Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
In Reply: Dr Levinson and colleagues suggest that no distinction should be made between psychiatric and nonpsychiatric conditions with respect to social stigma. While this issue deserves more analysis, there is substantial literature documenting the pervasive problem of stigmatization of psychiatric conditions,1,2 and the data do not suggest that the stigma has improved in recent decades. The 1999 Surgeon General's report on mental illness states that "stigma in some ways intensified over the past 40 years even though understanding improved."3 In contrast, literature documenting significant social stigma from other common health conditions like cancer, diabetes, or heart disease is difficult to identify (although no one would claim that it does not occur). A 1994 study of women with breast cancer found no evidence of stigma and concluded that women "initially perceived themselves to have more emotional support, rather than less."4
Botkin JR. Protecting the Privacy of Family Members in Research—Reply. JAMA. 2001;285(15):1960–1963. doi:10.1001/jama.285.15.1960
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