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Yalçın N, Özkan GG, Allegaert K, Ak S, Demirkan K. Web Survey of Turkish Pharmacy Students Comparing First and Fifth Years' Antidepressant Awareness and Stigmatizing Attitudes Regarding Depression and Anxiety. PHARMACY 2024; 12:45. [PMID: 38525725 PMCID: PMC10961788 DOI: 10.3390/pharmacy12020045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/21/2024] [Accepted: 02/29/2024] [Indexed: 03/26/2024] Open
Abstract
The prevalence of depression and anxiety has increased day by day. Prejudice, self-stigma, and public stigma, on the other hand, continue to prevent patients from seeking adequate treatment, particularly in traditional communities. In this web-based, cross-sectional study, both the presence of depression and anxiety, and the knowledge, attitude, and awareness of first- and fifth (final)-year pharmacy students were examined via an online survey. The aim was to demonstrate the potential impact of public information and five years of pharmacy school on knowledge, attitude, and awareness. Our study population consisted of first- and fifth-year pharmacy students enrolled in one faculty of pharmacy during the spring semester of 2022-2023. The Beck Depression Inventory and Beck Anxiety Scale were utilized to measure the presence of depression and anxiety, while the Depression and Antidepressant Awareness and Knowledge Scale (DAKAS) was applied to assess their knowledge, attitude, and awareness. Fifth-year participants (n = 101) exhibited noticeably fewer stigmatizing attitudes than first-year participants (n = 104) (p < 0.05). There was no statistically significant difference between the mean Beck Depression Inventory and Beck Anxiety scores in first- and fifth-year pharmacy students. Being in the fifth class (OR: 3.690; p = 0.025), being of female gender (OR: 4.653; p < 0.001), and having a relationship with someone who took a psychotropic (OR: 3.060; p = 0.008) were associated with a lower overall stigma score by multiple linear regression analysis. The students' awareness of antidepressants and familiarity with mental health issues at the end of their pharmacy education were higher and stigmatization behavior was lower than in first-year students. The positive attitudes at the end of their training towards depression will reduce the likelihood of future pharmacists' patients from being exposed to stigmatization, prevents the formation of an additional stress factor, and likely will improve pharmacy practices.
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Affiliation(s)
- Nadir Yalçın
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, 06230 Ankara, Türkiye;
| | - Gökçe Gül Özkan
- Faculty of Pharmacy, Hacettepe University, 06230 Ankara, Türkiye;
| | - Karel Allegaert
- Department of Pharmaceutical and Pharmacological Sciences, 3000 Leuven, Belgium;
- Department of Development and Regeneration, 3000 Leuven, Belgium
- Department of Hospital Pharmacy, Erasmus Medical Center, 3015GD Rotterdam, The Netherlands
| | - Sertaç Ak
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, 06230 Ankara, Türkiye;
| | - Kutay Demirkan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, 06230 Ankara, Türkiye;
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Szekely R, Mason O, Frohlich D, Barley E. 'It's not everybody's snapshot. It's just an insight into that world': A qualitative study of multiple perspectives towards understanding the mental health experience and addressing stigma in healthcare students through virtual reality. Digit Health 2024; 10:20552076231223801. [PMID: 38188857 PMCID: PMC10768613 DOI: 10.1177/20552076231223801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/14/2023] [Indexed: 01/09/2024] Open
Abstract
Objective The resurgence of virtual reality (VR) technologies has led to their increased use in contemporary healthcare education. One promising application is simulating the experiences of individuals with mental health conditions (MHCs) to reduce stigma among future healthcare professionals. This study set out to explore what those impacted by, or involved in, the education of healthcare students think about using VR in this way. Methods One individual interview and five focus groups were conducted with healthcare students (n = 7), healthcare educators (n = 6), and lived experience experts (n = 5). Before sharing their perspectives, participants familiarised themselves with VR equipment and immersive materials simulating MHCs. The constant comparative method and thematic analysis were used to analyse the data. Results Participants recognised the acceptability and utility of VR for addressing mental health stigma in healthcare students, emphasising the immersive nature of this technology. However, some participants raised concerns about the limited insight VR could provide into the experiences of patients with the same MHCs and its potential emotional impact on users. Participants recommended the incorporation of interactive, realistic environments with a person-centred focus into future VR-based stigma reduction interventions while stressing the importance of providing healthcare students with opportunities for reflection and support. Conclusions Healthcare students, healthcare educators, and lived experience experts highlighted both advantages and barriers associated with using VR to understand the experience of patients with MHCs. Furthermore, the recommendations put forward can inform the design, content, and delivery of VR-based stigma reduction interventions in healthcare education.
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Affiliation(s)
- Raul Szekely
- School of Psychology, University of Surrey, Guildford, UK
| | - Oliver Mason
- School of Psychology, University of Surrey, Guildford, UK
| | - David Frohlich
- Digital World Research Centre, University of Surrey, Guildford, UK
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Rees A, Cuthbert C, Shah V, Rong L, Peh D, Baptista A, Smith S. Medical student perceptions of mental illness: a cross-sectional transnational study in two medical schools. BMC MEDICAL EDUCATION 2023; 23:981. [PMID: 38124141 PMCID: PMC10731839 DOI: 10.1186/s12909-023-04962-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Despite shifting global attitudes, mental illness remains highly stigmatised amongst practicing doctors. This has wider implications on doctors' training to care for patients with mental illness. There is need for exploration of the presence and mitigation of stigma in early medical education to prevent such attitudes propagating into clinical practice. Thus, this study explores whether stigmatising attitudes are detectable amongst medical students in London and Singapore and examines whether they are ameliorated by specific curricular and welfare features of formal medical education, utilising the Mental Illness Stigma Framework (MISF). METHODS A mixed-methods approach was adopted. Medical students at Imperial College London (UK; n = 211) and Nanyang Technological University (Singapore; n = 141) completed a validated scale (the OMS-HC-15) to assess attitudes towards mental illness. Semi-structured interviews were conducted (Imperial: n = 12, NTU: n = 8) until theoretical saturation was reached. Quantitative data were analysed descriptively and comparatively using SPSS and interview data subjected to inductive thematic analysis. RESULTS Total OMS-HC-15 scores ranged from 19-51 for Imperial (n = 211) and 16-53 for NTU (n = 141). No significant differences in overall stigma scores were found between the two schools (p = 0.24), nor when comparing year groups within each school. Four themes were identified across interview data: student perceptions, impacts of medical school culture, university support, and curricular impacts on mental illness perceptions. Themes allowed identification of aspects of medical school that were well-received and warranted further emphasis by students, alongside areas for improvement. CONCLUSION Mental health stigma was identified in two medical schools, with differing cultures. Mean stigma scores obtained were comparable between both UK and Singaporean medical students. Nuanced differences were identified via subgroup analysis, and the MISF identified both shared and country-specific drivers for this stigma across the qualitative data. Actionable recommendations to mitigate this were hypothesised. Curricular improvements such as earlier psychiatric teaching and sharing of personal stories may improve future stigma scores as students' progress through the course. Specific welfare-based changes to formal support systems were also deemed to be beneficial by students. The impacts of welfare and curricular redesign in relation to societal influence on students' attitudes warrants further investigation, as does medical students' self-stigma.
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Affiliation(s)
- Annie Rees
- School of Medicine, Imperial College London, London, UK.
| | | | - Viraj Shah
- School of Medicine, Imperial College London, London, UK
| | - Lim Rong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Daniel Peh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Ana Baptista
- School of Medicine, Imperial College London, London, UK
- Medical Education Research Unit, Faculty of Medicine, Imperial College London, London, UK
| | - Susan Smith
- Medical Education Research Unit, Faculty of Medicine, Imperial College London, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
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Bouyssi A, Prebois S, Rougé-Bugat ME, Dupouy J, Driot D. [Stigmatisation of patients with mental disorders by medical interns specialising in general practice: A national survey]. L'ENCEPHALE 2023; 49:65-71. [PMID: 36253178 DOI: 10.1016/j.encep.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The objective was to assess the level of stigmatisation of psychiatric patients by medical interns specialising in general practice (GP), and to assess the influencing factors of stigmatisation. METHODS A national survey was carried out among interns in general practice (GP) contacted through their local associations from December 10, 2019 to March 9, 2020. An online questionnaire was diffused. The validated French version of the Mental Illness Clinicians' Attitudes (MICA) was used to measure stigmatising attitudes towards psychiatry and persons with psychiatric disorder by the interns. This 16-item scale is designed to measure attitudes of health care professionals towards people with mental illness with scores ranging from 16 to 96 (the most stigmatizing). Several covariates were collected: socio-demographics, personal experiences with mental health, and mental health trainings during medical studies. All questionnaires were strictly anonymized. Comparative analyses of the MICA score by group were performed using Student's tests. RESULTS A total of 389 interns responded. The majority of respondents were female (n=277; 71%) and the mean age was 27years [standard deviation (SD)±2.39]. The mean MICA rate was 40.64 (SD±8.09) for a neutral score of 56, reflecting low overall stigmatizing attitudes. MICA scores were significantly lower among female interns (40.11 vs. 41.95; P=0.042), those who had benefited from personal psychological or psychiatric support (38.70 vs. 41.61; P=0.001), and those who had completed a psychiatric externship (39.47 vs. 42.16; P=0.001). CONCLUSIONS GP interns had an attitude that is generally not very stigmatizing even if its improvement should still be sought. This is particularly verified among those who have completed a psychiatric internship during their externship. This suggested association should be supported by other studies. The stakes are high for the future management of patients since stigmatisation by a physician is strongly implied in the worse healthcare management of patients with psychiatric disorders, leading them to a shorter lifespan.
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Affiliation(s)
- A Bouyssi
- Département universitaire de médecine générale, université Paul-Sabatier Toulouse III, 133, route de Narbonne, 31062 Toulouse, France
| | - S Prebois
- Centre hospitalier universitaire Toulouse Purpan, service de psychiatrie, place du Dr-Baylac, TSA 40031, 31059 Toulouse cedex 9, France
| | - M-E Rougé-Bugat
- Département universitaire de médecine générale, université Paul-Sabatier Toulouse III, 133, route de Narbonne, 31062 Toulouse, France; UMR 1295 CERPOP Inserm, université Paul-Sabatier, 37, allées Jules-Guesde, 31000 Toulouse, France
| | - J Dupouy
- Département universitaire de médecine générale, université Paul-Sabatier Toulouse III, 133, route de Narbonne, 31062 Toulouse, France; UMR 1295 CERPOP Inserm, université Paul-Sabatier, 37, allées Jules-Guesde, 31000 Toulouse, France
| | - D Driot
- Département universitaire de médecine générale, université Paul-Sabatier Toulouse III, 133, route de Narbonne, 31062 Toulouse, France; UMR 1295 CERPOP Inserm, université Paul-Sabatier, 37, allées Jules-Guesde, 31000 Toulouse, France.
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ÇİLEK NZ, AKKAYA C. A Review on Mental Illness and Stigma. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2022. [DOI: 10.18863/pgy.1069845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The concept of stigma is a universal problem that has been the subject of many studies. The phenomenon of stigmatization in psychiatric disorders is also an issue that should be particularly emphasized. Studies have reported that the diagnostic groups most exposed to stigmatization are psychotic disorders, bipolar disorders, depressive disorders, anxiety disorders, and substance use disorders. The stigma process is shaped especially by the clinical features of psychiatric disorders and the society’s attributions to the causes of psychiatric disorders. IIn order for interventions to be developed to prevent stigmatization to be effective, the causes of stigmatization must first be understood.. Therefore, in this study, it is aimed to review the stigmatization processes separately according to the types of psychiatric disorders.
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Atienza-Carbonell B, Hernández-Évole H, Balanzá-Martínez V. A "patient as educator" intervention: Reducing stigmatizing attitudes toward mental illness among medical students. Front Public Health 2022; 10:1020929. [PMID: 36620261 PMCID: PMC9811258 DOI: 10.3389/fpubh.2022.1020929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction This pre-post quasi-experimental pilot study aimed to assess the degree of stigma toward mental illness and whether a single, direct-contact "patient as educator" intervention with people with mental illness can reduce the degree of stigma among medical students. Methods All second-year medical students from the University of Valencia were invited to voluntarily complete the Community Attitudes Toward the Mentally Ill (CAMI), Reported and Intended Behavior Scale (RIBS), and Mental Health Knowledge Scale (MAKS) questionnaires before and after participating in the formal medical psychology course. A "patient as educator" workshop with expert patients was organized in the middle of the semester. A total of 127 students completed the survey; 20 students participated in the workshop (workshop group), and the remaining 107 students only took the formal educational course, forming the control group. Results At baseline, the groups were demographically matched and did not differ in the components of stigma or knowledge of mental illness. After the intervention, a greater reduction in the CAMI subscales of authoritarianism and social restriction was observed in the workshop group than in the control group. In the workshop group, scores for the benevolence subscale of the CAMI decreased more among women than men. In the control group, scores for the authoritarianism and benevolence subscales of the CAMI increased and decreased significantly more, respectively, in women than men. No significant changes were observed in scores for the RIBS at post-intervention in either group. Discussion The results of this pilot study suggest that a brief, direct-contact intervention in addition to formal medical education may further help reduce stigmatizing attitudes during the first years of medical school.
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Affiliation(s)
- Beatriz Atienza-Carbonell
- Department of Medicine, University of Valencia, Valencia, Spain,Faculty of Health Sciences, Valencian International University, Valencia, Spain
| | | | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, Universitat de València, Valencia, Spain,Center for Biomedical Research in Mental Health Network (CIBERSAM), Health Institute, Carlos III, Madrid, Spain,Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders (TMAP), University of Valencia, Valencia, Spain,*Correspondence: Vicent Balanzá-Martínez
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Le Glaz A, Lemey C, Berrouiguet S, Walter M, Lemogne C, Flahault C. Physicians' and medical students' beliefs and attitudes toward psychotic disorders: A systematic review. J Psychosom Res 2022; 163:111054. [PMID: 36272378 DOI: 10.1016/j.jpsychores.2022.111054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 10/02/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to analyze physicians' and medical students' (MS) beliefs and attitudes toward people with psychotic disorders. METHODS This systematic review follows the PRISMA guidelines. It was conducted on 5 databases (Pubmed, PsycINFO, Pascal & Francis, Scopus and EMBASE) with a keyword string combining words for physicians' and students' professional status, attitudes toward people, and psychotic disorders. No limitations on publication dates were imposed. RESULTS This review includes 39 articles, among which quantitative studies are in the majority, and general practioners are mainly represented. Schizophrenia is the main condition used to illustrate psychotic disorders and measure stigmatizing attitudes. Physicians' and MS' beliefs toward people with psychotic disorders are mainly represented by dangerousness and unpredictability. They can be reinforced with socio-demographic criteria (age and female gender) or physicians' beliefs about the disease's etiology. The desire for social distance is higher toward patients with schizophrenia compared to other psychiatric disorders, and medical care could be impacted with a tendency to refer them at psychiatric specific care or to anticipate their difficulties and to modify their treatment plan. Stigma scores remain globally high during medical training. Even if specific anti-stigma trainings have a positive impact on beliefs and attitudes, these effects do not last in time. CONCLUSION This review highlights the importance to explore physicians' and medical students' representations about patient with psychosis to understand better their difficulties in the management of these patients.
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Affiliation(s)
- A Le Glaz
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France.
| | - C Lemey
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France.
| | - S Berrouiguet
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France; TIM, INSERM, UMR 1101, Brest, France.
| | - M Walter
- Brest Medical University Hospital, Université de Bretagne Occidentale, EA 7479 SPURBO, Brest, France; IMT Atlantique, Lab-STICC, UMR CNRS 6285, F-29238, Brest, France.
| | - C Lemogne
- Department of Psychiatry and Addictology, AP-HP.Centre-Université de Paris, Paris, Île-de-France, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.
| | - C Flahault
- Université de Paris, LPPS, F-92100 Boulogne-Billancourt, France; U.F. de Psychologie et Psychiatrie de Liaison et d'Urgences DMU Psychiatrie et Addictologie, AP-HP Centre Université de Paris, France.
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Nakanishi E, Tamachi M, Hashimoto T. Effectiveness of a Co-Production with Dialogue Program for Reducing Stigma against Mental Illness: A Quasi-Experimental Study with a Pre- and Post-Test Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14333. [PMID: 36361212 PMCID: PMC9654388 DOI: 10.3390/ijerph192114333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/24/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
For people with mental illnesses, stigma represents a barrier to social participation. Health professionals, including students, often hold stigma toward such individuals, Further, people with a mental illness often have self-stigma. This study aimed to both develop and examine the effectiveness of a new program based on co-production with dialogue for reducing stigma among both health science students and people with mental illnesses. This was a quasi-experimental study, with a pre- and post-test design and no control group. The sample comprised 28 university students majoring in occupational therapy and 20 community-dwelling people with mental illnesses. The Co-Production with Dialogue Program for Reducing Stigma (CPD-RS) was administered to this sample. Link's Devaluation Discrimination Scale (DDS) was used to assess whether the program reduced stigma. Compared to their preintervention scores, the students' postintervention DDS scores significantly decreased, persisting for at least one month, but those of people with mental illnesses showed no significant change. Both the students and the people with mental illnesses evaluated the program as "positive" through a questionnaire administered two months after the intervention. These results suggest that the CPD-RS reduces health science students' stigma toward people with mental illnesses and fosters mutual understanding between the two groups.
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Affiliation(s)
- Eiichi Nakanishi
- Department of Occupational Therapy, Faculty of Health Sciences, Bukkyo University, 7 Nishinokyo, Higashi-toganoo-cho, Nakagyo-ku, Kyoto 604-8418, Japan
- Department of Physical Therapy, Faculty of Health Sciences, Aino University, 4-5-4 Higashi-Ohda, Ibaraki City 567-0012, Japan
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 654-0142, Japan
| | - Masahiro Tamachi
- Department of Physical Therapy, Faculty of Health Sciences, Aino University, 4-5-4 Higashi-Ohda, Ibaraki City 567-0012, Japan
| | - Takeshi Hashimoto
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 654-0142, Japan
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Sher DA, Gibson JL, Sher HE. 'We've come a very, very, long way' Overcoming stigma of autism: An interpretative phenomenological analysis within the UK Jewish community. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:2066-2083. [PMID: 35317657 PMCID: PMC9597152 DOI: 10.1177/13623613221075099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Autistic people contend with high levels of stigma in a wide array of cultures worldwide. There is a scarcity of literature on stigma in relation to autism in faith communities, with some limited research on this issue in Christian, Muslim and Hindu populations. There is virtually no research focussing on this topic in Jewish communities and to our knowledge, none at all within UK Jewish contexts. In this study, we aimed to explore experiences of stigma towards autism and sought views on what steps have and can be taken to reduce such stigma. Using an interpretative phenomenological analysis approach, we conducted semi-structured interviews with 10 participants within the UK Jewish community, including parents, rabbis, SENDCos, teachers, and headmasters of autistic children in both mainstream and specialist autistic schools. Interviews were conducted over 2 months in 2020. During analysis, 5 superordinate (central) themes and 13 subordinate themes were abstracted from the data. Superordinate themes included 'Stigma not specific to the Jewish community'; 'Considerable strides made'; 'More a lack of knowledge or denial than stigma'; 'Fear of stigma is a real concern but not widely prevalent'; and 'Potent factors that reduce stigma in the Jewish community'. We recommend workshops for greater awareness and training for teachers and parents on autism and autistic children's experiences. We also recommend the formation of specialist autism schools in other communities and promotion of positive narratives concerning autistic people, as this successfully reduced stigma within the Jewish community.
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The impact of psychiatric education and clinical practice on students' beliefs toward people with mental illnesses. Arch Psychiatr Nurs 2022; 40:56-59. [PMID: 36064246 DOI: 10.1016/j.apnu.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 02/15/2022] [Accepted: 05/02/2022] [Indexed: 11/21/2022]
Abstract
It is common knowledge that people with psychiatric illnesses are stigmatized by a broad spectrum of society. The purpose of this study was to assess the beliefs of undergraduate students toward people with mental illnesses, and determine the impact of psychiatric education and clinical practice on their beliefs. A Quasi-Experimental, single-group pre-test post-test design was used. The study was performed at a private school of health sciences in Saudi Arabia. The study sample consisted of 42 students. For data collection, the Beliefs toward Mental Illness Scale was used. Following the psychiatric education and clinical practice, the total BMIS and subscale scores were significantly lower than the scores obtained before the course. There was a statistically significant difference in the BMIS total scores (t = 2.17, p = 0.001) and subscale scores (Poor social and interpersonal skills: t = 0.78, p = 0.001; Dangerousness: t = 1.17, p = 0.001; Incurability: t = 0.42, p = 0.001) between the pre-test and post-test data. This research indicates that psychiatric educational intervention using face-to-face interaction and clinical practice interaction can positively change stigmatizing beliefs of undergraduate students toward people with mental illnesses.
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Lin CH, Lai TY, Chen YJ, Lin SK. Social distance towards schizophrenia in health professionals. Asia Pac Psychiatry 2022; 14:e12506. [PMID: 34915596 DOI: 10.1111/appy.12506] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/06/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The stigma and prejudice of the public regarding psychiatric disorders are a long-standing social problem. However, health professionals are more likely to have negative attitudes and label people with mental health conditions. This study aimed to investigate how self-rated familiarity and literacy about schizophrenia are related to social distancing towards schizophrenia patients among health professionals in Taiwan. METHOD This study used a cross-sectional questionnaire survey and invited respondents to complete the survey either electronically or in a pencil/paper format. Respondents included health professionals in different disciplines and students under medical placements. The survey instrument consists of three parts: sociodemographic information, the 18-item Social Distance Scale for schizophrenia, and the 19-item Schizophrenia Experience and Knowledge Questionnaires. Data were analyzed using linear regression models to explore sociodemographic factors, self-rated familiarity, and literacy total scores about social distance, attitude, and opinions towards schizophrenia. RESULT In total, 420 health professionals completed the questionnaire, of which 24.5% were physicians, 36.0% nurses, 6.7% pharmacists, and 28.6% interns. The majority of respondents (n = 360, 85.7%) had contact experience with schizophrenia patients, and approximately 60% rated their experience as a positive impression. Although 62.9% of respondents had received psychiatric education or training, 86% believed that such education/training was insufficient. Moreover, over half of the respondents did not have confidence in their knowledge of schizophrenia. Older age, being married, and having more working experience were associated with high social distance, a negative attitude, and high prejudice. More familiarity with schizophrenia was associated with low social distance, a positive attitude, and less prejudice. A high literacy score was associated with a positive attitude and less prejudice, but no significant correlation was observed with social distance (β ± SE = -0.26 ± 0.14, p = .057). Among respondents who rated their past contact experiences as negative, neither familiarity nor literacy was associated with social distance. CONCLUSION High levels of self-rated familiarity and high literacy about schizophrenia were associated with low social distance, a positive attitude, and less prejudice towards schizophrenia among health professionals. Therefore, sufficient education and training are imperative to increase familiarity and knowledge of schizophrenia. Appropriate education could be implemented from different perspectives, including communication skills, resources of social support, and topics to reduce stigma and prejudice.
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Affiliation(s)
- Chen-Hua Lin
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Tzu-Yu Lai
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.,Division of Radiation Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yu-Jen Chen
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.,Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC.,Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Shun-Ku Lin
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.,Department of Chinese Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC.,Center of the General Education, University of Taipei, Taipei, Taiwan, ROC
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Kaligis F, Hillary R, Kusuma NMP, Sianipar HRP, Ramadhanti CS, Findyartini A, Indraswari MT, Magdalena CC, Nurraga GW. Medical students’ attitudes toward psychiatry in Indonesia. PLoS One 2022; 17:e0265605. [PMID: 35324955 PMCID: PMC8947139 DOI: 10.1371/journal.pone.0265605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 03/04/2022] [Indexed: 12/04/2022] Open
Abstract
Nearly two-thirds of psychiatric patients are reluctant to seek help from healthcare professionals due to stigma, discrimination, and negligence that evolve around the community, including healthcare providers. Future health professionals should have a positive attitude toward psychiatry and patients with mental health problems. Thus, it is vital to identify medical students’ attitudes toward psychiatry as future healthcare providers. The authors conducted a cross-sectional study by using online questionnaires of “Perceptions of Psychiatry” in Faculty of Medicine Universitas Indonesia, with first- and fourth-year students (before psychiatric rotation), as well as fifth-year students and alumni (after psychiatric rotation). Out of 250 questionnaires distributed, 224 subjects responded, with a response rate 89.6%. Chi-square or fisher analysis was conducted to know the correlation between gender and attitudes towards psychiatry. The frequency distribution method was applied to identify the degree of stigmatization from respondents. A mix of positive and negative perceptions towards psychiatry was identified. The overall response was favorable to both before and after psychiatric rotation groups. Differences in perceptions between male and female psychiatry students as a discipline and career were statistically significant. Correcting misapprehension and removing the stigma on psychiatry during medical education might decrease the stigma in the psychiatric field and patients.
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Affiliation(s)
- Fransiska Kaligis
- Faculty of Medicine Universitas Indonesia, Department of Psychiatry, Jakarta, Indonesia
- Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
- * E-mail:
| | - Ribka Hillary
- Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | | | | | | | - Ardi Findyartini
- Medical Education Unit, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | | | | | - Garda Widhi Nurraga
- Faculty of Medicine Universitas Indonesia, Department of Psychiatry, Jakarta, Indonesia
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Munir K, Oner O, Kerala C, Rustamov I, Boztas H, Juszkiewicz K, Wloszczak-Szubzda A, Kalmatayeva Z, Iskandarova A, Zeynalli S, Cibrev D, Kosherbayeva L, Miriyeva N, Jarosz MJ, Kurakbayev K, Soroka E, Mancevska S, Novruzova N, Emin M, Olajossy M, Bajraktarov S, Raleva M, Roy A, Waqar Azeem M, Bertelli M, Salvador-Carulla L, Javed A. Social distance and stigma towards persons with serious mental illness among medical students in five European Central Asia countries. Psychiatry Res 2022; 309:114409. [PMID: 35121341 DOI: 10.1016/j.psychres.2022.114409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 02/02/2023]
Abstract
The study investigated behavioral measures of social distance (i.e., desired proximity between self and others in social contexts) as an index of stigma against those with mental illness among medical students in the Republic of North Macedonia, Turkey, Azerbaijan, Kazakhstan, and Poland, using the Reported and Intended Behavior Scale (RIBS), a standardized, self-administered behavioral measure based on the Star Social Distance Scale. The students' responses to standardized clinical vignettes on schizophrenia, and depression with suicidal ideation, were also assessed. A total of 257 North Macedonian (females, 31.5%; 1-4 grades, 189; 5-6 grades, 68); 268 Turkish (females, 43.3%; 1-4 grades, 90; 5-6 grades, 178); 450 Kazakh (females, 28.4%, 71.6%; 1-4 grades, 312; 5-6 grades, 138); 512 Azerbaijani (females, 24%; 1-4 grades, 468; 5-6 grades, 44; females, 24%), and 317 Polish (females, 59.0%; 1-4 grades, 208; 5-6 grades, 109) students were surveyed. The responses on the RIBS social distance behavior measures did not improve with advancing medical school grade, but students across all sites viewed schizophrenia and depression as real medical illnesses. The results support the development of enhanced range of integrated training opportunities for medical student to socially interact with persons with mental illness sharing their experiences with them.
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Affiliation(s)
- Kerim Munir
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA; World Psychiatric Association, Geneva, Switzerland.
| | - Ozgur Oner
- World Psychiatric Association, Geneva, Switzerland; Bahcesehir University School of Medicine, Istanbul, Turkey
| | - Coskun Kerala
- Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
| | | | | | - Konrad Juszkiewicz
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan; Al-Farabi Kazakh National Medical University, Almaty, Kazakhstan
| | | | | | | | | | - Dragan Cibrev
- Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
| | - Lyazzat Kosherbayeva
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan; Al-Farabi Kazakh National Medical University, Almaty, Kazakhstan
| | | | | | | | | | - Sanja Mancevska
- Faculty of Human Sciences, University of Economics and Innovation, Lublin, Poland
| | | | - Melda Emin
- Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
| | | | - Stojan Bajraktarov
- Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
| | - Marija Raleva
- Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
| | - Ashok Roy
- World Psychiatric Association, Geneva, Switzerland; Coventry and Warwickshire Partnership NHS Trust, Birmingham, UK
| | - Muhammad Waqar Azeem
- World Psychiatric Association, Geneva, Switzerland; Department of Psychiatry, Sidra Medicine, Weill Cornell Medicine, Doha, Qatar
| | - Marco Bertelli
- World Psychiatric Association, Geneva, Switzerland; CREA (Centro Ricerca E Ambulatori), Fondazione San Sebastiano, Florence, Italy
| | - Luis Salvador-Carulla
- World Psychiatric Association, Geneva, Switzerland; Health Research Institute, Faculty of Health, University of Canberra, Australia
| | - Afzal Javed
- World Psychiatric Association, Geneva, Switzerland; Warwick Medical School, University of Warwick, UK
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14
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Stigmatizing attitudes and social perception towards mental illness among Moroccan medical students. Encephale 2022; 49:275-283. [DOI: 10.1016/j.encep.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/29/2021] [Accepted: 01/05/2022] [Indexed: 11/20/2022]
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15
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Newton-Howes G, Senior J, Beaglehole B, Purdie GL, Gordon SE. Does a comprehensive service user-led education programme effect more positive attitudes towards recovery and less stigmatising attitudes towards people with lived experience of mental distress in medical students? A comparative cohort study. Aust N Z J Psychiatry 2021; 55:903-910. [PMID: 33459033 DOI: 10.1177/0004867420987886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study sought to investigate the impact of a service user-led anti-stigma and discrimination education programme, encompassing numerous interventions focused on facilitating multiple forms of social contact, the promotion of recovery, and respect for human rights, on medical student attitudes. METHOD A comparison cohort study was used to compare the attitudes of two cohorts of medical students who received this programme as part of their fifth (the fifth-year cohort) or sixth (the sixth-year cohort) year psychological medical education attachment (programme cohorts) with two cohorts of equivalent students who received a standard psychological medical attachment (control cohorts). Attitudes to recovery (using the Recovery Attitudes Questionnaire) and stigma (using the Opening Minds Scale for Healthcare Providers) were measured at the beginning and end of the attachments for each year and compared both within and between the cohorts using Wilcoxon signed-rank or Wilcoxon rank-sum tests. RESULTS With sample sizes ranging from 46 to 70 across all cohorts, after their psychological medicine attachment both the programme and control cohorts showed more positive attitudes towards recovery and less stigmatising attitudes towards people with lived experience of mental distress. Significant differences between the programme cohorts and the control cohorts were found for recovery attitudes (median difference of 2, p < 0.05 in both fifth and sixth year), with particularly large differences being found for the 'recovery is possible and needs faith' subdomain of the Recovery Attitudes Questionnaire. There were no significant between cohort differences in terms of stigmatising attitudes as measured by the Opening Minds Scale for Healthcare Providers. CONCLUSION The introduction of a comprehensive service user-led anti-stigma and education programme resulted in significant improvements in recovery attitudes compared to a control cohort. However, it was not found to be similarly superior in facilitating less stigmatising attitudes. Various possible reasons for this are discussed.
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Affiliation(s)
- Giles Newton-Howes
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Jessica Senior
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Ben Beaglehole
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Gordon L Purdie
- Dean's Department, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Sarah E Gordon
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
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Attitudes towards People with Mental Illness and Low Interest in Psychiatry among Medical Students in Central and Eastern Europe. Psychiatr Q 2021; 92:407-418. [PMID: 32780288 DOI: 10.1007/s11126-020-09817-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study aimed to examine attitudes towards people with mental illness and psychiatry and interest in career choice in psychiatry among medical students from three medical schools in Czechia and Slovakia. A total of 495 medical students participated in a cross-sectional study. Participants completed (1) the Medical students' version of mental illness: clinicians' attitudes (MICA-2) scale, (2) the Reported and intended behaviour scale (RIBS), (3) the Attractiveness of working on a psychiatry-related position scale (P-ATTRACT), and (4) the Status of psychiatry scale (P-STATUS). Descriptive statistics, group comparisons and regression models were calculated. From 23 to 30% of students considered a specialization in psychiatry. However, only about 1% of them had a strong interest in psychiatry as a future career, moreover, students of higher years of study found psychiatry less attractive compared to those who are in the beginning of the study. The consideration of specialization in psychiatry was found to be statistically significantly associated with less stigmatizing attitudes and lower social distance towards people with mental illness. There were statistically significant differences in stigmatizing attitudes among medical schools, with a medical school emphasizing the education in psychiatry the most showing more positive attitudes. It is necessary to increase the interest in psychiatry and minimize stigma among medical students. Psychiatry curriculum in Central and Eastern European region should include more psychiatry-related courses, training in community and out-patient facilities, peer-lectors, and offer counselling after exposure to emotionally challenging clinical situations.
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Sideli L, Ferraro L, Cascia CL. Opinions about people with schizophrenia among medical students: Findings from an Italian cross-sectional study. Indian J Psychiatry 2021; 63:204-206. [PMID: 34194071 PMCID: PMC8214115 DOI: 10.4103/psychiatry.indianjpsychiatry_197_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/17/2020] [Accepted: 07/07/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Lucia Sideli
- Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Palermo, Italy. E-mail:
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Palermo, Italy. E-mail:
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Palermo, Italy. E-mail:
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Tergesen CL, Gurung D, Dhungana S, Risal A, Basel P, Tamrakar D, Amatya A, Park LP, Kohrt BA. Impact of Service User Video Presentations on Explicit and Implicit Stigma toward Mental Illness among Medical Students in Nepal: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042143. [PMID: 33671743 PMCID: PMC7926497 DOI: 10.3390/ijerph18042143] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 12/12/2022]
Abstract
This study evaluated the impact of didactic videos and service user testimonial videos on mental illness stigma among medical students. Two randomized controlled trials were conducted in Nepal. Study 1 examined stigma reduction for depression. Study 2 examined depression and psychosis. Participants were Nepali medical students (Study 1: n = 94, Study 2: n = 213) randomized to three conditions: a didactic video based on the mental health Gap Action Programme (mhGAP), a service user video about living with mental illness, or a control condition with no videos. In Study 1, videos only addressed depression. In Study 2, videos addressed depression and psychosis. In Study 1, both didactic and service user videos reduced stigma compared to the control. In Study 2 (depression and psychosis), there were no differences among the three arms. When comparing Study 1 and 2, there was greater stigma reduction in the service user video arm with only depression versus service user videos describing depression and psychosis. In summary, didactic and service user videos were associated with decreased stigma when content addressed only depression. However, no stigma reduction was seen when including depression and psychosis. This calls for considering different strategies to address stigma based on types of mental illnesses. ClinicalTrials.gov identifier: NCT03231761.
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Affiliation(s)
- Cori L. Tergesen
- Department of Psychology, DePaul University, Chicago, IL 60604, USA;
- Duke Global Health Institute, Duke University, Durham, NC 27708, USA;
| | - Dristy Gurung
- Transcultural Psychosocial Organization Nepal, Baluwatar, Kathmandu, Nepal;
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Saraswati Dhungana
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal; (S.D.); (P.B.)
| | - Ajay Risal
- Department of Psychiatry, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal; (A.R.); (D.T.)
| | - Prem Basel
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal; (S.D.); (P.B.)
| | - Dipesh Tamrakar
- Department of Psychiatry, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal; (A.R.); (D.T.)
| | | | - Lawrence P. Park
- Duke Global Health Institute, Duke University, Durham, NC 27708, USA;
- Infectious Disease Division, Department of Medicine, Duke University Medical Center, Durham, NC 27708, USA
| | - Brandon A. Kohrt
- Duke Global Health Institute, Duke University, Durham, NC 27708, USA;
- Transcultural Psychosocial Organization Nepal, Baluwatar, Kathmandu, Nepal;
- Division of Global Mental Health, Department of Psychiatry, George Washington University, Washington, DC 20037, USA
- Correspondence: ; Tel.: +1-202-741-2896
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Babicki M, Małecka M, Kowalski K, Bogudzińska B, Piotrowski P. Stigma Levels Toward Psychiatric Patients Among Medical Students-A Worldwide Online Survey Across 65 Countries. Front Psychiatry 2021; 12:798909. [PMID: 34966314 PMCID: PMC8710677 DOI: 10.3389/fpsyt.2021.798909] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/24/2021] [Indexed: 12/25/2022] Open
Abstract
Background: According to epidemiological data, over 450 million people worldwide suffer from mental disorders, presenting one of the major challenges of modern medicine. In their everyday lives, patients, in addition to fighting the disease itself, often struggle with stigmatization. This phenomenon negatively affects both the diagnostic and therapeutic processes, as well as the patients' everyday functioning. This study aimed to assess stigma attitudes toward psychiatry and psychiatric patients among undergraduate medical students. Methods: This study used a Computer-Assisted Web Interview (CAWI), which included the standardized items from the Mental Illness: Clinicians' Attitudes (MICA-2) scale to evaluate stigma. The study was disseminated via the internet to students from medical universities from 65 countries worldwide. Participation was voluntary and anonymous. The study involved 1,216 students from these 65 countries. Most of the sample were women, and most were medical faculty students and students living in cities with more than 500,000 residents. Taking into consideration Gross Domestic Product (GDP) per capita and Human Development Index (HDI) variables, it can be seen that there was a prevalence of medical students from highly developed countries. Results: For the whole sample, the mean MICA-2 score was 40.5 points. Women and medical and nursing students showed more positive attitudes toward psychiatric patients. Students from countries with the highest economic development levels also achieved statistically lower MICA-2 scores. Lower score means a more positive attitude. Conclusion: Stigma toward both psychiatry and psychiatric patients is common among undergraduate medical students. Female students and respondents with a history of mental disorders in countries with high HDI and GDP per capita indices show more favorable attitudes than other medical students. There is a need to further our understanding of the problem of stigmatization, both among the general population and among medical personnel, and to implement and maintain appropriate measures to reduce stigma toward psychiatry.
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Affiliation(s)
- Mateusz Babicki
- Department of Family Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Monika Małecka
- Department and Clinic of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | - Krzysztof Kowalski
- Department and Clinic of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | - Bogna Bogudzińska
- Students' Scientific Group at the Faculty of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | - Patryk Piotrowski
- Department and Clinic of Psychiatry, Wroclaw Medical University, Wrocław, Poland.,Section of Epidemiology and Social Psychiatry, Department and Clinic of Psychiatry, Wroclaw Medical University, Wrocław, Poland.,Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wrocław, Poland
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Motlová LB, Janoušková M, Formánek T, Goetz M, Holub D, Hubeňák J, Kašpárek T, Látalová K, Papežová H, Světlák M, Šilhán P, Trančík P, Vevera J, Balon R. Medical Students' Career Choice and Attitudes Toward Psychiatry: Case of the Czech Republic. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2020; 44:751-755. [PMID: 33000447 DOI: 10.1007/s40596-020-01311-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE A survey among medical students of all medical schools in the Czech Republic was conducted to investigate attitudes and views of psychiatry and career choice of psychiatry. METHODS A Czech version of the Attitudes to Psychiatry Scale (APS) and a questionnaire surveying demographic characteristics and choices of future specialty were distributed to all medical students of eight medical schools in the Czech Republic via the schools' internal communication systems in the form of an anonymous online questionnaire. RESULTS Out of a total of 10,147 medical students in the Czech Republic (academic year 2019/2020), 2418 students participated in the survey (response rate 23.8%). Psychiatry as a non-exclusive career choice was considered by 31.3% respondents; child and adolescent psychiatry was considered by 15.4% respondents. Psychiatry as the only choice was considered by 1.6%, and child and adolescent psychiatry was not considered at all. The interest in both specialties was declining since the first year of study. The status of psychiatry among other medical specialties was perceived as low; students were rather discouraged from entering psychiatry by their families. They did not feel encouraged by their teachers to pursue career in psychiatry despite the fact that they were interested in psychiatry. They also felt uncomfortable with patients with mental illness. CONCLUSIONS Despite high enthusiasm for psychiatry in the first year of medical school, only a small proportion of medical students consider to choose psychiatry, and especially child and adolescent psychiatry, as a career at the end of medical school.
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Affiliation(s)
| | | | - Tomáš Formánek
- National Institute of Mental Health, Klecany, Czech Republic
| | - Michal Goetz
- Charles University Second Medical Faculty, Prague, Czech Republic
| | - David Holub
- Charles University First Medical Faculty, Prague, Czech Republic
| | - Jan Hubeňák
- Charles University Faculty of Medicine in Hradec Králové, Hradec Králové, Czech Republic
| | - Tomáš Kašpárek
- Masaryk University Faculty of Medicine, Brno, Czech Republic
| | - Klára Látalová
- University Palacky Olomouc Faculty of Medicine and Dentistry, Olomouc, Czech Republic
| | - Hana Papežová
- Charles University First Medical Faculty, Prague, Czech Republic
| | | | - Petr Šilhán
- University of Ostrava Faculty of Medicine, Ostrava, Czech Republic
| | - Pavel Trančík
- Psychiatric Hospital Bohnice, Prague, Czech Republic
| | - Jan Vevera
- Charles University Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Richard Balon
- Wayne State University School of Medicine, Detroit, MI, USA
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Hooblaul M, Cobbing S, Daniels KJ. The knowledge, attitudes and perceptions of physiotherapists in KwaZulu-Natal, South Africa, towards mental health. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2020; 76:1483. [PMID: 33241158 PMCID: PMC7669947 DOI: 10.4102/sajp.v76i1.1483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/21/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Physiotherapists are trained to manage patients with physical needs, but because of limited training at an undergraduate level in mental health, patients may not receive holistic care. This lack of knowledge often can deny people living with a mental illness (PLWMI) the potential benefits of physiotherapy treatment and exercise. OBJECTIVES Our study conducted in the KwaZulu-Natal province of South Africa aimed to determine the knowledge, attitudes and perceptions of physiotherapists working in the Department of Health (DoH) in KwaZulu-Natal, South Africa, towards mental health, and to determine whether their undergraduate training prepared them to manage PLWMI. METHODS A mixed-method design was employed. The Attitudes to Psychiatry (ATP-30) questionnaire was distributed to 153 physiotherapists in KwaZulu-Natal. Focus groups were conducted to ascertain whether their undergraduate training prepared them adequately to manage PLWMI. RESULTS A total of 124 physiotherapists completed the questionnaires. The mean ATP-30 scores was 103.70 (SD = 11.71). Females had slightly higher ATP-30 scores than males. Physiotherapists indicated in the focus groups that they received limited training about mental health at an undergraduate level. CONCLUSION Physiotherapists working in the KwaZulu-Natal public sector have a positive attitude towards mental health and managing PLWMI. Participants expressed the need for the inclusion of theoretical and practical knowledge about mental health in the undergraduate curriculum and postgraduate courses related to this topic. CLINICAL IMPLICATIONS The outcomes of this study show the importance of the inclusion of mental health in the undergraduate physiotherapy programme. Exposure to the theoretical and practical knowledge of mental health during the undergraduate physiotherapy programme will assist qualified physiotherapists better manage PLWMI. Future studies should be conducted in the other provinces and in the private practice setting in South Africa, so as to compare the results.
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Affiliation(s)
- Marilyn Hooblaul
- KwaZulu-Natal Department of Health, Ekuhlengeni Psychiatric Hospital, Durban, South Africa
| | - Saul Cobbing
- Department of Physiotherapy, University of KwaZulu-Natal, Durban, South Africa
| | - Kurt J. Daniels
- Department of Physiotherapy, University of KwaZulu-Natal, Durban, South Africa
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Medlock MM. Applying the Medical Model to Psychiatric History-Taking: A Teaching Approach that Addresses Learner Stigma. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2020; 44:640-641. [PMID: 32572839 DOI: 10.1007/s40596-020-01255-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/31/2020] [Indexed: 06/11/2023]
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Beyond the curriculum: a cross-sectional study of medical student psychological distress, and health care needs, practices and barriers. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1215-1221. [PMID: 31511927 DOI: 10.1007/s00127-019-01771-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 09/03/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Medical students report significant levels of distress, and are reluctant to seek help despite health care needs, often citing factors associated with the medical school environment beyond training, generally termed the 'hidden curriculum'. OBJECTIVES The primary objectives of the current study were to establish the level of psychological distress in a sample of medical students enrolled in an Atlantic Canadian medical school, explore factors that predict the psychological distress, examine health care needs, concerns, and practices, and consider potential barriers to care. METHODS Instruments assessing distress (i.e., the Kessler Psychological Distress scale), predictors of distress (i.e., the Perceived Medical School Stress scale), and health care needs and practices (i.e., the Medical Student Health Survey) were administered to 180 medical students. Distress was also compared to three age, sex, and frequency matched Canadian Community Health Survey (CCHS) samples representing the general Canadian population, full time university/college students, and those reporting Anxiety Disorder diagnosed by a healthcare provider. RESULTS Medical students reported significantly higher levels of psychological distress than each comparison group, which was significantly predicted by training year, and three PMSS subscales, i.e., "Medical school controls my life", "Is more a threat than a challenge", and "Long hours and responsibilities associated with clinical training". Eighty-six percent of students reported health care needs ranging from common complaints to mental illness, with many either seeking services outside their training institution, consulting with peers, or not attaining care, primarily for reasons of confidentiality and/or non-permissive training schedules. CONCLUSIONS Medical student psychological distress is significant, and while it may reflect rigors of training, it is also linked with stigma, perceptions that the curriculum is controlling and can often be considerably overwhelming. As a function of this environment, students may not be adequately attending to their own health issues.
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Ma HI, Hsieh CE. An Anti-Stigma Course for Occupational Therapy Students in Taiwan: Development and Pilot Testing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155599. [PMID: 32756448 PMCID: PMC7432861 DOI: 10.3390/ijerph17155599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/27/2020] [Accepted: 07/31/2020] [Indexed: 01/05/2023]
Abstract
Attitudes of healthcare professionals towards people with disorders/disabilities are important for the development of therapeutic relationships, as well as to the evaluation and intervention processes. Therefore, it is critical to be aware and reduce stigmatizing attitudes in future healthcare professionals. An 18-week anti-stigma course was developed for occupational therapy students based on literature review and focus group interview. The course consisted of three components, including social contact, roleplaying, and critical reflection strategies. A quasi-experimental design was implemented to evaluate participants at three time points (i.e., pre-test, post-test, and one year after completion) using the Social Distance Scale and several questionnaires (i.e., stigmatising attitudes towards mental illness, physical disabilities, and children with emotional behavioural disorders). A total of 16 students completed the course and had significantly decreased social distance and stigmatising attitudes towards mental illness and emotional behavioural disorders in the post-test. These decreases remained one year later. The results support the provision of an anti-stigma course for occupational therapy students to reduce stigmatising attitudes. Future research should extend the anti-stigma course to occupational therapy students at other universities to increase both the sample size and overall generalisability.
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Affiliation(s)
- Hui-Ing Ma
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 700, Taiwan;
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 700, Taiwan
- Correspondence: ; Tel.: +86-6235-3535
| | - Chu-En Hsieh
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 700, Taiwan;
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Albury C, Strain WD, Brocq SL, Logue J, Lloyd C, Tahrani A. The importance of language in engagement between health-care professionals and people living with obesity: a joint consensus statement. Lancet Diabetes Endocrinol 2020; 8:447-455. [PMID: 32333880 DOI: 10.1016/s2213-8587(20)30102-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/03/2020] [Accepted: 03/03/2020] [Indexed: 12/21/2022]
Abstract
Obesity is a chronic condition that requires long-term management and is associated with unprecedented stigma in different settings, including during interactions with the health-care system. This stigma has a negative effect on the mental and physical health of people with obesity and can lead to avoidance of health care and disruption of the doctor-patient relationship. Considerable evidence exists to suggest that simply having a conversation about obesity can lead to weight loss, which translates into health benefits. However, both health-care practitioners and people living with obesity report apprehension in initiating this conversation. We have collaborated with stakeholders from Obesity UK, physicians, dieticians, clinical psychologists, obesity researchers, conversation analysts, nurses, and representatives from National Health Service England Diabetes and Obesity. This group has contributed to the production of this consensus statement, which addresses how people living with obesity wish to have their condition referred to and provides practical guidance for health-care professionals to facilitate collaborative and supportive discussions about obesity. Expert stakeholders consider that changes to language used at the point of care can alleviate the stigma of obesity within the health-care system and support improved outcomes for both people living with obesity and for the health-care system.
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Affiliation(s)
- Charlotte Albury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - W David Strain
- Diabetes and Vascular Medicine Research Centre, Institute of Biomedical and Clinical Science and College of Medicine and Health, University of Exeter, Exeter, UK.
| | | | - Jennifer Logue
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Cathy Lloyd
- School of Health, Wellbeing and Social Care in the Faculty of Wellbeing, Education and Language Studies at the Open University, Milton Keynes, UK
| | - Abd Tahrani
- National Institute for Health Research, University of Birmingham, Birmingham, UK; University Hospitals Birmingham National Health Service Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
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Level of Stigma among Spanish Nursing Students toward Mental Illness and Associated Factors: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234870. [PMID: 31816966 PMCID: PMC6926928 DOI: 10.3390/ijerph16234870] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/29/2019] [Accepted: 12/02/2019] [Indexed: 12/13/2022]
Abstract
Mental health problems have been identified by the World Health Organization as a global development priority. Negative attitudes toward mental health patients have been documented in multiple health professionals. The aim of this study was to determine the level of stigma and associated factors toward people with mental health problems among students doing their degree in nursing. An explanatory sequential mixed-methods approach. A cross-sectional descriptive observational study was carried out on a sample of 359 students doing their degree in nursing. Students had to be enrolled in any of the four years of study of the degree at the time the questionnaire was done. We explored the perception and experience of students doing their degree in nursing regarding the level of stigma, through in-depth interviews (n = 30). The mean overall Mental Health Stigma Scale (MHSS) score was 30.7 points (SD = 4.52); 29.5% (n = 106) scored low for stigma, 49.9% (n = 179) showed moderate stigma, and 20.6% (n = 74) scored high. The multivariate analysis showed that 4th-year students had an OR of 0.41 (CI95%: 0.20–0.84) for high/moderate stigma and that 3rd-year students had an OR of 0.49 for high/moderate stigma compared with 1st-year students. We also observed that students with family members with mental health problems had an OR of 2.05 (CI95%: 1.19–3.56) for high/moderate stigma compared with students who did not have family members with mental health problems. The following categories emerged: fear and lack of knowledge, breaking the silence, and integration into society. The levels of mental health stigma in our sample of nursing students were moderate. Stigma levels were lower in 3rd- and 4th-year students (i.e., after having received training in mental health), and in students with family members with mental health problems.
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Public attitudes towards depression and schizophrenia in an urban Turkish sample. Asian J Psychiatr 2019; 45:1-6. [PMID: 31422167 DOI: 10.1016/j.ajp.2019.07.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 06/05/2019] [Accepted: 07/07/2019] [Indexed: 12/13/2022]
Abstract
Stigma towards mental illness influences help-seeking behavior and prevents individuals with a mental illness from seeking the appropriate treatment for their condition. In Turkey, a shift from inpatient psychiatric mental health care towards a community-based, low-threshold system highlights the importance of understanding public attitudes towards the mentally ill. This study aims to underpin developments in mental health care through culturally sensitive research. Public stigma towards schizophrenia and depression is examined for the first time simultaneously in a community sample. Unlabeled case vignettes of either schizophrenia or depression as well as an assessment of mental illness attribution and the desire for social distance (SDS) were presented to an urban Turkish sample (N = 295). Analysis of variance revealed that attribution to mental illness determines significant levels of stigma for schizophrenia, however not for depression. Furthermore, desire for social distance (SDS) was significantly higher for the schizophrenia condition compared to depression. Depression and schizophrenia evoke different reactions within the Turkish population, specifically the attribution to mental illness increases stigma. This finding is discussed in light of the contact hypothesis, and furthermore contextualized within literature on familiarity with depression symptoms on the one hand, and perceived dangerousness and symptom severity of schizophrenia on the other hand. Implementation of timely and culturally sensitive adapted interventions within the ongoing reform of the Turkish mental health care system is recommended.
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Pranckeviciene A, Zardeckaite-Matulaitiene K, Marksaityte R, Endriulaitiene A, Tillman DR, Hof DD. Social distance in Lithuanian psychology and social work students and professionals. Soc Psychiatry Psychiatr Epidemiol 2018; 53:849-857. [PMID: 29453748 DOI: 10.1007/s00127-018-1495-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 02/01/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE This cross-sectional study aimed to compare desire for social distance from people with mental illness in the disciplines of social work and psychology, and among students and professionals having different professional experience. METHODS 948 respondents (715 students and 233 professionals) from Lithuanian educational and mental health-care institutions participated in an anonymous survey. Social distance was measured using Lithuanian Social Distance Scale which was created for this study. Participants also answered questions about familiarity with mental illness. Bias of social desirability was measured using the balanced inventory of desirable responding. RESULTS Series of ANCOVA analysis revealed that psychology and social work master's and PhD students reported less social distance from people with mental illness when compared with bachelor's students. Familiarity with mental illness was significantly related to less social distance in the student sample, but not in professionals' sample. The strongest desire for social distance in the professionals' sample was observed in social workers having less than 5 years of professional practice and most experienced psychologists with more than 10 years of professional practice. CONCLUSIONS Social distance from people with mental illness decreases through the study years; however, results of professional psychologists and social workers illustrate different trajectories in social distance through the professional career. The results of this study support the need for anti-stigma programmes and initiatives orientated towards mental health professionals.
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Affiliation(s)
- Aiste Pranckeviciene
- Neuroscience Institute, Lithuanian University of Health Sciences, Eiveniu str. 4, 50161, Kaunas, Lithuania. .,Psychology Department, Vytautas Magnus University, Jonavos str. 66-328, 44191, Kaunas, Lithuania.
| | | | - Rasa Marksaityte
- Psychology Department, Vytautas Magnus University, Jonavos str. 66-328, 44191, Kaunas, Lithuania
| | - Aukse Endriulaitiene
- Psychology Department, Vytautas Magnus University, Jonavos str. 66-328, 44191, Kaunas, Lithuania
| | - Douglas R Tillman
- Univeristy of Nebraska Kearney, 2504 9th Ave, Kearney, NE, 68849, USA
| | - David D Hof
- Univeristy of Nebraska Kearney, 2504 9th Ave, Kearney, NE, 68849, USA
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Dupouy J, Vergnes A, Laporte C, Kinouani S, Auriacombe M, Oustric S, Rougé Bugat ME. Intensity of previous teaching but not diagnostic skills influences stigmatization of patients with substance use disorder by general practice residents. A vignette study among French final-year residents in general practice. Eur J Gen Pract 2018; 24:160-166. [PMID: 29792534 PMCID: PMC5974755 DOI: 10.1080/13814788.2018.1470239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: High levels of stigma towards patients with substance use disorder (SUD) have been found in health professionals and medical students. Objectives: To assess the capability of residents in general practice to diagnose SUD correctly; to assess their stigmatization of patients with SUD and to assess the correlation between both variables. We hypothesized a negative correlation. Methods: In 2014, we conducted a cross-sectional survey among French residents in general practice, using a self-administered questionnaire. First, a clinical case of SUD (tramadol) was presented, to assess the diagnosis and retained diagnostic criteria. A second clinical vignette was presented (intravenous heroin user) to assess stigmatization with the Attitudes to Mental Illness Questionnaire (AMIQ). Its score ranges from –10 (negative attitude) to +10 (positive attitude). AMIQ scores of residents who diagnosed SUD correctly versus incorrectly, and who had received at least six hours versus less than six hours of teaching on this topic, were compared using Student’s t-test. Results: Of 1284 solicited residents, 303 participated (23.6%), 249 residents diagnosed SUD correctly (82.2%). The mean AMIQ score was –3.91 (SD 2.4) without significant difference regarding the correct diagnosis of SUD; but with a significant difference between residents who had received training in SUD for at least six hours versus residents less trained (AMIQ scores –3.76 (SD 2.46) versus −4.50 (SD 2.27), p = .0354). Conclusion: Residents in general practice had a good capacity to diagnose SUD correctly but on average expressed negative attitudes toward people with SUD. More SUD teaching seems to help in reducing stigmatizing attitudes.
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Affiliation(s)
- Julie Dupouy
- a Département Universitaire de Médecine Générale , Université de Toulouse III Paul Sabatier, Faculté de Médecine , Toulouse , France.,b Inserm UMR1027, Université de Toulouse III Paul Sabatier, Faculté de Médecine , Toulouse , France
| | - Aurore Vergnes
- a Département Universitaire de Médecine Générale , Université de Toulouse III Paul Sabatier, Faculté de Médecine , Toulouse , France
| | - Catherine Laporte
- c Département de Médecine Générale , Université de Clermont-Ferrand, Faculté de médecine , Clermont-Ferrand , France.,d EA 7280 NPsy-Sydo, Faculté de médecine de Clermont-Ferrand, Université d'Auvergne , Clermont-Ferrand , France
| | - Shérazade Kinouani
- e Université de Bordeaux , Bordeaux , France.,f Inserm UMR1219, Neuroepidemiologie , Bordeaux , France.,g Département de Médecine Générale , Université de Bordeaux , Bordeaux , France
| | - Marc Auriacombe
- h Pôle Addictologie , CH Charles Perrens et CHU de Bordeaux , Bordeaux Cedex , France.,i Laboratoire SANPSY, CNRS USR 3413, Université de Bordeaux, PAC Carreire , Bordeaux Cedex , France
| | - Stéphane Oustric
- a Département Universitaire de Médecine Générale , Université de Toulouse III Paul Sabatier, Faculté de Médecine , Toulouse , France.,b Inserm UMR1027, Université de Toulouse III Paul Sabatier, Faculté de Médecine , Toulouse , France
| | - Marie-Eve Rougé Bugat
- a Département Universitaire de Médecine Générale , Université de Toulouse III Paul Sabatier, Faculté de Médecine , Toulouse , France.,b Inserm UMR1027, Université de Toulouse III Paul Sabatier, Faculté de Médecine , Toulouse , France
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Eksteen HC, Becker PJ, Lippi G. Stigmatization towards the mentally ill: Perceptions of psychiatrists, pre-clinical and post-clinical rotation medical students. Int J Soc Psychiatry 2017; 63:782-791. [PMID: 29067838 DOI: 10.1177/0020764017735865] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Stigma towards the mentally ill is a well-known phenomenon and it is not restricted to certain communities or countries. Stigma, be it self-stigma or public stigma, has a major influence in mental health care. AIM The aim of this study was to determine whether stigmatizing attitudes towards the mentally ill differ according to the level of knowledge about psychiatric illnesses and whether the level of exposure towards the mentally ill plays a role in stigmatizing attitudes. METHOD This study was carried out by assessing psychiatrists ( n = 68), pre-clinical ( n = 194) and post-clinical ( n = 354) medical students' attitudes towards the mentally ill using the Mental Illness: Clinicians' Attitudes (MICA) scale. The scale is scored on a Likert scale with higher scores indicating higher levels of stigmatization. RESULTS Participants in the three groups had statistical significant different levels of stigma with a decline in scores as you are more exposed to psychiatry. Familiarity with mental illness was associated with less stigma. Participants who had friends or family members who suffered from mental illness or they themselves suffered from a mental illness had less stigma. CONCLUSION More exposure to mental health-related issues are needed not only in communities but also in medical schools. Medical students need to be targeted for educational intervention because they are the future doctors who might pursue psychiatry as their field of choice. Stigma against psychiatry as a medical profession should also be addressed. If psychiatry is to be respected as a medical profession, mental illness-related stigma interventions need to be put in place to raise awareness about the negative impact of stigma.
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Affiliation(s)
- Hendri-Charl Eksteen
- 1 Department of Psychiatry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Piet J Becker
- 2 Research Office, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Gian Lippi
- 1 Department of Psychiatry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Haddad M, Waqas A, Sukhera AB, Tarar AZ. The psychometric characteristics of the revised depression attitude questionnaire (R-DAQ) in Pakistani medical practitioners: a cross-sectional study of doctors in Lahore. BMC Res Notes 2017; 10:333. [PMID: 28750688 PMCID: PMC5530926 DOI: 10.1186/s13104-017-2652-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 07/21/2017] [Indexed: 11/10/2022] Open
Abstract
Background Depression is common mental health problem and leading contributor to the global burden of disease. The attitudes and beliefs of the public and of health professionals influence social acceptance and affect the esteem and help-seeking of people experiencing mental health problems. The attitudes of clinicians are particularly relevant to their role in accurately recognising and providing appropriate support and management of depression. This study examines the characteristics of the revised depression attitude questionnaire (R-DAQ) with doctors working in healthcare settings in Lahore, Pakistan. Methods A cross-sectional survey was conducted in 2015 using the revised depression attitude questionnaire (R-DAQ). A convenience sample of 700 medical practitioners based in six hospitals in Lahore was approached to participate in the survey. The R-DAQ structure was examined using Parallel Analysis from polychoric correlations. Unweighted least squares analysis (ULSA) was used for factor extraction. Model fit was estimated using goodness-of-fit indices and the root mean square of standardized residuals (RMSR), and internal consistency reliability for the overall scale and subscales was assessed using reliability estimates based on Mislevy and Bock (BILOG 3 Item analysis and test scoring with binary logistic models. Mooresville: Scientific Software, 55) and the McDonald’s Omega statistic. Findings using this approach were compared with principal axis factor analysis based on Pearson correlation matrix. Results 601 (86%) of the doctors approached consented to participate in the study. Exploratory factor analysis of R-DAQ scale responses demonstrated the same 3-factor structure as in the UK development study, though analyses indicated removal of 7 of the 22 items because of weak loading or poor model fit. The 3 factor solution accounted for 49.8% of the common variance. Scale reliability and internal consistency were adequate: total scale standardised alpha was 0.694; subscale reliability for professional confidence was 0.732, therapeutic optimism/pessimism was 0.638, and generalist perspective was 0.769. Conclusions The R-DAQ was developed with a predominantly UK-based sample of health professionals. This study indicates that this scale functions adequately and provides a valid measure of depression attitudes for medical practitioners in Pakistan, with the same factor structure as in the scale development sample. However, optimal scale function necessitated removal of several items, with a 15-item scale enabling the most parsimonious factor solution for this population.
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Affiliation(s)
- Mark Haddad
- Centre for Mental Health Research; School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK. .,East London NHS Foundation Trust, London, UK.
| | - Ahmed Waqas
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| | | | - Asad Zaman Tarar
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
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Simon N, Verdoux H. [Impact of education program and clinical posting in psychiatry on medical students' stigmatizing attitudes towards psychiatry and psychiatric disorders]. Encephale 2017; 44:329-336. [PMID: 28606624 DOI: 10.1016/j.encep.2017.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 05/04/2017] [Accepted: 05/05/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to explore whether a medical student education program and clinical posting in psychiatry had an impact on medical students' stigmatizing attitudes towards psychiatry and psychiatric disorders. METHODS Medical students from the University of Bordeaux were recruited during their 4-year course at the beginning of the academic education program in psychiatry. Medical students who were concomitantly in a clinical posting in wards of psychiatry or neurology were invited to participate in the study. The medical student version of the scale Mental Illness: Clinicians' Attitudes (MICA) was used to measure their attitudes towards psychiatry and persons with psychiatric disorder. This 16-item scale is designed to measure attitudes of health care professionals towards people with mental illness, a higher score indicating more stigmatizing attitudes. Items exploring history of psychiatric disorders in close persons were added at the end of the MICA scale. The questionnaire was completed twice by each student, at the beginning and the end of the 11-week clinical posting. All questionnaires were strictly anonymized. Multivariate linear regression analyses were used to identify the variables independently associated with MICA total score. RESULTS At the beginning of the education program and clinical posting, 174 students completed the MICA scale: the mean MICA total score was equal to 46.4 (SD 6.9) in students in clinical posting in psychiatry (n=72) and 45.1 (SD 7.01) in those in neurology (n=102). At the end of the academic and clinical training, 138 students again completed the questionnaire, with mean MICA total scores equal to 41.4 (SD 8.1) in students in clinical posting in psychiatry (n=51) and 43.5 (SD 7.3) in those in neurology (n=87). Multivariate analyses showed that lower total MICA scores were independently associated with the time of assessment (lower scores at the end of education program and clinical posting) (b=-2.8; P=0.001), female gender (b=-1.8; P=0.03) and history of a psychiatric disorder in a close person (b=-1.92; P=0.02). Type of clinical posting (psychiatry vs. neurology) was not independently associated with MICA total scores (b=-0.02; P=0.98). A significant interaction was found between the variables "time of assessment" and "type of clinical posting" (P=0.05): stratified analyses showed that MICA total scores decreased significantly only when the clinical posting was in psychiatry (b=-4.66; P=0.001), with no significant change in medical students in neurology wards (b=-1.45; P=0.16). CONCLUSION Stigmatizing attitudes of medical students towards psychiatry and psychiatric disorders are reduced by an education program in psychiatry, with a positive impact more marked when the education program is concomitant to a clinical posting in psychiatry. As future health professionals in charge of persons with psychiatric disorders, medical students are key targets of actions aimed at reducing stigma towards mental health disorders. It is hence of great importance to promote clinical training in psychiatric wards during medical studies for all future practitioners, irrespective of their future specialty.
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Affiliation(s)
- N Simon
- Centre hospitalier Charles-Perrens, 121, rue de la Béchade, 33076 Bordeaux cedex, France
| | - H Verdoux
- Centre hospitalier Charles-Perrens, 121, rue de la Béchade, 33076 Bordeaux cedex, France; Université de Bordeaux, U657, 121, rue de la Béchade, 33000 Bordeaux, France; Inserm, U657, 33000 Bordeaux, France.
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da Rocha Neto HG, Rosenheck RA, Stefanovics EA, Cavalcanti MT. Attitudes of Brazilian Medical Students Towards Psychiatric Patients and Mental Illness: A Quantitative Study Before and After Completing the Psychiatric Clerkship. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:315-319. [PMID: 26883528 DOI: 10.1007/s40596-016-0510-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 02/03/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The authors evaluated whether a psychiatric clerkship reduces stigmatized attitudes towards people with mental illness among medical students. METHODS A 56-item questionnaire was used to assess the attitudes of medical students towards patients with mental illness and their beliefs about its causes before and after their participation in their psychiatric clerkship at a major medical school in Rio de Janeiro. Exploratory factor analysis identified four factors, reflecting "social acceptance of people with mental illness," "normalizing roles for people with mental illness in society," "non-belief in supernatural causes for mental illness," and "belief in bio-psychosocial causes for mental illness." Analysis of variance was used to evaluate changes in these factors before and after the clerkship. RESULTS One significant difference was identified with a higher score on the factor representing social acceptance after as compared to before the clerkship (p = 0.0074). No significant differences were observed on the other factors. CONCLUSION Participation in a psychiatric clerkship was associated with greater social acceptance but not with improvement on other attitudinal factors. This may reflect ceiling effects in responses before the clerkship concerning supernatural and bio-psychosocial beliefs about causes of mental illness that left little room for change.
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Wang Y, Wang X, Zhang W, Liang X, Tian D, Qu Z. Risk factors of the stigma towards psychiatric patients among primary healthcare workers in China: a county study. BMC Psychiatry 2017; 17:62. [PMID: 28178950 PMCID: PMC5299763 DOI: 10.1186/s12888-017-1215-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attitude towards psychiatric patients among healthcare workers has an impact on quality of medical care and rehabilitation of patients. In China, primary healthcare workers play an important role in mental health care, but little is known about the attitude of them towards psychiatric patients. This study aims to examine the risk factors associated with stigma among primary healthcare workers in West China. METHODS This cross-sectional study randomly recruited 395 primary healthcare workers in Mianzhu County, China. Data were collected via self-reported questionnaires. Descriptive analyses, bivariate analyses, and hierarchical linear regressions were performed by SPSS 17.0 to test the factors that accounted for the variation of stigma towards psychiatric patients. RESULTS Several risk factors were confirmed, including the satisfaction of income, work experience in psychiatric/ psychological departments, rehabilitation of patients, contact quality, and the attitude of mass media. However, demographic factors, the rest of work-related factors, and contact frequency might not be related with primary healthcare workers' attitude towards psychiatric patients. CONCLUSIONS The findings suggested that the quality of contact between primary healthcare workers and psychiatric patients be enhanced in order to decrease the stigma of healthcare staff. On-the-job training and institutional medical education needs a further exploration and development.
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Affiliation(s)
- Yang Wang
- 0000 0004 1936 9991grid.35403.31School of Social Work, University of Illinois at Urbana-Champaign, 1010 W Nevada St, Champaign, 61801 IL USA
| | - Xiaohua Wang
- 0000 0004 1789 9964grid.20513.35School of Social Development and Public Policy, China Institute of Health and Center for Behavioral Health, Beijing Normal University, No. 19, XinJieKouWai St, Beijing, 100875 China
| | - Weijun Zhang
- 0000 0004 1789 9964grid.20513.35School of Social Development and Public Policy, China Institute of Health and Center for Behavioral Health, Beijing Normal University, No. 19, XinJieKouWai St, Beijing, 100875 China
| | - Xiaoyun Liang
- 0000 0004 1789 9964grid.20513.35School of Social Development and Public Policy, China Institute of Health and Center for Behavioral Health, Beijing Normal University, No. 19, XinJieKouWai St, Beijing, 100875 China
| | - Donghua Tian
- 0000 0004 1789 9964grid.20513.35School of Social Development and Public Policy, China Institute of Health and Center for Behavioral Health, Beijing Normal University, No. 19, XinJieKouWai St, Beijing, 100875 China
| | - Zhiyong Qu
- School of Social Development and Public Policy, China Institute of Health and Center for Behavioral Health, Beijing Normal University, No. 19, XinJieKouWai St, Beijing, 100875, China.
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Taghva A, Farsi Z, Javanmard Y, Atashi A, Hajebi A, Noorbala AA. Strategies to reduce the stigma toward people with mental disorders in Iran: stakeholders' perspectives. BMC Psychiatry 2017; 17:17. [PMID: 28088199 PMCID: PMC5237535 DOI: 10.1186/s12888-016-1169-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 12/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stigma affects all aspects of mental disorders, and is the most important risk factor for promoting mental health. The aim of this study was to explore strategies effective in reducing the stigma toward people with mental disorders in Iran. METHODS This qualitative study was conducted from 2013 to 2016. All participants were recruited by purposive sampling method. The majority of them were stakeholders of mental health in Iran. Data were collected through eight individual interviews, two focus groups, and six written narratives. The data were collected, coded and analyzed simultaneously. Content analysis was employed to analyze the qualitative interview data. RESULTS The major themes that emerged were: "Emphasis on education and changing attitudes", "Changing the culture", "Promoting supportive services", "Role of various organizations and institutions", "Integrated reform of structures and policies to improve the performance of custodians", and "Evidence-based actions". CONCLUSIONS This study did not investigate the extent of stigma or its origins, rather it examines strategies appropriate for implementation in Iran. Additional studies are needed to evaluate the effectiveness of strategies for reducing the stigma attached to patients with mental disorders.
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Affiliation(s)
- Arsia Taghva
- Psychiatry Department, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Zahra Farsi
- Community Health Department, Faculty of Nursing, AJA University of Medical Sciences, Kaj St., Shariati St, Tehran, Iran.
| | | | - Afsaneh Atashi
- Clinical Psychology Bangalore University, Bangalore, India
| | - Ahmad Hajebi
- Research Center for Addiction & Risky Behavior (ReCARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran
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Abstract
Negative attitudes toward people with mental illness are a widespread concern and may vary across countries. This study used a 36-item questionnaire to compare attitudes toward people with mental illness and beliefs about the causes of mental illness among medical students from the United States, Brazil, Ghana, Nigeria, and China (N = 1131). Exploratory factor analysis identified the underlying factor structure of the questionnaire, and analysis of covariance was then used to compare factors representing four nonstigmatized attitudes across students from the five countries. US Medical students scored highest on all four factors, followed by those from Brazil. Nigerian and Ghanaian students scored lowest on nonsupernatural etiology of mental illness, and Chinese students showed the lowest score on personal social acceptance and public policy acceptance of people with mental illness. Differences in medical student attitudes between these five countries suggest underlying sociocultural differences in attitudes with the more stigmatized attitudes in developing countries.
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Amini H, Shoar S, Tabatabaee M, Arabzadeh S. The Effect of Clinical Exposure to Patients on Medical Students' Attitude Towards Mental Illness. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016; 10:e1887. [PMID: 27822275 PMCID: PMC5097344 DOI: 10.17795/ijpbs-1887] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 08/10/2015] [Accepted: 04/09/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Stigma of mental disorders causes a reduction in seeking help from the health care professionals and is evident across the world. OBJECTIVES The current study aimed to compare medical students' attitude towards mental illness after two different psychiatry clerkships in terms of the level of clinical exposure to patients with mental illness. PATIENTS AND METHODS Through a quasi-experimental study, all of the 4th-year medical students were invited to enroll this study conducted in Tehran University of Medical Sciences (TUMS). They were non-randomly assigned into two different psychiatry clerkships from January 2009 to January 2010. One group was enrolled in the traditional lecture-based course (low-exposure) while the second group participated in a novel method with increased hours of patient exposure (high-exposure). Attitude towards mental illness (AMI) was measured by a 22-item questionnaire before and after the clerkship and data were compared between the two groups in terms of changing attitude towards mental illness in five different categories. RESULTS A total of 211 participants were enrolled in the study (115 female) of which 115 students (54.5%) were in low-exposure group and 96 students (45.5%) in the high-exposure group. Generally, AMI scores did not differ between the two groups and did not show any significant changes before and after the psychiatry clerkship. The only exceptions to this were AMI4 category (the concept of etiology of the mental illness), which significantly improved after the clerkship in the low-exposure (P = 0.011) and the high-exposure groups (P = 0.024), respectively. CONCLUSIONS Exposure of medical students to patients with mental illness did not improve attitude towards mental illness and psychiatric conditions.
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Affiliation(s)
- Homayoun Amini
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, IR Iran; Psychosomatic Research Centre, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Saeed Shoar
- Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Maryam Tabatabaee
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Somaye Arabzadeh
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, IR Iran
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Winkler P, Mladá K, Janoušková M, Weissová A, Tušková E, Csémy L, Evans-Lacko S. Attitudes towards the people with mental illness: comparison between Czech medical doctors and general population. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1265-73. [PMID: 27357820 DOI: 10.1007/s00127-016-1263-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 06/22/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE Stigma among health care professionals is detrimental to the life of those with mental health problems. In the region of post-communist Europe, the level of stigma among health care providers remains understudied. We aimed to compare attitudes towards people with mental illness between Czech medical doctors and the general population. METHODS The Community Attitudes towards Mentally Ill (CAMI) scale was used to measure stigmatizing attitudes among a nationally representative sample of (1) adults residing in the Czech Republic (n = 1810) and (2) Czech medical doctors (n = 1200). Descriptive statistics and multivariable linear regression were used to assess differences between both samples. RESULTS Compared to the general adult population in the Czech Republic, Czech medical doctors demonstrated less stigmatizing attitudes toward people with mental illness in 26 of the 27 CAMI items as well as in the total CAMI score. Medical doctors, however, were more likely to consider mental hospitals as an up-to-date method of treating people with mental illness. CONCLUSIONS Our findings demonstrate more favourable attitudes towards people with mental illness among Czech medical doctors when compared to the Czech general population. Stigma, however, is high among both these groups.
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Affiliation(s)
- Petr Winkler
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.
- Personal Social Services Research Unit London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
| | - Karolína Mladá
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Miroslava Janoušková
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Aneta Weissová
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Eva Tušková
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Ladislav Csémy
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Sara Evans-Lacko
- Personal Social Services Research Unit London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
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The Influence of Causal Explanations and Diagnostic Labeling on Psychology Students' Beliefs About Treatments, Prognosis, Dangerousness and Unpredictability in Schizophrenia. Community Ment Health J 2016; 52:361-9. [PMID: 26081981 DOI: 10.1007/s10597-015-9901-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 06/10/2015] [Indexed: 12/31/2022]
Abstract
This study explored views of 566 Italian psychology students about schizophrenia. The most frequently cited causes were psychological traumas (68 %) and heredity (54 %). Thirty-three percent of students firmly believed that people with the condition could recover. Reporting heredity among the causes, and identifying schizophrenia were both associated with prognostic pessimism, greater confidence in pharmacological treatments and lower confidence in psychological treatments. Schizophrenia labeling was also associated with higher perception of unpredictability and dangerousness. Compared to first year students, fourth/fifth year students more frequently reported heredity among the causes, and were more pessimistic about schizophrenia recovery. Stigma topics should be included in future psychologists' education.
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Abstract
Since the beginning of the twenty-first century, research on stigma has continued. Building on conceptual and empirical work, the recent period clarifies new types of stigmas, expansion of measures, identification of new directions, and increasingly complex levels. Standard beliefs have been challenged, the relationship between stigma research and public debates reconsidered, and new scientific foundations for policy and programs suggested. We begin with a summary of the most recent Annual Review articles on stigma, which reminded sociologists of conceptual tools, informed them of developments from academic neighbors, and claimed findings from the early period of "resurgence." Continued (even accelerated) progress has also revealed a central problem. Terms and measures are often used interchangeably, leading to confusion and decreasing accumulated knowledge. Drawing from this work but focusing on the past 14 years of stigma research (including mental illness, sexual orientation, HIV/AIDS, and race/ethnicity), we provide a theoretical architecture of concepts (e.g., prejudice, experienced/received discrimination), drawn together through a stigma process (i.e., stigmatization), based on four theoretical premises. Many characteristics of the mark (e.g., discredited, concealable) and variants (i.e., stigma types and targets) become the focus of increasingly specific and multidimensional definitions. Drawing from complex and systems science, we propose a stigma complex, a system of interrelated, heterogeneous parts bringing together insights across disciplines to provide a more realistic and complicated sense of the challenge facing research and change efforts. The Framework Integrating Normative Influences on Stigma (FINIS) offers a multilevel approach that can be tailored to stigmatized statuses. Finally, we outline challenges for the next phase of stigma research, with the goal of continuing scientific activity that enhances our understanding of stigma and builds the scientific foundation for efforts to reduce intolerance.
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Amarasuriya SD, Jorm AF, Reavley NJ, Mackinnon AJ. Stigmatising attitudes of undergraduates towards their peers with depression: a cross-sectional study in Sri Lanka. BMC Psychiatry 2015; 15:129. [PMID: 26087847 PMCID: PMC4472246 DOI: 10.1186/s12888-015-0523-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 06/09/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is limited research examining mental health-related stigma of undergraduates in non-western developing countries. This study examined stigma of undergraduates in Sri Lanka towards another depressed undergraduate. METHODS A hypothetical vignette of an undergraduate suffering from depression was presented. A total of 4650 undergraduates responded to scales assessing their personal stigma towards and desire for social distance from this individual. Exploratory structural equation modelling (ESEM) was performed to determine the dimensionality and loading pattern of the items on these two stigma scales. Multiple linear regressions were used to explore correlates of the identified dimensions of stigma. RESULTS Previous findings that the Social Distance Scale forms a single dimension and that the Personal Stigma Scale consists of two dimensions were supported. However, the measurement structure of the dimensions of stigma on the latter scales, labelled 'Weak-not-Sick' and 'Dangerous-Undesirable' , differed from previous work. A high level of stigma in relation to the 'Weak-not-Sick' Scale was observed. However, some correlates associated with lower levels of stigma on this scale, such as being in the Medical Faculty, were associated with higher levels of stigma on the 'Dangerous-Undesirable' and 'Social Distance' scales. In contrast, labelling the problem as a mental health-related problem, with absence of specific psychiatric terminology, was associated with lower levels of stigma on these latter two scales. Exposure to a mental health problem in family or friends or from personal experience was also associated with lower stigma on the Social Distance Scale. However, the effect sizes of these relationships were small. CONCLUSIONS The findings highlight differences in the measurement structure and score distribution of the 'Weak-not-Sick' and 'Dangerous-Undesirable' scales when used in different cultural and demographic contexts. The dimensionality of stigma relevant to these scales must always be established prior to their use in different contexts. Furthermore, campaigns targeted at improving knowledge about depression as a real illness and as a psychiatric condition need to ensure that such attempts are not associated with increases in other aspects of stigma.
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Affiliation(s)
- Santushi D. Amarasuriya
- Behavioural Sciences Stream, Faculty of Medicine, University of Colombo, No. 25, PO Box 271, Kynsey Road, Colombo 8, Sri Lanka ,Centre for Mental Health, Melbourne School of Population and Global Health, 207 Bouverie Street, University of Melbourne, Melbourne, VIC 3010 Australia
| | - Anthony F. Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, 207 Bouverie Street, University of Melbourne, Melbourne, VIC 3010 Australia
| | - Nicola J. Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, 207 Bouverie Street, University of Melbourne, Melbourne, VIC 3010 Australia
| | - Andrew J. Mackinnon
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville VIC 3052 Melbourne, Australia
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Lyons Z, Laugharne J, Laugharne R, Appiah-Poku J. Stigma towards mental illness among medical students in Australia and Ghana. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2015; 39:305-308. [PMID: 24844404 DOI: 10.1007/s40596-014-0147-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 04/28/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Stigma towards mental illness has been found to impact adversely on medical students' attitudes towards psychiatry. This study aimed to assess the impact of stigma among final year students at the University of Science and Technology in Kumasi, Ghana, and the University of Western Australia. METHOD A 28-item "Attitudes and stigma towards mental health" questionnaire was distributed to final year students at both universities. RESULTS There was a significant difference in questionnaire scores, with Australian students showing more positive attitudes towards mental illness and lower levels of stigma compared with Ghanaian students. CONCLUSION Stigmatization was expressed by Australian and Ghanaian students. A combination of medical school experiences and wider societal and cultural beliefs could be responsible for students' attitudes towards mental illness. Educators can develop locally relevant anti-stigma teaching resources throughout the psychiatry curriculum to improve students' attitudes towards psychiatry as a discipline and mental illness in general.
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Affiliation(s)
- Zaza Lyons
- University of Western Australia, Crawley, Western Australia, Australia,
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Spanish validation of the social stigma scale: Community Attitudes towards Mental Illness. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2015; 9:150-7. [PMID: 25882535 DOI: 10.1016/j.rpsm.2015.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 02/11/2015] [Accepted: 02/22/2015] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The stigma against people with mental illness is very high. In Spain there are currently no tools to assess this construct. The aim of this study was to validate the Spanish version of the Community Attitudes towards Mental Illness questionnaire in an adolescent population, and determining its internal consistency and temporal stability. Another analysis by gender will be also performed. MATERIAL AND METHODS A translation and back-translation of the Community Attitudes towards Mental Illness was performed. A total of 150 students of between 14 and 18 years-old were evaluated with this tool in two stages. Internal consistency was tested using Cronbach α; and intraclass correlation coefficient was used for test-retest reliability. Gender-stratified analyses were also performed. RESULTS The Cronbach α was 0.861 for the first evaluation and 0.909 for the second evaluation. The values of the intraclass correlation coefficient ranged from 0.775 to 0.339 in the item by item analysis, and between 0.88 and 0.81 in the subscales. In the segmentation by gender, it was found that girls scored between 0.797 and 0.863 in the intraclass correlation coefficient, and boys scored between 0.889 and 0.774. CONCLUSIONS In conclusion, the Community Attitudes towards Mental Illness is a reliable tool for the assessment of social stigma. Although reliable results have been found for boys and girls, our results found some gender differences in the analysis.
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Lyons Z, Janca A. Impact of a psychiatry clerkship on stigma, attitudes towards psychiatry, and psychiatry as a career choice. BMC MEDICAL EDUCATION 2015; 15:34. [PMID: 25888984 PMCID: PMC4357197 DOI: 10.1186/s12909-015-0307-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 02/12/2015] [Indexed: 05/17/2023]
Abstract
BACKGROUND Mental illnesses are a major public health problem around the world and the prevalence and burden of common mental disorders is growing. Psychiatry is an unpopular career choice for many medical students and this impacts negatively on the supply of psychiatrists to the workforce. The psychiatry clerkship can play an important role in influencing students' attitudes towards psychiatry, either positively or negatively. However, stigma towards mental illness detracts students from considering a career in psychiatry. The aim of this study was to assess the impact of an eight week psychiatry clerkship on i) student knowledge and interest in psychiatry; ii) psychiatry as a career choice; iii) attitudes towards psychiatry; and iv) perceptions of stigma towards mental illness. METHOD Year 4 medical students at the University of Western Australia completed two questionnaires, the Balon Attitudes Towards Psychiatry and the Mental Illness Clinicians Attitudes (MICA), at the beginning and end of the psychiatry clerkship. Interest in, knowledge of, and consideration of psychiatry as a career were also assessed. Non-parametric tests were used to compare baseline and follow-up differences on the Balon and MICA. Unpaired t-tests compared mean differences for interest, knowledge and psychiatry as a career. RESULTS Attitudes towards psychiatry were positive at the beginning of the clerkship. Overall, there was a significant decrease in negative and stigmatising views towards mental illness post clerkship measured by the MICA, but the follow-up mean score remained close to the neutral value with views in some areas becoming more negative. There was no significant improvement in students' interest in psychiatry post clerkship, however, knowledge of psychiatry improved significantly. Numbers of students 'definitely considering' psychiatry as a career increased significantly from 7 (4.6%) students at baseline to 17 (10.5%) at follow-up. CONCLUSION The clerkship made a modest impact on students' attitudes to psychiatry, stigma and consideration of psychiatry as a career. Integration of strategies to overcome stigma towards mental illness and the mental health profession into pre-clinical teaching may provide students with skills to prepare them for the clerkship. This may assist in improving attitudes towards psychiatry and encourage more students towards a psychiatry career.
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Affiliation(s)
- Zaza Lyons
- School of Psychiatry and Clinical Neurosciences, M521, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, 6009, Western Australia, Australia.
| | - Aleksandar Janca
- School of Psychiatry and Clinical Neurosciences, M521, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, 6009, Western Australia, Australia.
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Giasuddin NA, Levav I, Gal G. Mental health stigma and attitudes to psychiatry among Bangladeshi medical students. Int J Soc Psychiatry 2015; 61:137-47. [PMID: 24913265 DOI: 10.1177/0020764014537237] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The shortage of specialized human resources in mental health in Bangladesh requires active recruitment of psychiatric residents. In addition, the involvement of positively inclined health personnel, for example, medical doctors, emerges as an immediate priority. AIM To explore stigma among medical students toward persons with mental disorders (PMDs) and their attitudes toward psychiatry. METHOD A cross-sectional study was conducted at Faridpur Medical College in Bangladesh before (First year) and following psychiatric rotation (Fifth year). Students (N = 200) filled anonymous questionnaires measuring stigma toward PMDs and attitudes to psychiatry. RESULTS Upper medical school year (p = .028), older age (p = .005), mother's lower academic level (p = .043), upper and lower socioeconomic level affiliation (p = .008) and self-consultation for mental or neurological complaints (p = .032) were associated with increased stigma toward PMDs. More favorable attitudes toward psychiatry were found in upper medical school year (p = .073) and were significantly associated with female gender (p = .018) and middle socioeconomic level affiliation (p = .013). CONCLUSION The relative improvement in attitudes toward psychiatry in the upper medical school year is overshadowed by the increased stigma toward PMDs. Specific anti-stigma program in the curriculum and strategies to improve the attitudes are required.
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Affiliation(s)
| | - Itzhak Levav
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Gilad Gal
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel Aviv, Israel
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Failde I, Salazar A, Elorza J, Casais L, Pérez V, Martínez LC, Gilaberte I. Spanish medical students' attitudes and views towards mental health and psychiatry: a multicentric cross-sectional study. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2014; 38:332-8. [PMID: 24664595 DOI: 10.1007/s40596-014-0101-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 09/12/2013] [Indexed: 05/04/2023]
Abstract
OBJECTIVE The aim of this study is to investigate the attitudes towards mental illness and psychiatry among fifth year Spanish medical students. METHODS The study included 171 students from three medical schools located in different areas of Spain: Cádiz; UCA (n = 113), Madrid; San Pablo-CEU (n = 22), and Barcelona; UAB (n = 36). They responded, prior to their undergraduate medical course in psychiatry, to the AMI questionnaire to measure the attitudes towards mental illness and to Balon's adapted questionnaire to investigate their view towards psychiatry. RESULTS The students (93.4 %) had a positive attitude towards mental illness (AMI). Attitudes towards psychiatry were fairly positive with a few negative views, specifically regarding the role of psychiatrists (items 11 and 13) and the prestige of the specialty (item 16). There were some statistically significant differences between the three medical schools in the perception of psychiatry as a medical discipline. A better attitude towards mental illness was associated with a better view of the overall merits of psychiatry. CONCLUSIONS Findings suggest that Spanish medical students do not have a negative attitude towards mental illness and they have a good perception of psychiatry, although there are still some misconceptions about this specialty. These student's attitudes could favor an appropriate management of patients suffering from mental illness.
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Magliano L, Read J, Sagliocchi A, Patalano M, Oliviero N. Effect of diagnostic labeling and causal explanations on medical students' views about treatments for psychosis and the need to share information with service users. Psychiatry Res 2013; 210:402-7. [PMID: 23916362 DOI: 10.1016/j.psychres.2013.07.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 04/24/2013] [Accepted: 07/07/2013] [Indexed: 11/15/2022]
Abstract
This study examines whether medical students' views of treatments for 'schizophrenia' and of patients' rights to be informed about their condition and their medication were influenced by diagnostic labeling and causal explanations and whether they differed over medical training. Three hundred and eighty-one Italian students attending their first or fifth/sixth year of medical studies read a vignette portraying someone who met diagnostic criteria for 'schizophrenia' and completed a self-report questionnaire. The study found that labeling the case as 'schizophrenia' and naming heredity among its causes were associated with confidence in psychiatrists and psychiatric drugs. Naming psychological traumas among the causes was associated with confidence in psychologists and greater acknowledgment of users' right to be informed about drugs. Compared to first year students, those at their fifth/sixth-year of studies more strongly endorsed drugs, had less confidence in psychologists and family support, and were less keen to share information on drugs with patients. These findings highlight that students' beliefs vary during training and are significantly related to diagnostic labeling and belief in a biogenetic causal model. Psychiatric curricula for medical students should include greater integration of psychological and medical aspects in clinical management of 'schizophrenia'; more information on the psychosocial causes of mental health problems.
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Affiliation(s)
- Lorenza Magliano
- Department of Psychology, Second University of Naples, Viale Ellittico 31, 81100 Caserta, Italy.
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Differences in views of schizophrenia during medical education: a comparative study of 1st versus 5th-6th year Italian medical students. Soc Psychiatry Psychiatr Epidemiol 2013; 48:1647-55. [PMID: 23117816 DOI: 10.1007/s00127-012-0610-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 10/08/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE This study explored medical students' causal explanations and views of schizophrenia, and whether they changed during medical education. METHOD The survey was carried out on medical students of the Second University of Naples, Italy, who attended their first-year and their fifth- or sixth-year of lessons. The 381 who accepted were asked to read a case-vignette describing a person who met the ICD-10 criteria for schizophrenia and then fill in the Opinions on mental illness Questionnaire. RESULTS The most frequently cited causes were psychological traumas (60%) and stress (56%), followed by misuse of street drugs (47%), and heredity (42%). 28% of students stated that persons with the disorder could be well again, and 28% that they were unpredictable. Labeling the case as "schizophrenia" and naming heredity among the causes were associated with pessimism about recovery and higher perception of social distance. First-year students more frequently reported psychological traumas among the causes (76 vs. 45%), and less frequently heredity (35 vs. 81%) and stress (42 vs. 69%), and they perceived less social distance from the "schizophrenics" than fifth/sixth-year students. In particular, 18% percent of first-year versus 38% of fifth/sixth-year students believed that these persons were kept at a distance by the other, and 45 versus 57% felt frightened by persons with the condition. CONCLUSIONS These results indicate a need to include education on stigma and recovery in schizophrenia in the training of medical students.
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Martínez-Zambrano F, García-Morales E, García-Franco M, Miguel J, Villellas R, Pascual G, Arenas O, Ochoa S. Intervention for reducing stigma: Assessing the influence of gender and knowledge. World J Psychiatry 2013; 3:18-24. [PMID: 24175182 PMCID: PMC3782181 DOI: 10.5498/wjp.v3.i2.18] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/10/2013] [Accepted: 04/17/2013] [Indexed: 02/05/2023] Open
Abstract
AIM To evaluate the effectiveness in reducing social stigma of an intervention and to assess the influence of gender and knowledge. METHODS The program consisted in providing information and contact with users of mental health in order to reduce social stigma in the school environment. A total of 62 secondary school students (age 14-16 years) were evaluated with the Opinions on Mental Illness (OMI) questionnaire before and after the intervention. The subscales of the OMI were: authoritarianism, interpersonal etiology, benevolence, restrictiveness and negativism. The analysis was performed over the total sample, separating by gender and knowledge of someone with a mental disorder. t-test for repeated measures was used in the statistical analysis. RESULTS All the OMI subscales showed a significant change after the intervention (P < 0.001), except for benevolence. Women presented significant changes in the subscales of authoritarianism and restrictiveness, while men presented changes in negativism and interpersonal etiology rather than restrictiveness (P < 0.001-0.003). Students that knew someone with a mental disorder presented significant changes in authoritarianism, interpersonal etiology, and negativism (P < 0.001-0.003) and students that do not know anyone with a mental disorder improved in restrictiveness and authoritarianism (P < 0.001-0.001). In all the subscales of the instrument the students improved their perception of mental disorders, reducing their levels of stigma. CONCLUSION The intervention designed to reduce social stigma was effective, especially in the area of authoritarianism. The whole sample showed improved attitudes towards mental illness, although the areas were different depending on gender and knowledge.
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Effects of short-term interventions to reduce mental health-related stigma in university or college students: a systematic review. J Nerv Ment Dis 2013; 201:490-503. [PMID: 23719324 DOI: 10.1097/nmd.0b013e31829480df] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Although there are many interventions to reduce mental health-related stigma in university or college students, their overall effect is unknown. This article systematically reviews intervention studies and aims to identify the effective approaches. We searched 11 bibliographic databases, Google, Web sites of relevant associations, and reference lists and contacted specialists. A total of 35 studies (N = 4257) of a wide range of interventions met the inclusion criteria. Social contact or video-based social contact interventions seemed to be the most effective in improving attitudes and reducing desire for social distance. Evidence from one study suggests that a lecture that provided treatment information may enhance students' attitudes toward the use of services. However, methodological weaknesses in many studies were also found. There was a lack of evidence for interventions in medical students, for long-term effects of interventions, or for having a positive impact on actual behaviors. Further research having more rigorous methods is needed to confirm this.
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