Objectives: The principal aim of this study was to investigate the potential interrelationship between the experience and impact of stigma and functioning on a Latin-American bipolar population. To our knowledge, these aspects have not been studied simultaneously on patients affected with bipolar disorder.

Methods: Two-hundred and forty-one participants with bipolar disorder were recruited through the research and mental services from Latin-American countries (Argentina, Brazil and Colombia). Functional impairment was assessed with the Functioning Assessment Short Test (FAST), an interview that evaluates disability. Stigma was evaluated with the Interview on Stigma and Discrimination (ISD), an instrument that has been developed for surveying mental health consumers and family members about their experiences with stigma and discrimination. The ISD is scored as two separate scales, the Stigma Experiences Scale (SES) and the Stigma Impact Scale (SIS). Symptoms were assessed using the YMRS and HAM-D.

Results: Functioning was associated with the SES and the SIS in Brazil and Colombia, but not in Argentina. Several variables had a bivariate association with the composite stigma score. After multilevel adjustment, however, only being on disability benefit, current depressive and (hypo) manic symptoms and functioning were associated with the perception of stigma.

Conclusions: This is the first study to demonstrate an association between stigma and functioning in bipolar disorder. The multicentric nature of the study strengthens this finding. We discuss here how this effect may come to existence and possible implications for practitioners who may want to lower the burden associated with stigma in bipolar disorder.