2 articles
Stigmatization is a social phenomenon that adversely affects not only access to care but also the quality of medical services. In the medical context, stigma occurs when patients – or even healthcare professionals – are treated differently, with prejudice or a lack of empathy, due to certain traits, conditions, or social affiliations.
We conducted a narrative review of stigma in healthcare settings. Searches were performed in PubMed/MEDLINE and Google Scholar, and complemented by consulting official public-health websites (WHO, ECDC, UNAIDS, Romanian MoH/NIPH) for the period 1 Jan 2000 – 27 Jul 2025 (English/Romanian). Search strategies combined terms related to stigma/discrimination, healthcare/quality of care, and vulnerable groups, with backward- and forward-citation tracking. Two reviewers screened against predefined criteria (peer-reviewed studies, reviews, authoritative institutional reports). Opinion pieces, non-healthcare contexts, duplicates, and inaccessible full texts were excluded, and evidence was synthesized qualitatively.
Stigma in healthcare appears as discriminatory behavior that fosters exclusion, leading to delayed diagnoses, treatment abandonment, and loss of trust in the system. Vulnerable groups – such as people living with HIV/AIDS, those with mental disorders, LGBTQ+ individuals, substance users, the homeless, and ethnic minorities – are most affected. HIV-positive patients often face avoidance, while those with psychiatric conditions may be seen as “unpredictable” or dangerous. Such attitudes harm patients’ health, deepen inequities, and erode the core ethics of equity and respect. Stigma undermines the patient–provider relationship, discouraging preventive care and adherence to treatment, and can cause complete disengagement. For providers, stigma fosters “dehumanization,” unconscious bias, and skewed clinical decisions, leading to substandard care. Healthcare workers experiencing their own health issues may internalize stigma, avoid seeking help, and compromise the care they deliver.
Health-related stigma is widespread and takes multiple forms, profoundly degrading the quality of medical care and hindering patients’ access to services. Medical stigma generates serious systemic consequences: patients delay seeking treatment, avoid interacting with the health system, suffer emotional distress and burnout, and face extreme difficulty with social reintegration. These realities underscore the need for strategic interventions in professional education, legislation, and public awareness to combat stigma in healthcare.
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.
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.
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.
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.