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Muthelo L, Mbombi MO, Mphekgwana P, Mabila LN, Dhau I, Tlouyamma J, Mashaba RG, Mothapo K, Ntimane CB, Seakamela KP, Nemuramba R, Maimela E, Sodi T. Exploring mental health problems and support needs among pregnant and parenting teenagers in rural areas Of Limpopo, South Africa. BMC Womens Health 2024; 24:236. [PMID: 38614989 PMCID: PMC11015670 DOI: 10.1186/s12905-024-03040-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 03/21/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Globally, teenage pregnancy is among the most social problems, affecting 21 million adolescents aged 15-19. Due to the increased responsibility of prenatal and postnatal care for their infants without support, pregnant and parenting teenagers, tend to experience mental health problems. Factors contributing to these problems among pregnant and parenting teenagers in rural African settings have hardly received scholarly attention and, therefore, are less understood. The purpose of the study was to explore mental health and challenges among pregnant and parenting teenagers,. METHOD(S) The study adopted a qualitative descriptive, exploratory, and phenomenological design. Purposive sampling was used to select 22 pregnant and parenting teenagers 18 years or older. Data were collected in ten selected clinics within the Demographic Surveillance Systems (HDSS) of DIMAMO and analysed using qualitative content analysis. RESULTS The findings reveal that pregnant and parenting teenagers in rural areas experience various mental challenges such as depression. These challenges are caused by social problems such as stigmatisation, lack of support from families and friends, as well as parenting demands that contribute to poor progress at school or dropouts. Pregnant teens expressed concerns about the lack of spousal support resulting from abandoning their partners. CONCLUSIONS Stress and depression were self-reported as mental problems among participants with various psychosocial implications, such as school dropout and miscarriage. There are various contributing factors to the mental health problems identified among pregnant and parenting teenagers, including inadequate family and spousal support. Access to integrated reproductive, psychosocial, and mental health services could be essential for these pregnant and parenting teenagers, to improve their mental well-being and improve the support system.
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Affiliation(s)
- Livhuwani Muthelo
- Department of Nursing Science, University of Limpopo, SOVENGA, Private Bag X1106, Polokwane, 0727, South Africa.
| | - Masenyani Oupa Mbombi
- Department of Nursing Science, University of Limpopo, SOVENGA, Private Bag X1106, Polokwane, 0727, South Africa
| | - Peter Mphekgwana
- Research Administration and Development, University of Limpopo, SOVENGA, Private Bag X1106, Polokwane, 0727, South Africa
| | - Linneth Nkateko Mabila
- Department of Pharmacy, University of Limpopo, SOVENGA, Private Bag X1106, Polokwane, 0727, South Africa
| | - Inos Dhau
- Department of Geography and Environmental Studies, University of Limpopo, SOVENGA, Private Bag X1106, Polokwane, 0727, South Africa
| | - Joseph Tlouyamma
- Department of Computer Science, University of Limpopo, SOVENGA, Private Bag X1106, Polokwane, 0727, South Africa
| | - Reneilwe Given Mashaba
- DIMAMO Population Health Research Centre, University of Limpopo, SOVENGA, Private Bag X1106, Polokwane, 0727, South Africa
| | - Katlego Mothapo
- DIMAMO Population Health Research Centre, University of Limpopo, SOVENGA, Private Bag X1106, Polokwane, 0727, South Africa
| | - Cairo Bruce Ntimane
- DIMAMO Population Health Research Centre, University of Limpopo, SOVENGA, Private Bag X1106, Polokwane, 0727, South Africa
| | - Kagiso Peace Seakamela
- DIMAMO Population Health Research Centre, University of Limpopo, SOVENGA, Private Bag X1106, Polokwane, 0727, South Africa
| | - Rathani Nemuramba
- DIMAMO Population Health Research Centre, University of Limpopo, SOVENGA, Private Bag X1106, Polokwane, 0727, South Africa
| | - Eric Maimela
- Department of Public Health, University of Limpopo, Private Bag X1106, SOVENGA 0727, Polokwane, South Africa
| | - Tholene Sodi
- Research Chair Mental Health, University of Limpopo, Private Bag X1106, Polokwane, 0727, SOVENGA, South Africa
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Quiles C, Sy H, Verdoux H. Stigmatization towards electro convulsive therapy: Impact of practical teaching on medical and nursing students. Encephale 2024; 50:125-129. [PMID: 37121808 DOI: 10.1016/j.encep.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/06/2023] [Accepted: 01/12/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND This study explored the impact of theoretical and practical teaching on electro convulsive therapy (ECT) on medical and nursing students' stigmatizing attitudes towards ECT and representations of it. METHOD Fourth-year medical students and nursing students answered questions from the Questionnaire on Attitudes and Knowledge of ECT (QuAKE) and from the Mental Illness: Clinicians' Attitudes version 2 (MICA v2) scale. The questionnaires were completed before and after observing a 3-hour practical training session in the ECT unit. The endpoint was the impact of practical training as assessed by MICA and QuAKE scores. Multivariate analyses were used to explore the impact of practical training on MICA and QuAKE total scores. RESULTS Stigmatizing attitudes and representations of both medical and nursing students towards ECT were reduced after practical training (β=-4.43 [95% CI -6.15; -2.70] p=0.0001). The impact was greater in medical students (β=-8.03; 95% CI [-10.71; -5.43], P=0.0001) than in nursing students (β=-2.77; 95% CI [-4.98; to 0.44], P=0.02). Gender, psychiatric history in close persons, and having already followed a psychiatric/ECT course had no independent impact on stigmatizing attitudes towards ECT and representations of it. CONCLUSION Practical training in ECT should be given to all health professionals to improve access to it.
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Affiliation(s)
- Clélia Quiles
- Centre Hospitalier Charles Perrens, 121, rue de la Béchade, CS81285, 33076 Bordeaux Cedex, France; Université de Bordeaux, Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, 33000 Bordeaux, France.
| | - Héloïse Sy
- Centre Hospitalier Charles Perrens, 121, rue de la Béchade, CS81285, 33076 Bordeaux Cedex, France
| | - Hélène Verdoux
- Centre Hospitalier Charles Perrens, 121, rue de la Béchade, CS81285, 33076 Bordeaux Cedex, France; Université de Bordeaux, Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, 33000 Bordeaux, France
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Fekih-Romdhane F, Boukadida Y, Abassi B, Chaibi LS, Conus P, Krebs MO, Thornicroft G, Cheour M, Jahrami HA. French validation of the barriers to access to care evaluation (BACE-3) scale. Encephale 2024:S0013-7006(24)00010-1. [PMID: 38311478 DOI: 10.1016/j.encep.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND The aim of this study was to develop and evaluate a French version of the Barriers to Access to Care Evaluation (BACE-3) scale that is tailored to the socio-cultural and language setting of the study. METHODS The translation of the BACE-3 into French and its validation were the two key components of this psychometric investigation. An online survey was created and circulated to French-speaking participants who volunteered to participate in the study. RESULTS For all translated questions, the reliability analysis key results (Cronbach's alpha and McDonald's Omega) were both>0.95, which is an excellent reliability value. The BACE-3 items were shown to be positively related to one another, implying excellent validity. Results of exploratory and confirmatory factor analyses showed that all stigma-related items were loaded under the same factor. CONCLUSIONS The BACE-3 has been validated in French, and its psychometric qualities have been thoroughly evaluated and found to be excellent.
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Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia; The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, 1, rue des orangers, 2010 Manouba, Tunisia.
| | - Youssef Boukadida
- The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, 1, rue des orangers, 2010 Manouba, Tunisia
| | - Bouthaina Abassi
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia; The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, 1, rue des orangers, 2010 Manouba, Tunisia
| | - Leila Sarra Chaibi
- The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, 1, rue des orangers, 2010 Manouba, Tunisia
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie-Odile Krebs
- Laboratoire de physiopathologie des maladies psychiatriques, UMR_S1266 institut de psychiatrie et neurosciences de Paris, université Paris Descartes, Inserm, Paris, France; Institut de psychiatrie (CNRS GDR 3557), Paris, France; Service hospitalo universitaire, faculté de médecine Paris Descartes, centre hospitalier Sainte-Anne, université Paris Descartes, Paris, France
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia; The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, 1, rue des orangers, 2010 Manouba, Tunisia
| | - Haitham A Jahrami
- Ministry of Health, Manama, Bahrain; Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Liu LS, Jia X, Zhu A, Ran GJ, Siegert R, French N, Johnston D. Stigmatising and Racialising COVID-19: Asian People's Experience in New Zealand. J Racial Ethn Health Disparities 2023; 10:2704-2717. [PMID: 36369460 PMCID: PMC9651882 DOI: 10.1007/s40615-022-01448-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022]
Abstract
The Asian community - the second largest non-European ethnic community in New Zealand - plays an important role in combatting the COVID-19 pandemic, evidenced by their active advocation for border control and mass masking. Despite the long history of racial discrimination against the Asian population, the Asian community has experienced certain degrees of racial discrimination associated with the stigmatisation as the cause of the COVID-19 outbreak in New Zealand. Based on data from a quantitative online survey with 402 valid responses within the Asian communities across New Zealand and the in-depth interviews with 19 Asian people in Auckland, New Zealand, this paper will illustrate Asian people's experience of racial discrimination and stigmatisation during the pandemic in the country. The survey shows that since the outbreak of COVID-19, under a quarter of the participants reported experiencing discrimination, and a third reported knowing an immediate contact who had experienced discrimination. However, when looking beyond their immediate social circle, an even higher proportion reported noticing racism and stigmatisation through the traditional or social media due to COVID-19. Major variations of the degree of racial discrimination experienced are determined by three demographic variables: ethnicity, age, and region. The in-depth interviews largely echoed the survey findings and highlighted a strong correlation between the perceived racial discrimination among the local Asian community and the stigmatisation associated with COVID-19. These findings are important for improving the way we manage future pandemics and other disasters within the context of the UN Sendai Framework for Disaster Risk Reduction.
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Affiliation(s)
- Liangni Sally Liu
- School of Humanities, Media and Creative Communication, Massey University, Auckland, New Zealand.
| | - Xiaoyun Jia
- Institute of Governance & School of Politics and Public Administration, Shangdong University, Qingdao, China
- School of Mathematical and Computational Sciences, Massey University, Auckland, New Zealand
| | - Andrew Zhu
- Trace Research Ltd, Auckland, New Zealand
| | - Guanyu Jason Ran
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Richard Siegert
- Department of Psychology & Neuroscience, School of Clinical Sciences, University of Technology, Auckland, New Zealand
| | - Nigel French
- Infectious Diseases Research Centre, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | - David Johnston
- Joint Centre for Disaster Research, Massey University, Wellington, New Zealand.
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Sánchez López S, Barrington DJ, Poveda Bautista R, Moll López S. Spanish menstrual literacy and experiences of menstruation. BMC Womens Health 2023; 23:161. [PMID: 37016318 PMCID: PMC10074887 DOI: 10.1186/s12905-023-02293-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/20/2023] [Indexed: 04/06/2023] Open
Abstract
There is growing recognition of the important role menstrual health plays in achieving health, education, and gender equity. Yet, stigmatisation and taboo remain present and negative emotions like fear and shame dominate the narrative when speaking about periods. This paper analyses how formal and informal menstrual education is received in Spain, to understand the role of menstrual health literacy in the way menstruation is experienced, and to identify what information would be useful to integrate into formal menstrual education. An online survey with more than 4000 participants (aged between 14 and 80, both people who will/do/have previously menstruate/d and those who do not menstruate) was conducted. Data was gathered using the digital platform Typeform, descriptive and inferential statistical analyses were performed with SPSS software and qualitative data was thematically analysed using Nvivo. Many participants declared not having received sufficient information on menstruation prior to menarche, particularly about how to physically manage it. Furthermore, negative emotions like shame, worry, and fear were recurrently reported to describe menarche; this has not changed between generations. Interestingly, we saw an increase in stress and sadness with an increase in perceived knowledge of the reproductive role of menstruation. We did observe a reduction in negative emotions when people who menstruate perceived they had sufficient information on how to manage their first bleeding. It is recommended that menstrual education beyond reproductive biology, particularly including how to physically manage periods, is integrated into school curricula. Menstrual education of everyone - including those who do not menstruate-can improve how periods are experienced in Spain.
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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]. 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Chan HN, Mohamad A, Abdul Rashid A, Ho BK, Abdul Aziz Cooper A, Mukhtar Aajamer H, Noor Emjah E, Krishnan JS, Hwee GNL. Assessing knowledge, acts of discrimination, stigmatizing attitudes and its associated factors towards people living with HIV (PLHIV) among Family Medicine trainees in Malaysia. Malays Fam Physician 2022; 17:33-42. [PMID: 36606169 PMCID: PMC9809432 DOI: 10.51866/oa1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Human immunodeficiency virus (HlV)-related stigmatisation and discrimination adversely affect health outcomes in terms of timely diagnosis, treatment and care. Despite global efforts, they remain common among healthcare workers worldwide. In Malaysia, family medicine specialists are entrusted with the care of HIV patients at the primary care level. This study aimed to assess HIV-related knowledge, acts of discrimination, stigmatising attitudes and their associated factors among family medicine trainees in Malaysia. METHODOLOGY This cross-sectional study was conducted among 397 family medicine trainees in Malaysia using a validated, self-administered questionnaire that assessed the participants' sociodemographic information, HIV/AIDS knowledge, stigmatising attitudes (attitudes of blame, attitudes towards imposed measures, comfort in dealing with HIV patients) and acts of discrimination. RESULTS The most common stigmatisation was "attitudes of blame" (mean [SD] score: 3.0 (0.74); range score:1-5), and the most frequent discriminatory act was breaching patient confidentiality (54.9%). Around 82.1% had good knowledge of HIV/AIDS. Married participants and participants who had 7 years or less in service were more stigmatising in "attitudes of imposed measures" towards people living with HIV (p=0.006). CONCLUSION Family medicine trainees exhibited stigmatisation and discrimination towards HIV patients despite having good HIV knowledge. Hence, appropriate and concerted health education should be given to all family medicine trainees to eliminate stigmatisation and discrimination.
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Affiliation(s)
- Hiang Ngee Chan
- MBBS (IMU), FRACGP (Australia) Klinik Kesihatan Cheras, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia.
| | - Anuar Mohamad
- MD (UKM), Dr. Fam. Med (UKM) Klinik Kesihatan Cheras, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpu, Malaysia
| | - Aneesa Abdul Rashid
- MBBCh BAO (NUI), DrFamMed (UKM) Department of Family Medicine, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia (UPM), UPM, Serdang, Malaysia
| | - Bee Kiau Ho
- MBBS (UM), MMed (Family Medicine) Klinik Kesihatan Bandar Botanic, Jalan Langat, Bandar Botanic, Klang, Selangor, Malaysia
| | - Alia Abdul Aziz Cooper
- MBChB (University of Dundee), FRACGP (Australia) Klinik Kesihatan Kota Damansara 40-70, Jalan Pekaka 8/3, Kota Damansara, Petaling Jaya, Selangor, Malaysia
| | - Haslina Mukhtar Aajamer
- MD (USU), Graduate Certificate of Family Medicine (AFPM) Klinik Medina, Subang Jaya, Malaysia
| | - Ermi Noor Emjah
- MD (USM), Diploma in Family Medicine (AFPM) Pejabat Kesihatan Daerah Hulu Langat, Kajang, Selangor, Malaysia
| | - Jashithra Syamala Krishnan
- MBBS (AIMST), Diploma in Family Medicine (AFPM) Klinik Kesihatan Pandamaran, Persiaran Raja Muda Musa, Klang, Selangor, Malaysia
| | - Gloria Neo Lih Hwee
- MD (CSMU), Graduate Certificate in Family Medicine (AFPM) Klinik Alam Medic, Taman Sri Muda, Subang Jaya, Selangor, Malaysia
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Valery KM, Violeau L, Fournier T, Yvon F, Arfeuillere S, Bonilla-Guerrero J, Caria A, Carrier A, Destaillats JM, Follenfant A, Laberon S, Lalbin-Wander N, Martinez E, Staedel B, Touroude R, Vigneault L, Roux S, Prouteau A. Part of the solution yet part of the problem: factors of schizophrenia stigma in mental health professionals. Int J Psychiatry Clin Pract 2022:1-11. [PMID: 36200837 DOI: 10.1080/13651501.2022.2129068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
BACKGROUND Stigma is highly prejudicial to persons with schizophrenia, their families, the society and the health care system. Mental health professionals (MHP) are considered to be one of the main sources of schizophrenia stigma. OBJECTIVES The aim of the study was to identify individual and contextual factors associated with stigma in MHP in its three dimensions (stereotypes, prejudices, discrimination, Fiske, 1998). METHODS An online survey was conducted with specific measures of MHP stigma (stereotypes, prejudices and discrimination). Four categories of potential associated factors were also measured: sociodemographic characteristics, contextual characteristics (e.g., Work setting), individual characteristics (e.g., Profession, Recovery-oriented practices) and theoretical beliefs (e.g., Biological beliefs, Perceived similarities, Continuum versus Categorical beliefs). RESULTS Responses of 357 MHP were analysed. Factors that were the most strongly associated with MHP stigma were Perceived similarities, Categorical beliefs, Biological beliefs, Recovery-oriented practice and Work setting (independent practice). Conversely, Gender, Specific trainings in stigma or recovery and Cognitive aetiology beliefs showed no association with any of MHP stigma dimension. Remaining factors show associations with a weak effect size. CONCLUSIONS The survey results suggest that MHP stigma is more influenced by individual factors such as theoretical beliefs and recovery-oriented practices than contextual factors. These original results provide perspectives for reducing stigma in mental health practices.Key pointsMental health professionals (MHP) considering they share similarities with persons with schizophrenia or believing that schizophrenia is not a discrete social category but rather the extreme on a continuum between 'normal' and 'pathologic' reported less stigmatisation.MHP holding higher professional utility beliefs and using recovery-oriented practice reported fewer stereotypes, prejudice and discrimination.Other factors such as age, academic level, contact frequency, familiarity and multidisciplinary practice show associations with a weak effect size.
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Affiliation(s)
- Kevin-Marc Valery
- LabPsy, Univ. Bordeaux, Bordeaux, France.,Adult Psychiatry Department, Jonzac Hospital, Jonzac, France
| | - Louis Violeau
- LabPsy, Univ. Bordeaux, Bordeaux, France.,Adult Psychiatry Department, Jonzac Hospital, Jonzac, France
| | - Thomas Fournier
- LabPsy, Univ. Bordeaux, Bordeaux, France.,Adult Psychiatry Department, Jonzac Hospital, Jonzac, France
| | | | | | | | | | | | | | | | | | | | - Eric Martinez
- Adult Psychiatry Department, Jonzac Hospital, Jonzac, France
| | | | | | | | | | - Antoinette Prouteau
- LabPsy, Univ. Bordeaux, Bordeaux, France.,Adult Psychiatry Department, Jonzac Hospital, Jonzac, France
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Sabri A, Obtel M, Kharbach A, Doufik J, Baba MA, Abouqal R, Razine R. The cultural epidemiology of stigma among people with schizophrenia : Adaptation and cross-cultural validation of the Explanatory Model Interview Catalogue (EMIC), in Dialectal Arabic (Darija), Morocco. Rev Epidemiol Sante Publique 2022:S0398-7620(22)00337-6. [PMID: 35623932 DOI: 10.1016/j.respe.2022.03.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/29/2021] [Accepted: 03/10/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Stigma underlies the violation of certain social, economic, and cultural rights of patients with schizophrenia, including their access to treatment and care. Measurement of stigma remains as complex and multifaceted as the phenomenon itself. Several measurement tools are available to assess the prevalence, intensity and qualities of stigma. The aim of the study was to carry out a cross-cultural adaptation of the Explanatory Model Interview Catalogue (EMIC), in the Moroccan Arabic dialect commonly known as "Darija". PATIENTS AND METHOD The study was conducted in three psychiatric departments of public hospitals in the Souss-Massa region, located in southern Morocco. For the diagnosis of schizophrenia, the study was based on the decisions of the psychiatrists practicing at the study sites. The cross-cultural adaptation in Moroccan Darija of the stigma scale developed by Michel Weiss in the EMIC was carried out according to the six-step scientific method developed by Dorcas et al. RESULTS Cronbach's alpha (internal consistency) was 0.845. Convergent validity determined by Pearson's coefficient showed a significant inter-item correlation and the intra-class correlation coefficient (test-retest) was 0.975 (0.993; 0.991). The item added in relation to the COVID-19 situation presented psychometric values similar to the others. CONCLUSION The Darija version is culturally acceptable and can be used to approach the phenomenon of stigmatization in Morocco.
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Ait Idar A, Madani M, Berghalout M, Adali I, Manoudi F. [Stigma in psychiatry]. Encephale 2021; 48:288-293. [PMID: 34148648 DOI: 10.1016/j.encep.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/23/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022]
Abstract
Mental illness affects 48.9 % of the Moroccan population. Despite this significant figure, mental illness remains unrecognized. The patients suffering from mental disorders are therefore subject to stigma and social rejection. A descriptive study was conducted at the consultation service of the psychiatric Ibn Nafiss hospital of the CHU of Marrakech. We chose as a sample 100 stabilized patients, followed on an outpatient basis. The study included the three mental disorders: depressive disorder, bipolar disorder, and schizophrenia. The number of patients in each group had been fixed beforehand; and we tried to get a fairly even distribution between the two genders. The questionnaire had three main axes: (1) Sociodemographic data of the patient. (2) Knowledge of the disease. (3) Evaluation of the experience of stigma. The results of our sample were as follows: For both sexes the age extremes were 19 to 68 years with an average of 38.5 with a clear predominance of women. For the entire population, most patients were single with a percentage of 60 %. Two thirds of the patients, i.e. 59 %, did not exceed primary school. For personal medical history, endocrine pathologies were the most prevalent, at 18 % of cases, while depression was the most common family psychiatric history in our study. We noticed that our population suffered more discrimination and disclosure from those around them regardless of family, social and professional with less appreciation of the positive aspects.
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Affiliation(s)
- A Ait Idar
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc.
| | - M Madani
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
| | - M Berghalout
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
| | - I Adali
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
| | - F Manoudi
- CHU Mohammed VI BP2360 Principal, avenue Ibn Sina, Marrakech, Maroc
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11
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Pawlak S, Wathelet M, Olivier F, Fovet T, Amad A. [Impact of an educational video on the representations of electroconvulsive therapy among psychiatrists in Hauts-de-France and Occitanie]. Encephale 2021; 47:441-444. [PMID: 34148645 DOI: 10.1016/j.encep.2021.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/17/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Despite its effectiveness and good tolerance, electro-convulsive therapy (ECT) is under-used in current clinical practice probably because of stigma and the negative image of this treatment. The main objective of this study was to evaluate the impact of an educational video on the representations of ECT among psychiatrists and psychiatric residents in the North and in Occitanie districts of France. METHOD We evaluated the representations of ECT through the Questionnaire on Attitudes and Knowledge of ECT (QuAKE) before (T0) and after (T1) viewing a short educational video. Scores at T0 and T1 were compared with a paired t-test. Factors associated with the improvement of the representations were investigated using a logistic regression model. RESULTS In all, 195 responses were obtained. The QuAKE score at T1 was significantly better than at T0 (29.4 at T1 vs. 31.5 at T0, P<0.001). The more negative the representations were at T0, the higher the probability of a decrease in the score at T1 (OR=1.07 [1.02-1.13], P=0.003). DISCUSSION Our study showed a beneficial effect of a short educational video on psychiatrists' representations of ECT. The wide use of this type of media, allowing information and destigmatization, could considerably optimize access to ECT for patients.
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Affiliation(s)
- S Pawlak
- Service de psychiatrie, centre hospitalier Valenciennes, 114, avenue Desandrouin, 59300 Valenciennes, France; Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), 211, rue du Général-Leclerc, 59350 Saint-André-lez-Lille, France
| | - M Wathelet
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), 211, rue du Général-Leclerc, 59350 Saint-André-lez-Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), 59000 Lille, France; Université de Lille, Inserm, CHU Lille, U1172-LilNCog - Lille Neuroscience & Cognition, 59000 Lille, France
| | - F Olivier
- Fédération régionale de recherche en psychiatrie et santé mentale Occitanie, FERREPSY Occitanie, 31000 Toulouse, France; Centre Hospitalier de Montauban, 82000 Montauban, France
| | - T Fovet
- Centre national de ressources et de résilience Lille-Paris (CN2R), 59000 Lille, France; Université de Lille, Inserm, CHU Lille, U1172-LilNCog - Lille Neuroscience & Cognition, 59000 Lille, France
| | - A Amad
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), 211, rue du Général-Leclerc, 59350 Saint-André-lez-Lille, France; Université de Lille, Inserm, CHU Lille, U1172-LilNCog - Lille Neuroscience & Cognition, 59000 Lille, France.
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12
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Fontesse S, Stinglhamber F, Demoulin S, de Timary P, Maurage P. Self-dehumanisation in severe alcohol use disorder: Links with self-stigma and environmental satisfaction. Int J Psychol 2021; 56:878-884. [PMID: 33973251 DOI: 10.1002/ijop.12774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 04/21/2021] [Indexed: 11/09/2022]
Abstract
Metadehumanisation (i.e., the perception of being considered as less than human by others) is proposed to be widespread in stigmatised populations, such as people with severe alcohol use disorder (SAUD). However, the relations between metadehumanisation, self-dehumanisation (i.e., the self-perception of being less than human), and stigmatisation (i.e., the negative taint applied to some groups) remain unexplored. The aim of this research is thus to investigate the relations between these processes. Metadehumanisation, self-dehumanisation, self-stigma (and its subdimensions) and environmental satisfaction were assessed in 120 inpatients with SAUD and analysed in a mediational model. Stigma awareness was positively associated with metadehumanisation, whereas environmental satisfaction was negatively associated with metadehumanisation. Stigma's application to the self was associated with increased self-dehumanisation. Self-stigma and self-dehumanisation are closely intertwined phenomena. Self-dehumanisation seems to follow a multi-step process suggesting that some steps, such as dehumanisation awareness, are missing from current models of dehumanisation.
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Affiliation(s)
- Sullivan Fontesse
- Louvain Experimental Psychopathology Research Group, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Florence Stinglhamber
- Work and Organizational Psychology Lab, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Stéphanie Demoulin
- Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Philippe de Timary
- Louvain Experimental Psychopathology Research Group, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium.,Department of Adult Psychiatry, Cliniques Universitaires Saint Luc and Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
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Wabitsch M, V Schnurbein J, Vollbach H, Lennerz B, Weyhreter H, Wiegand S, Kiess W, Hebebrand J, Brandt S. [Innovative medical care concepts for adolescents with severe obesity]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:831-838. [PMID: 32518967 DOI: 10.1007/s00103-020-03167-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There is no convincing, science-based treatment or care concept for adolescents with severe obesity in Germany or other countries. The affected young people have an increased risk of numerous somatic comorbidities (e.g. type 2 diabetes mellitus, orthopaedic disorders and sleep apnoea syndrome), mental disorders (e.g. depression and anxiety disorders, social phobia and self-harming behaviour), as well as social isolation (e.g. avoidance of school and unemployment), which develops due to functional impairments and stigmatisation. Despite the negative effects of severe obesity in adolescence, these young people are medically difficult to reach and treat. Only a small percentage of patients actively seek treatment.Aware of these difficulties, the German multi-centre Youth with Extreme Obesity (YES) Study (funded by the German Ministry of Education and Science; 01 GI 1120 A and B) was carried out between 2012 and 2019 with the aim of improving care concepts for this neglected group of young people. In our article, we show possible supply routes. These consist of accompanying the adolescents and treating their comorbidities, sustainable lifestyle interventions in a protected environment and treatment for weight reduction through bariatric surgery. The overriding goals for patients are an increase in self-esteem, early diagnosis and treatment of secondary diseases and integration into the training and labour market.
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Affiliation(s)
- Martin Wabitsch
- Sektion Pädiatrische Endokrinologie und Diabetologie, Universitätsklinik für Kinder- und Jugendmedizin Ulm, Eythstr. 24, 89075, Ulm, Deutschland.
| | - Julia V Schnurbein
- Sektion Pädiatrische Endokrinologie und Diabetologie, Universitätsklinik für Kinder- und Jugendmedizin Ulm, Eythstr. 24, 89075, Ulm, Deutschland
| | - Heike Vollbach
- Sektion Pädiatrische Endokrinologie und Diabetologie, Universitätsklinik für Kinder- und Jugendmedizin Ulm, Eythstr. 24, 89075, Ulm, Deutschland
- Zentrum für Kinderheilkunde, Universitätsklinikum Bonn, Bonn, Deutschland
| | - Belinda Lennerz
- Sektion Pädiatrische Endokrinologie und Diabetologie, Universitätsklinik für Kinder- und Jugendmedizin Ulm, Eythstr. 24, 89075, Ulm, Deutschland
- Division of Endocrinology, Boston Children's Hospital, Boston, USA
| | - Helmut Weyhreter
- Sektion Pädiatrische Endokrinologie und Diabetologie, Universitätsklinik für Kinder- und Jugendmedizin Ulm, Eythstr. 24, 89075, Ulm, Deutschland
| | - Susanna Wiegand
- Sozialpädiatrisches Zentrum, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Wieland Kiess
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Leipzig, Deutschland
| | - Johannes Hebebrand
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, LVR-Klinikum Essen, Essen, Deutschland
| | - Stephanie Brandt
- Sektion Pädiatrische Endokrinologie und Diabetologie, Universitätsklinik für Kinder- und Jugendmedizin Ulm, Eythstr. 24, 89075, Ulm, Deutschland
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Perry A, Lawrence V, Henderson C. Stigmatisation of those with mental health conditions in the acute general hospital setting. A qualitative framework synthesis. Soc Sci Med 2020; 255:112974. [PMID: 32388323 DOI: 10.1016/j.socscimed.2020.112974] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/26/2020] [Accepted: 03/29/2020] [Indexed: 01/22/2023]
Abstract
RATIONALE Patients with long-term mental health conditions often have complex physical, mental, and social needs. They are frequent users of the acute general healthcare system, but can experience stigmatising attitudes and behaviours, and structural discrimination. We wished to improve understanding of stigmatisation in the acute healthcare setting, to target areas for future intervention. OBJECTIVE A synthesis of qualitative literature was undertaken in order to understand how patients with long-term mental health conditions are stigmatised, or otherwise treated, within the acute healthcare system. METHOD A theory-driven framework approach was implemented. Existing stigma theory was used to outline a framework for categorizing stigmatising and non-stigmatising phenomena within the acute healthcare system. RESULTS A systematic literature search of qualitative studies identified a sample of 51 studies that would inform the framework. Using data in these studies, a final theoretical 'best fit' framework was developed. In this framework there is an overarching pattern of labelling and stereotyping, plus five ways in which patients with mental health conditions are stigmatised in the acute healthcare system: devaluation, social control, avoidance, rejection, and failure to act. In addition, the framework outlines positive attitudes and behaviours - valuing, adjustment, responding, legitimising, and positive action - which contrast with the stigmatisation patterns. CONCLUSIONS The study offers a framework for identifying stigmatisation and positive treatment of those with mental health conditions in an acute health setting. This framework is of potential value in targeting areas for improved quality of care and may have utility beyond this setting and stigmatised group.
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Affiliation(s)
- Amanda Perry
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Vanessa Lawrence
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Claire Henderson
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
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15
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Côté D, Dubé J, Gravel S, Gratton D, White BW. Cumulative stigma among injured immigrant workers: a qualitative exploratory study in Montreal (Quebec, Canada). Disabil Rehabil 2019; 42:1153-1166. [PMID: 30686038 DOI: 10.1080/09638288.2018.1517281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: This paper presents the phenomenon of stigmatisation among injured immigrant and ethnocultural minority workers experiencing a long-standing disability. Stigmatisation was one of the main findings of our study, the aim of which was to gain insight into the work rehabilitation process in the context of intercultural relations in Quebec. Various categories of stakeholders took part in the study, which sought to describe their experiences and perspectives and to identify the constraints, barriers, facilitators, and specific needs they encounter in terms of intercultural competencies.Methods: A purposive sample of 40 individuals was selected and divided into four groups: workers (N = 9), clinicians (N = 15), workers' compensation board rehabilitation experts (N = 14), and workplace representatives (N = 2). Semi-structured interviews were conducted using the critical incident technique, combined with an "explicitation" interviewing technique. Data collection and analysis procedures were based on grounded theory.Results: This study shows that immigrant and ethnocultural minority workers may experience stigmatisation as a cumulative process involving different concomitant parts of their "identity": age, gender, social class, ethnicity, mental health, and occupational injuries. Cumulative stigma may aggravate personal distress and feelings of shame, rejection, and disqualification from full social acceptance. Negative anticipatory judgements made by practitioners may undermine the therapeutic relationship and breach mutual trust and confidence.Conclusions: The phenomenon of stigmatisation is well documented in the sociological and health literature, but studies tend to focus on only one type of stigma at a time. Future research should focus on the cumulative process of stigmatisation specifically affecting immigrant and ethnocultural minority workers and its potentially damaging impact on self-concept, healthcare delivery, rehabilitation interventions, and the return to work.Implications for rehabilitationThe repetition of certain clinical situations with people from certain groups should not lead practitioners to undue generalizations, even if they may sometimes be accurate; these generalizations must always be verified on a case by case basis.Ethnicity and culture, along with other social attributions, should serve as working hypotheses or support tools in health communication, not as hindrances to clinical reasoning.Practitioners should deepen their understanding of the patient's treatment expectations and the support available for rehabilitation in his family and community.Stigma in the context of care is linked to the idea of conforming to the proposed institutional models of care (including expected beliefs, attitudes, and behaviours). Therefore, practitioners should be aware that alleged differences, misunderstanding or disagreements can highlight an asymmetry in practitioner-patient power relationships.Organisations should also promote exchange and reflection on how to adapt their institutional models to avoid asymmetrical power relations.Intercultural training should be promoted at the various organisational levels so that managers, decision-makers, and practitioners share a common knowledge of the challenges of intervention in multi-ethnic settings.
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Affiliation(s)
- Daniel Côté
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Canada.,Département d'anthropologie, Universite de Montreal, Montreal, Canada
| | - Jessica Dubé
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Canada.,École des sciences de la gestion, Université du Québec à Montréal (UQAM), Montreal, Canada
| | - Sylvie Gravel
- Département d'anthropologie, Universite de Montreal, Montreal, Canada
| | - Danielle Gratton
- Centre intégré de santé et de services sociaux de Laval, Laval, Canada
| | - Bob W White
- Département d'anthropologie, Universite de Montreal, Montreal, Canada
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Abstract
Eugenics is often referred to in debates on the ethics of reproductive technologies and practices, in relation to the creation of moral boundaries between acceptable and unacceptable technologies, and acceptable and unacceptable uses of these technologies. Historians have argued that twentieth century eugenics cannot be reduced to a uniform set of practices, and that no simple lessons can be drawn from this complex history. Some authors stress the similarities between past eugenics and present reproductive technologies and practices (what I define throughout the paper as 'the continuity view') in order to condemn the latter. Others focus on the differences between past and present practices (what I define throughout the paper as 'the discontinuity view') in order to defend contemporary reproductive technologies. In this paper, I explore the meanings of the word 'eugenics' and the relationship between its past and present uses in terms of contemporary debates on reproductive technologies and practices. I argue that moral disagreement about present technologies originate in divergent views of condemnable and justifiable features of the past.
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Affiliation(s)
- Giulia Cavaliere
- Department of Global Health and Social Medicine, School of Global Affairs, King's College London, Room 3.12, Bush House (NE), 30, Aldwych, London, WC2B 4BG, UK.
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17
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Richa S, Chammay R, Dargél A, Henry C, Masson M. Ethical considerations in bipolar disorders. Encephale 2018; 44:286-287. [PMID: 29415803 DOI: 10.1016/j.encep.2017.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 12/11/2017] [Accepted: 12/11/2017] [Indexed: 10/18/2022]
Abstract
The implications of biomedical ethics principles extend to both medical care and biomedical research. They are particularly relevant for psychiatry in which pathologies are often chronic and disabling. Bipolar disorders impact the ability to make judgements and to take decisions during mood episodes and remain a stigmatised condition. Early interventions, even those in the prodromal phase, pose ethical questions for both clinicians and researchers. The degree of patients' autonomy in their clinical care must also now be considered from a biomedical ethics perspective.
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Affiliation(s)
- S Richa
- Department of psychiatry, faculty of medicine, Saint-Joseph university, Pobox 17-5208 Beirut, Lebanon.
| | - R Chammay
- Department of psychiatry, faculty of medicine, Saint-Joseph university, Pobox 17-5208 Beirut, Lebanon
| | - A Dargél
- Unité perception et mémoire, Institut Pasteur, 25-28, rue du Docteur Roux, 75015 Paris, France; Unité mixte de recherche, centre national de la recherche scientifique, UMRS-CNRS 3571, 3, rue Michel Ange, 75016 Paris, France; Nightingale hospitals Paris-Clinique Bellevue-Meudon, 8, avenue du 11-Novembre-1918, 92190 Meudon, France
| | - C Henry
- Unité perception et mémoire, Institut Pasteur, 25-28, rue du Docteur Roux, 75015 Paris, France; Université Paris-Est, UPEC, 61, avenue du Général-de-Gaulle, 94000 Créteil, France; Pôle de psychiatrie, hôpital H. Mondor-A. Chenevier, AP-HP, 31, rue du Parc, 94000 Créteil, France
| | - M Masson
- Service-hospitalo universitaire, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Nightingale hospitals Paris-Clinique du Château, 11, bis rue de la Porte-Jaune, 92380 Garches, France
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18
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Kelly J, Albutt K, Kabanga J, Anderson K, VanRooyen M. Rejection, acceptance and the spectrum between: understanding male attitudes and experiences towards conflict-related sexual violence in eastern Democratic Republic of Congo. BMC Womens Health 2017; 17:127. [PMID: 29221482 PMCID: PMC5721471 DOI: 10.1186/s12905-017-0479-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 11/27/2017] [Indexed: 11/21/2022]
Abstract
Background Female survivors of sexual violence in conflict experience not only physical and psychological sequelae from the event itself, but often many negative social outcomes, such as rejection and ostracisation from their families and community. Male relatives – whether husbands, fathers, brothers – play a key role in determining how the family and community respond to a survivor of sexual violence. Understanding these perspectives could help improve services for survivors of sexual violence, as well as their families and communities. Methods This study draws on qualitative data gathered from focus groups of 68 men in the eastern region of Democratic Republic of Congo. Men were asked about their experiences as relatives of women who had experienced sexual violence. Results Two dominant themes arose throughout the focus groups: factors driving rejection and pathways to acceptance. Factors driving rejection included: fear of sexually transmitted infections, social stigma directed toward the husbands themselves, and an understanding of marriage and fidelity that is incompatible with rape. Men also touched on their own trauma, including struggling with witnessing a rape that took place in public, or caring for a survivor with a child from rape. They noted that the economic burden of medical treatment for survivors was a salient factor in the decision to reject. Pathways to acceptance included factors such as the love of their spouse or relative, survivors’ potential to give continued financial contribution to the family, the need to keep the family together to care for children in the home, and pressure from people of importance in the community. Conclusion This study provides unique insight into how male relatives respond to close family members who have experienced sexual violence. This is particularly critical since the reaction of a male relative after rape can be the most pivotal factor in promoting or impeding recovery for a survivor. These results emphasise the importance of services that focus not only on the survivor of violence herself, but also on key family members that can ideally help support her recovery. Electronic supplementary material The online version of this article (10.1186/s12905-017-0479-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jocelyn Kelly
- Harvard Humanitarian Initiative, Harvard University, Cambridge, USA
| | - Katherine Albutt
- Department of General Surgery, Massachusetts General Hospital, Boston, USA.,Program in Global Surgery and Social Change, Harvard University, Cambridge, USA
| | - Justin Kabanga
- Centre D'Assistance Médico Psychosociale, South Kivu, Democratic Republic of the Congo
| | - Kimberley Anderson
- Psychotraumacentrum Zuid Nederland, Reinier van Arkel Groep, Bethaniestraat 10, 5211 LJ, 's-Hertogenbosch, Netherlands.
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Winkler P, Janoušková M, Kožený J, Pasz J, Mladá K, Weissová A, Tušková E, Evans-Lacko S. Short video interventions to reduce mental health stigma: a multi-centre randomised controlled trial in nursing high schools. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1549-1557. [PMID: 29101447 DOI: 10.1007/s00127-017-1449-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/22/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND We aimed to assess whether short video interventions could reduce stigma among nursing students. METHODS A multi-centre, randomised controlled trial was conducted. Participating schools were randomly selected and randomly assigned to receive: (1) an informational leaflet, (2) a short video intervention or (3) a seminar involving direct contact with a service user. The Community Attitudes towards Mental Illness (CAMI) and Reported and Intended Behaviour Scale (RIBS) were selected as primary outcome measures. SPANOVA models were built and Cohen's d calculated to assess the overall effects in each of the trial arms. RESULTS Compared to the baseline, effect sizes immediately after the intervention were small in the flyer arm (CAMI: d = 0.25; RIBS: d = 0.07), medium in the seminar arm (CAMI: d = 0.61; RIBS: d = 0.58), and medium in the video arm (CAMI: d = 0.49 RIBS: d = 0.26; n = 237). Effect sizes at the follow-up were vanishing in the flyer arm (CAMI: d = 0.05; RIBS: d = 0.04), medium in the seminar arm (CAMI: d = 0.43; RIBS: d = 0.26; n = 254), and small in the video arm (CAMI: d = 0.22 RIBS: d = 0.21; n = 237). CONCLUSION Seminar had the strongest and relatively stable effect on students' attitudes and intended behaviour, but the effect of short video interventions was also considerable and stable over time. Since short effective video interventions are relatively cheap, conveniently accessible and easy to disseminate globally, we recommend them for further research and development.
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Affiliation(s)
- Petr Winkler
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, Klecany, 250 67, Czech Republic. .,Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK. .,Department of Social Geography and Regional Development, Faculty of Science, Charles University, Albertov 6, Prague, 128 43, Czech Republic.
| | - Miroslava Janoušková
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, Klecany, 250 67, Czech Republic
| | - Jiří Kožený
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, Klecany, 250 67, Czech Republic.,The 3rd Faculty of Medicine, Charles University, Ruská 2411/87, 100 00, Prague, Czech Republic
| | - Jiří Pasz
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, Klecany, 250 67, Czech Republic.,Department of Social Geography and Regional Development, Faculty of Science, Charles University, Albertov 6, Prague, 128 43, Czech Republic
| | - Karolína Mladá
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, Klecany, 250 67, Czech Republic
| | - Aneta Weissová
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, Klecany, 250 67, Czech Republic
| | - Eva Tušková
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, Klecany, 250 67, Czech Republic
| | - Sara Evans-Lacko
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.,Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
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Charlier P, Bou Abdallah F, Mostefai Dulac Y, Deo S, Jacqueline S, Brun L, Hervé C. ["Palimpsest scar" lesions in a context of torture (Darfur, Sudan)]. Ann Dermatol Venereol 2017; 144:696-699. [PMID: 28728860 DOI: 10.1016/j.annder.2017.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/16/2017] [Accepted: 06/12/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND As a result of the current exponentially growing refugee population from the Middle-East and East Africa (Sudan, Darfur, Eritrea), clinicians (including forensic pathologists) are seeing atypical skin lesions, mainly of a traumatic nature, but in some cases associated with long-standing lesions related to ethnic practices. PATIENTS AND METHODS A case of torture sequelae is presented herein in a patient originally from Darfur (Sudan): cutaneous incisions were made on old scars several times using a knife. DISCUSSION The clinical presentation of scarification lesions and that of atypically healed wounds (presumably an effect of inflammation induced by the introduction of irritating foreign bodies such as sand, salt, etc.) are completely different: in all cases they indicate a relative timeframe of the facts, which the clinician should not overlook in reconstructing the patient's course and the injuries to which he has been subjected (hence the proposed designation of "palimpsest scar", in the sense that a palimpsest is a manuscript on a parchment that previously contained writing but has been scratched clean to be overwritten). Thus, a "palimpsest scar" constitutes a fresh scar on top of and hiding another (ritual) scar in a context of ethnic cleansing. The diagnostic and clinical significance comes from the importance of differentiating between ethnic-type lesions and those induced by physical violence and abuse in a context of war.
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Affiliation(s)
- P Charlier
- Laboratoire d'éthique médicale et de médecine légale (EA4569), université Paris-Descartes, 45, rue des Saints-Pères, 75006 Paris, France; CASH & IPES, 403, avenue de la République, 92000 Nanterre, France; UFR des sciences de la santé, UVSQ, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France.
| | - F Bou Abdallah
- Laboratoire d'éthique médicale et de médecine légale (EA4569), université Paris-Descartes, 45, rue des Saints-Pères, 75006 Paris, France; Université libanaise, faculté des sciences médicales, Hadat, Liban
| | - Y Mostefai Dulac
- CASH & IPES, 403, avenue de la République, 92000 Nanterre, France
| | - S Deo
- UFR des sciences de la santé, UVSQ, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France
| | - S Jacqueline
- UFR des sciences de la santé, UVSQ, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France
| | - L Brun
- Service d'anatomo-pathologie, hôpital de Parakou, Parakou, Bénin
| | - C Hervé
- Laboratoire d'éthique médicale et de médecine légale (EA4569), université Paris-Descartes, 45, rue des Saints-Pères, 75006 Paris, France; CASH & IPES, 403, avenue de la République, 92000 Nanterre, France
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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: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Chalmers J, Lancaster K, Hughes C. The stigmatisation of 'ice' and under-reporting of meth/amphetamine use in general population surveys: A case study from Australia. Int J Drug Policy 2016; 36:15-24. [PMID: 27450550 DOI: 10.1016/j.drugpo.2016.06.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 05/27/2016] [Accepted: 06/01/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Stigmatisation of illicit drug use is known to discourage people from reporting their use of illicit drugs. In the context of Australia's two recent "ice-epidemics" this study examines whether rapid increases in community concern about meth/amphetamine concurrent with increased stigmatising media reporting about meth/amphetamine "epidemics" are associated with increased under-reporting of its use in population surveys. METHODS We examined the relationship between general population trends in self-reported lifetime use of and attitudes towards meth/amphetamine between 2001 and 2013, contextualised against related stimulants and heroin, using five waves of Australia's National Drug Strategy Household Survey (NDSHS), alongside trends in print media reporting on meth/amphetamine from 2001 to 2014. RESULTS Analysis of NDSHS data showed significant increases in community concern about meth/amphetamine between 2004 and 2007, and 2010 and 2013 in all birth cohorts and age groups. In both periods self-reported lifetime use of meth/amphetamine fell in many birth cohorts. The falls were only statistically significant in the first period, for birth cohorts from 1961-1963 to 1973-1975. Falls in lifetime use within a cohort from one period to the next are incongruous and we did not observe them in the other drugs considered. Equally, increases in concern were specific to meth/amphetamine. We counted substantial and rapid increase in the number of newspaper reports about meth/amphetamine in both periods, particularly reports including the term 'epidemic'. CONCLUSIONS Rapid increases in the quantum of media reporting stigmatising a drug (through its construction as an 'epidemic') accompanying increased general public concerns about the drug may increase the tendency to under-report lifetime use. This may make it difficult to rely upon household surveys to observe trends in patterns of use and suggests that policy makers, media and others in the AOD sector should avoid stigmatisation of drugs, particularly during periods of heightened concern.
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Affiliation(s)
- Jenny Chalmers
- National Drug and Alcohol Research Centre, UNSW Australia, Australia.
| | - Kari Lancaster
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW Australia, Australia
| | - Caitlin Hughes
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW Australia, Australia
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Korsaga/Somé N, Salissou L, Tapsoba GP, Ouédraogo MS, Traoré F, Doulla M, Barro/Traoré F, Niamba P, Traoré A. [Ichthyosis and social stigma in Burkina Faso]. Ann Dermatol Venereol 2016; 143:554-8. [PMID: 27133359 DOI: 10.1016/j.annder.2016.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 02/07/2016] [Accepted: 03/17/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Through the story of two families presenting ichthyosis, we report the support and social integration difficulties inherent in these genetic diseases. PATIENTS AND METHODS Family No. 1: a 38-year-old shepherd and his wife of 25 years both had lamellar ichthyosis that had been present continually since childhood. They had had 2 stillborn infants as well as a live newborn that were all presenting lamellar ichthyosis. Family No. 2: a 45-year-old housewife was seen at our consultation with her 3 youngest children aged 8 years, 6 years and 18 months. According to the mother, at birth, all 3 children were covered with a membrane resembling plastic that crackled during movement, and they had red eyes. Examination of the 3 children revealed a clinical picture of lamellar ichthyosis with ectropion, malformed ears and brachydactyly. Although they presented delayed growth and weight development, psychomotor development was normal. There was no consanguinity between the parents. DISCUSSION In both families, the visible nature of the dermatosis resulted in discrimination and ostracism. The precarious living conditions of the parents and the high cost of treatment in an African setting resulted in degradation of quality of life with exacerbation of the difficulties of social integration, resulting in a lack of schooling and a bleak future for these children.
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Affiliation(s)
- N Korsaga/Somé
- Service de dermatologie-vénéreologie, CHU Yalgado Ouédraogo, Kadiogo 10 BP 269, Ouagadougou, Burkina Faso.
| | - L Salissou
- Service de dermatologie-vénéreologie, CHU Yalgado Ouédraogo, Kadiogo 10 BP 269, Ouagadougou, Burkina Faso
| | - G P Tapsoba
- Service de dermatologie-vénéreologie, CHU Yalgado Ouédraogo, Kadiogo 10 BP 269, Ouagadougou, Burkina Faso
| | - M S Ouédraogo
- Service de dermatologie-vénéreologie, CHU Yalgado Ouédraogo, Kadiogo 10 BP 269, Ouagadougou, Burkina Faso
| | - F Traoré
- Service de dermatologie-vénéreologie, CHU Yalgado Ouédraogo, Kadiogo 10 BP 269, Ouagadougou, Burkina Faso
| | - M Doulla
- Service de dermatologie-vénéreologie, CHU Yalgado Ouédraogo, Kadiogo 10 BP 269, Ouagadougou, Burkina Faso
| | - F Barro/Traoré
- Service de dermatologie-vénéreologie, CHU Yalgado Ouédraogo, Kadiogo 10 BP 269, Ouagadougou, Burkina Faso
| | - P Niamba
- Service de dermatologie-vénéreologie, CHU Yalgado Ouédraogo, Kadiogo 10 BP 269, Ouagadougou, Burkina Faso
| | - A Traoré
- Service de dermatologie-vénéreologie, CHU Yalgado Ouédraogo, Kadiogo 10 BP 269, Ouagadougou, Burkina Faso
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Clarke A. Anticipated stigma and blameless guilt: Mothers' evaluation of life with the sex-linked disorder, hypohidrotic ectodermal dysplasia (XHED). Soc Sci Med 2016; 158:141-8. [PMID: 27140840 PMCID: PMC4884667 DOI: 10.1016/j.socscimed.2016.04.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 04/20/2016] [Accepted: 04/22/2016] [Indexed: 11/29/2022]
Abstract
Practical experience of a genetic disorder may influence how parents approach reproduction, if they know their child may be affected by an inherited condition. One important aspect of this practical experience is the stigmatisation which family members may experience or witness. We outline the concept of stigma and how it affects those in families with a condition that impacts upon physical appearance. We then consider the accounts given by females in families affected by the rare sex-linked disorder, X-linked hypohidrotic ectodermal dysplasia (XHED), which principally affects males but can be passed through female carriers to affect their sons. The stigmatisation of affected males is as important in the accounts given by their womenfolk as the physical effects of the condition; this impacts on their talk about transmission of the disorder to the next generation. Perspectives may also change over time. The mothers of affected sons differ from their daughters, who do not yet have children, and from their mothers, who may express more strongly their sense of guilt at having transmitted the condition, despite there being no question of moral culpability. We conclude with suggestions about other contexts where the possibility of stigma may influence reproductive decisions.
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Affiliation(s)
- Angus Clarke
- Medical Genetics, Cancer & Genetics, School of Medicine, Cardiff University, Wales UK.
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Thonon B, Pletinx A, Grandjean A, Billieux J, Larøi F. The effects of a documentary film about schizophrenia on cognitive, affective and behavioural aspects of stigmatisation. J Behav Ther Exp Psychiatry 2016; 50:196-200. [PMID: 26298842 DOI: 10.1016/j.jbtep.2015.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/06/2015] [Accepted: 08/06/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Stereotypes about schizophrenia may lead to prejudicial attitudes and discrimination with debilitating effects on people diagnosed with schizophrenia. There is thus a need to develop interventions aiming to prevent, reduce or eliminate such stereotypes. The aim of this study was to evaluate the effects of a documentary film on schizophrenia on cognitive, affective and behavioural aspects of stigmatisation. METHODS Forty-nine participants were assessed on measures of stereotypes and social distance, and on the Model of Stereotype Content, which includes measures of stereotypes, emotional reactions and behavioural tendencies. Participants were randomly assigned into either a condition in which they viewed the documentary film (Film group), or into a control condition in which no intervention was conducted (Control group). RESULTS Only participants in the Film group revealed a significant decrease of negative stereotypes (Dangerousness and Unpredictability) and desired Social distance, and a significant increase in the perception of sociability in persons with schizophrenia. LIMITATIONS Small sample size and its reduced generalizability are the main limitations in this study. CONCLUSIONS These findings suggest that a documentary film promoting indirect contact with people diagnosed with schizophrenia is a promising tool to prevent and reduce stigmatisation regarding schizophrenia..
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Affiliation(s)
- Bénédicte Thonon
- Department of Psychology: Cognition and Behaviour, University of Liège, Boulevard du Rectorat, 3 (B33), 4000 Liège, Belgium.
| | - Amandine Pletinx
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Catholic University of Louvain, Place Cardinal Mercier, 10, 1348 Louvain-la-Neuve, Belgium
| | - Allison Grandjean
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Catholic University of Louvain, Place Cardinal Mercier, 10, 1348 Louvain-la-Neuve, Belgium
| | - Joël Billieux
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Catholic University of Louvain, Place Cardinal Mercier, 10, 1348 Louvain-la-Neuve, Belgium
| | - Frank Larøi
- Department of Psychology: Cognition and Behaviour, University of Liège, Boulevard du Rectorat, 3 (B33), 4000 Liège, Belgium
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Homer CV, Tod AM, Thompson AR, Allmark P, Goyder E. Expectations and patients' experiences of obesity prior to bariatric surgery: a qualitative study. BMJ Open 2016; 6:e009389. [PMID: 26857104 PMCID: PMC4746450 DOI: 10.1136/bmjopen-2015-009389] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 09/24/2015] [Accepted: 11/17/2015] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES This study aimed to understand the experiences and expectations of people seeking bariatric surgery in England and identify implications for behavioural and self-management interventions. DESIGN A qualitative study using modified photovoice methods, triangulating photography with semistructured indepth interviews analysed using framework techniques. SETTING Areas served by two bariatric surgery multidisciplinary teams in the north of England. PARTICIPANTS 18 adults (14 women and 4 men) who accepted for bariatric surgery, and were aged between 30 and 61 years. Participants were recruited through hospital-based tier 4 bariatric surgery multidisciplinary teams. RESULTS The experiences of participants indicates the nature and extent of the burden of obesity. Problems included stigmatisation, shame, poor health, physical function and reliance on medications. Participants expected surgery to result in major physical and psychological improvement. They described how this expectation was rooted in their experiences of stigma and shame. These feelings were reinforced by previous unsuccessful weight loss attempts. Participants expected extreme and sometimes unrealistic levels of sustained weight loss, as well as improvements to physical and mental health. The overall desire and expectation of bariatric surgery was of 'normality'. Participants had received previous support from clinicians and in weight management services. However, they reported that their expectations of surgery had not been reviewed by services, and expectations appeared to be unrealistic. Likewise, their experience of stigmatisation had not been addressed. CONCLUSIONS The unrealistic expectations identified here may negatively affect postoperative outcomes. The findings indicate the importance of services addressing feelings of shame and stigmatisation, and modifying patient's expectations and goals for the postoperative period.
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Affiliation(s)
| | - Angela Mary Tod
- School of Nursing and Midwifery, University of Sheffield, Sheffield UK
| | - Andrew R Thompson
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Peter Allmark
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - Elizabeth Goyder
- Section of Public Health, School of Health And Related Research, University of Sheffield, Sheffield, UK
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Jones N, Keeling M, Thandi G, Greenberg N. Stigmatisation, perceived barriers to care, help seeking and the mental health of British Military personnel. Soc Psychiatry Psychiatr Epidemiol 2015; 50:1873-83. [PMID: 26373774 DOI: 10.1007/s00127-015-1118-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 09/05/2015] [Indexed: 01/22/2023]
Abstract
INTRODUCTION The relationship between mental health symptoms, stigmatising beliefs about mental health and help seeking is complex and poorly understood. METHOD 1636 UK Armed Forces personnel provided study data immediately after deployment (T1) and approximately 6 months later (T2). Stigmatising beliefs were assessed using an eight-item scale previously used in studies of UK military personnel. Symptoms of probable common mental disorder, probable post-traumatic stress disorder and subjective stressful, emotional, relationship and family problems were evaluated at T1 and T2. Help seeking during deployment was assessed at T1 and post-deployment help seeking at T2. Alcohol use and subjective alcohol problems were assessed at T2 only. RESULTS Reporting a probable mental health disorder or potentially harmful alcohol use following deployment was both significantly associated with higher levels of stigmatising beliefs. The reported degree of stigma was associated with changes in mental health symptom levels; compared to those who were never classified as a probable mental health disorder case, recovered cases experienced significantly lower levels of stigmatisation, whereas new onset cases reported significantly higher levels. CONCLUSION The way that individuals report mental health stigmatisation is not static; rather stigma fluctuates in proportion to the frequency and severity of psychological symptoms. These results suggest that public health stigma-reduction strategies which aim to promote engagement with mental health services should be focused towards people who are experiencing worsening mental health. Our results suggest that willing volunteers who have recovered from a mental-ill-health episode may be well placed to assist in the delivery of such a strategy.
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Bhugra D, Sartorius N, Fiorillo A, Evans-Lacko S, Ventriglio A, Hermans MHM, Vallon P, Dales J, Racetovic G, Samochowiec J, Roca Bennemar M, Becker T, Kurimay T, Gaebel W. EPA guidance on how to improve the image of psychiatry and of the psychiatrist. Eur Psychiatry 2015; 30:423-30. [PMID: 25735809 DOI: 10.1016/j.eurpsy.2015.02.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/02/2015] [Accepted: 02/02/2015] [Indexed: 01/10/2023] Open
Abstract
Stigma against mental illness and the mentally ill is well known. However, stigma against psychiatrists and mental health professionals is known but not discussed widely. Public attitudes and also those of other professionals affect recruitment into psychiatry and mental health services. The reasons for this discriminatory attitude are many and often not dissimilar to those held against mentally ill individuals. In this Guidance paper we present some of the factors affecting the image of psychiatry and psychiatrists which is perceived by the public at large. We look at the portrayal of psychiatry, psychiatrists in the media and literature which may affect attitudes. We also explore potential causes and explanations and propose some strategies in dealing with negative attitudes. Reduction in negative attitudes will improve recruitment and retention in psychiatry. We recommend that national psychiatric societies and other stakeholders, including patients, their families and carers, have a major and significant role to play in dealing with stigma, discrimination and prejudice against psychiatry and psychiatrists.
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Affiliation(s)
- D Bhugra
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - N Sartorius
- Association for the Improvement of Mental Health Programmes (AMH), Geneva, Switzerland
| | - A Fiorillo
- Department of Psychiatry, University of Naples, Naples, Italy
| | - S Evans-Lacko
- Department of Health Service and Population Research, King's College, London, UK
| | - A Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - M H M Hermans
- Child and Adolescent Psychiatry, Fortuinstraat, Mechelen, Belgium
| | - P Vallon
- Swiss Society of Psychiatry and Psychotherapy, Geneva, Switzerland
| | - J Dales
- University of Leicester, Leicester, UK
| | - G Racetovic
- Centar za Mentalino Zdravlje, Prijedor, Bosnia and Herzegovina
| | - J Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Poland
| | | | - T Becker
- Department of Psychiatry II,Ulm University,Bezirkskrankenhaus, Günzburg, Germany
| | - T Kurimay
- Institute of Behaviour Sciences, Semmelweis University, Budapest, Hungary
| | - W Gaebel
- Department of Psychiatry and Psychotherapy, Heinrich-Heine-University, Düsseldorf, Germany
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Abstract
This study uses Goffman's [1963. Stigma: Notes on the Management of Spoiled Identity, New Jersey, Prentice-Hall] theory of stigma as an intellectual scaffold to help understand the social meaning of HIV/AIDS stigma from People Living with HIV/AIDS. The study adopts a qualitative approach because of its appropriateness for unravelling subjective phenomena such as the experiences of HIV/AIDS stigma. In-depth interviews were conducted with 10 HIV-positive employees of a retailing company located in the Western Cape province of South Africa who volunteered to participate in the study. The participants with the discreditable stigma internalised society's prejudice towards those living with the virus. As a result, the participants relied on self-isolation and social withdrawal to cope with enacted stigma. Managing information about one's status and deciding whether, who, when, etc., to tell are crucial questions. The participants feared being devalued by family, friends, co-workers and the community. In concurrence with Goffman [1963], the HIV/AIDS stigma is seen as about relationships.
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Affiliation(s)
- N. Judgeo
- MA Industrial Psychology, a post-graduate student at the University of South Africa, is registered with the Health and Professions Council of South Africa as a Psychologist under the category Industrial, South Africa
| | - K.P. Moalusi
- M.ADM Industrial Psychology, is a Senior Lecturer in the Department of Industrial & Organisational Psychology at the University of South Africa (UNISA), Pretoria, South Africa
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