-192. doi：10.4103/psychiatry.indianjpsychiatry_612_19

21. BharatV, HabarthJ, KeledjianN, et al. Association between subjective social status and facets of depression self-stigma[J]. J Community Psychol, 2020, 48(3): 1059-1065. doi：10.1002/jcop.22314

22. 周金运. 青少年抑郁症患者社会支持、病耻感和就医行为关系的研究[D]. 昆明: 昆明医科大学, 2020.ZhouJY. A study on the relationship among social support, stigma and medical behavior of adolescent depression patients[D]. Kunming: Kunming Medical University, 2020.

23. 谢军, 耿峰, 董毅, 等. 抑郁症患者童年期虐待与自我病耻感水平的相关性研究[J]. 中华全科医学, 2019, 17(7): 1171-1173.XieJ, GengF, DongY, et al. The correlational study between childhood trauma and self-stigma in depression[J]. Chinese Journal of General Practice, 2019, 17(7): 1171-1173.

24. RanMS, ZhangTM, WongIY, et al. Internalized stigma in people with severe mental illness in rural China[J]. Int J Soc Psychiatry, 2018, 64(1): 9-16. doi：10.1177/0020764017743999

25. 尹程. 住院抑郁症患者病耻感影响因素研究[D]. 南京: 南京师范大学, 2018.YinC. A study on influencing factors of stigma in hospitalized patients with depression[D]. Nanjing: Nanjing Normal University, 2018.

26. 谢红芬, 胡启梅, 王桂梅, 等. 门诊抑郁症患者病耻感现状及影响因素分析[J]. 护理管理杂志, 2018, 18(7): 466-469.XieHF, HuQM, WangGM, et al. Analysis of stigma status and influencing factors in outpatients with depression[J]. Journal of Nursing Administration, 2018, 18(7): 466-469.

27. 茅丽利. 首发抑郁症患者病耻感现状调查及影响因素分析[J]. 护理与康复, 2018, 17(11): 12-15. doi：10.3969/j.issn.1671-9875.2018.11.003MaoLL. Present situation investigation and influencing factors analysis on stigma of patients with first-episode depression[J]. Journal of Nursing and Rehabilitation, 2018, 17(11): 12-15. doi：10.3969/j.issn.1671-9875.2018.11.003

28. 韩树华. 探讨抑郁症患者自护能力及应对方式与自我病耻感的研究[J]. 国际护理学杂志, 2018, 37(23): 3180-3183. doi：10.3760/cma.j.issn.1673-4351.2018.23.004HanSH. Study on self-care ability, coping style and self-stigma of depressed patients[J]. International Journal of Nursing, 2018, 37(23): 3180-3183. doi：10.3760/cma.j.issn.1673-4351.2018.23.004

29. FengSJ, GaoHM, WangL, et al. Perceptions of stigma and its correlates among patients with major depressive disorder: a multicenter survey from China[J]. Asia Pac Psychiatry, 2017, 9(3): e12260. doi：10.1111/appy.12260

30. HolubovaM, PraskoJ, OciskovaM, et al. Self-stigma and quality of life in patients with depressive disorder: a cross-sectional study[J]. Neuropsychiatr Dis Treat, 2016, 12: 2677-2687. doi：10.2147/ndt.s118593

31. SedláckováZ, KamarádováD, PráskoJ, et al. Treatment adherence and self-stigma in patients with depressive disorder in remission - a cross-sectional study[J]. Neuro Endocrinol Lett, 2015, 36(2): 171-177.

32. 陈鲁, 陈宜刚, 林征, 等. 抑郁症患者自我效能与自我病耻感的相关性[J]. 江苏医药, 2015, 41(16): 1928-1930.ChenL, ChenYG, LinZ, et al. Relationship of self-efficacy and self-stigma in patients with depressive disorder[J]. Jiangsu Medical Journal, 2015, 41(16): 1928-1930.

33. 陈宜刚, 陈鲁, 周航, 等. 抑郁症患者生活质量与自我病耻感的相关性研究[J]. 中国全科医学, 2015, 18(16): 1950-1953. doi：10.3969/j.issn.1007-9572.2015.16.019ChenYG, ChenL, ZhouH, et al. Correlation between the life quality and self-stigma of patients with depressive disorder[J]. Chinese General Practice, 2015, 18(16): 1950-1953. doi：10.3969/j.issn.1007-9572.2015.16.019

34. GaudianoBA, MillerIW. Self-stigma and attitudes about treatment in depressed patients in a hospital setting[J]. Int J Soc Psychiatry, 2013, 59(6): 586-591. doi：10.1177/0020764012446404

35. 崔向军, 周亚青, 李丽娜, 等. 抑郁症患者的病耻感与应对方式的相关研究[J]. 中国健康心理学杂志, 2012, 20(6): 814-815.CuiXJ, ZhouYQ, LiLN, et al. Correlation between stigma and coping styles in patients with depression[J]. China Journal of Health Psychology, 2012, 20(6): 814-815.

36. 陈敏, 赵相英, 王爱琴, 等. 抑郁症患者的病耻感和社会支持研究[J]. 济宁医学院学报, 2012, 35(6): 405-406,409.ChenM, ZhaoXY, WangAQ, et al. Study of stigma and social support in depressive patients[J]. Journal of Jining Medical University, 2012, 35(6): 405-406, 409.

37. 张俊丽. 抑郁自我污名、自我效能感与社交回避的关系[D]. 开封: 河南大学, 2010.ZhangJL. The relationship among depression self-stigma, self-efficacy and social avoidance for the depression[D]. Kaifeng: Henan University, 2010.

38. 吴志国, 苑成梅, 王振, 等. 心境障碍患者自我病耻感及相关因素研究[J]. 上海交通大学学报(医学版), 2011, 31(11): 1527-1531.WuZG, YuanCM, WangZ, et al. Self-stigma in patients with mood disorders and its related factors[J]. Journal of Shanghai Jiaotong University (Medical Science), 2011, 31(11): 1527-1531.

39. ConnerKO, CopelandVC, GroteNK, et al. Mental health treatment seeking among older adults with depression: the impact of stigma and race[J]. Am J Geriatr Psychiatry, 2010, 18(6): 531-543. doi：10.1097/jgp.0b013e3181cc0366

40. BoreckiL, Gozdzik-ZelaznyA, PokorskiM. Personality and perception of stigma in psychiatric patients with depressive disorders[J]. Eur J Med Res, 2010, 15(Suppl 2): 10-16. doi：10.1186/2047-783x-15-s2-10

41. RuschLC, KanterJW, ManosRC, et al. Depression stigma in a predominantly low income African American sample with elevated depressive symptoms[J]. J Nerv Ment Dis, 2008, 196(12): 919-922.

42. WernerP, Stein-ShvachmanI, HeinikJ. Perceptions of self-stigma and its correlates among older adults with depression: a preliminary study[J]. Int Psychogeriatr, 2009, 21(6): 1180-1189. doi：10.1017/s1041610209990470

43. YenCF, ChenCC, LeeY, et al. Self-stigma and its correlates among outpatients with depressive disorders[J]. Psychiatr Serv, 2005, 56(5): 599-601. doi：10.1176/appi.ps.56.5.599

44. 张萌, 吕婷. 中国精神疾病患者病耻感研究的Meta分析[J]. 职业与健康, 2020, 36(8): 1124-1129.ZhangM, LyuT. Meta-analysis of the perceived stigma in Chinese people with mental disorder[J]. Occupation and Health, 2020, 36(8): 1124-1129.

45. 周英, 潘胜茂, 赵春阳, 等. 精神病患者病耻感状况及影响因素分析[J]. 中华现代护理杂志, 2014, 20(15): 1770-1773.ZhouY, PanSM, ZhaoCY, et al. Analysis of stigma status and influencing factors in psychiatric patients[J]. Chinese Journal of Modern Nursing, 2014, 20(15): 1770-1773.

46. Sabado-LiwagMD, PikeJR, ZamoraM, et al. Mental health self-stigma moderates the effect of social support on depression, anxiety and stress among young adult Pacific Islanders[J]. SSM Ment Health, 2025, 8: 100471. doi：10.1016/j.ssmmh.2025.100471

47. LiXH, ZhangTM, YauYY, et al. Peer-to-peer contact, social support and self-stigma among people with severe mental illness in Hong Kong[J]. Int J Soc Psychiatry, 2021, 67(6): 622-631. doi：10.1177/0020764020966009

48. WangDF, ZhouYN, LiuYH, et al. Social support and depressive symptoms: exploring stigma and self-efficacy in a moderated mediation model[J]. BMC Psychiatry, 2022, 22(1): 117. doi：10.1186/s12888-022-03740-6

49. KanterJW, BuschAM, WeeksCE, et al. The nature of clinical depression: symptoms, syndromes, and behavior analysis[J]. Behav Anal, 2008, 31(1): 1-21. doi：10.1007/bf03392158

50. 王华阳, 翁史旻, 李欣, 等. 精神分裂症患者自我病耻感与病耻抵抗调查及影响因素分析[J]. 国际精神病学杂志, 2018, 45(6): 1001-1004.WangHY, WengSM, LiX, et al. Self-illness disorder and sickness resistance in patients with schizophrenia and analysis of influencing factors[J]. Journal of International Psychiatry, 2018, 45(6): 1001-1004.

51. CortrightC, AnD, LansfordJE, et al. The relations among depressive symptoms, self-esteem, and optimism during adolescence: longitudinal evidence from nine countries[J]. Dev Psychopathol, 2025, 15: 1-12. doi：10.1017/s0954579425100497

52. ShimotsuS, HorikawaN. Self-stigma in depressive patients: association of cognitive schemata, depression, and self-esteem[J]. Asian J Psychiatr, 2016, 24: 125-129. doi：10.1016/j.ajp.2016.09.003

53. 童萍, 卜平, 董丽平, 等. 知行分析疗法治疗抑郁症的效果研究[J]. 中国全科医学, 2019, 22(9): 1096-1100.TongP, BuP, DongLP, et al. Effects of perceptual and behavioral analysis therapy on major depressive disorder[J]. Chinese General Practice, 2019, 22(9): 1096-1100.

54. HillmanLA, Peden-McAlpineC, Ramalho-de-OliveiraD, et al. The medication experience: a concept analysis[J]. Pharmacy (Basel), 2020, 9(1): 7. doi：10.3390/pharmacy9010007

55. 周佳男, 尹慧芳, 刘媛媛, 等. 不同年龄社区人群精神疾病病耻感及其影响因素分析[J]. 精神医学杂志, 2021, 34(1): 39-42, 46.ZhouJN, YinHF, LiuYY, et al. Analysis of stigma of mental illness and its influencing factors in community populations of different ages[J]. Journal of Psychiatry, 2021, 34(1): 39-42, 46.

56. LopezV, SanchezK, KillianMO, et al. Depression screening and education: an examination of mental health literacy and stigma in a sample of Hispanic women[J]. BMC Public Health, 2018, 18(1): 646. doi：10.1186/s12889-018-5516-4

57. HanssonL, LexénA, HolménJ. The effectiveness of narrative enhancement and cognitive therapy: a randomized controlled study of a self-stigma intervention[J]. Soc Psychiatry Psychiatr Epidemiol, 2017, 52(11): 1415-1423. doi：10.1007/s00127-017-1385-x

58. WangY, AnS, YangX, et al. Disease information disclosure among patients with mental illness and their family members in China[J]. Front Psychiatry, 2023, 13: 1036568. doi：10.3389/fpsyt.2022.1036568

59. CarrollK, WarnockCA, OndrusekA, et al. Substance use, stigma, and coping in treatment: a qualitative study of participant perspectives[J]. Drug Alcohol Depend Rep, 2025, 17: 100380. doi：10.1016/j.dadr.2025.100380