ABSTRACT Self‐stigma profoundly impacts psychological well‐being in individuals with bipolar disorder, yet the mechanisms underlying this relationship remain unclear. This study examined whether self‐compassion mediates the relationship between self‐stigma and psychological well‐being, whether treatment adherence moderates this mediating pathway, and whether age moderates the direct relationship. A cross‐sectional study was conducted with 121 outpatients diagnosed with Bipolar Type I Disorder receiving care at two hospitals in Eastern Türkiye between January 2024 and February 2025. Participants completed validated measures of self‐stigma, self‐compassion, and psychological well‐being during clinical remission. Data were analysed using mediation, moderated mediation, and simple moderation models with bootstrap procedures. Self‐stigma demonstrated a strong negative total effect on well‐being. Self‐compassion partially mediated this relationship, explaining 27% of the total effect. Critically, moderated mediation analysis revealed that treatment adherence significantly altered the strength of this mediating pathway. Among individuals with poor treatment adherence, self‐stigma more severely compromised self‐compassion, resulting in a substantially stronger indirect effect on well‐being compared to those with good adherence. The difference between these conditional indirect effects was statistically significant. Additionally, age moderated the direct relationship between self‐stigma and well‐being, with younger adults showing greater vulnerability than older adults, though age did not moderate the self‐compassion pathway. These findings identify self‐compassion as a key but conditionally effective protective mechanism against self‐stigma. Treatment adherence emerges as a critical factor that preserves this protective mechanism, suggesting that adherence promotion represents both a clinical and psychosocial intervention target for mental health nurses.
Yıldız et al. (Sun,) studied this question.