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Affiliation(s)
- Alison J Gray
- Queen Elizabeth Psychiatric Hospital, Edgbaston, Birmingham B15 2QZ, UK
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Magliano L, Strino A, Punzo R, Acone R, Affuso G, Read J. Effects of the diagnostic label 'schizophrenia', actively used or passively accepted, on general practitioners' views of this disorder. Int J Soc Psychiatry 2017; 63:224-234. [PMID: 28466742 DOI: 10.1177/0020764017695353] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND General practitioners (GPs) play a key role in the care of somatic and psychiatric problems in people diagnosed with schizophrenia (PWS). It is probable that, like other health professionals, GPs are not all free of prejudices toward PWS. In clinical practice, GPs sometimes interact with clients diagnosed with schizophrenia by specialists, passively accepting this diagnosis. Other times, GPs interact with clients having symptoms of schizophrenia but who have not been diagnosed. In this case, GPs are expected to actively make a diagnosis. Giving the key role of GPs in the process of care, it is worthwhile examining whether passive acceptance and active usage of the diagnosis schizophrenia have differential effects on GPs' attitudes toward people with this disorder. AIMS To investigate GPs' views of schizophrenia and whether they were influenced by a 'schizophrenia' label, passively accepted or actively used. METHODS A total of 430 randomly selected GPs were invited to complete a questionnaire about their views of schizophrenia, either after reading a description of this disorder and making a diagnosis, or without being provided with a description but passively accepting the label 'schizophrenia' given in the questionnaire. RESULTS The GPs who passively accepted the label schizophrenia ( n = 195) and those who actively identified schizophrenia from the description ( n = 127) had similar views. Compared to the GPs who did not identify schizophrenia in the description ( n = 65), those who used the diagnosis, actively or passively: more frequently reported heredity and less frequently psychosocial factors as causes of the disorder; were more skeptical about recovery; were more convinced of the need for long-term pharmacotherapies; believed more strongly that PWS should be discriminated against when in medical hospital; and perceived PWS as more dangerous and as kept at greater social distance. CONCLUSION The diagnosis 'schizophrenia', however used, is associated with pessimistic views. Stigma education should be provided to GPs.
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Affiliation(s)
- Lorenza Magliano
- 1 Department of Psychology, Campania University 'Luigi Vanvitelli', Caserta, Italy
| | - Antonella Strino
- 1 Department of Psychology, Campania University 'Luigi Vanvitelli', Caserta, Italy
| | - Rosanna Punzo
- 1 Department of Psychology, Campania University 'Luigi Vanvitelli', Caserta, Italy
| | - Roberta Acone
- 1 Department of Psychology, Campania University 'Luigi Vanvitelli', Caserta, Italy
| | - Gaetana Affuso
- 1 Department of Psychology, Campania University 'Luigi Vanvitelli', Caserta, Italy
| | - John Read
- 2 School of Psychology, University of East London, London, UK
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Pascucci M, Ventriglio A, Stella E, Di Sabatino D, La Montagna M, Nicastro R, Parente P, De Angelis A, Pozzi G, Janiri L, Bellomo A. Empathy and attitudes towards mental illness among Italian medical students. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/17542863.2016.1276947] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Marco Pascucci
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Eleonora Stella
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Dario Di Sabatino
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Maddalena La Montagna
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Rossana Nicastro
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Paolo Parente
- Department of Public Health, Section of Hygiene, Catholic University of Sacred Heart, Rome, Italy
| | - Andrea De Angelis
- Institute of Psychiatry and Psychology, Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
| | - Gino Pozzi
- Institute of Psychiatry and Psychology, Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
| | - Luigi Janiri
- Institute of Psychiatry and Psychology, Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Patra S, Patro BK, Nebhinani N. Images of psychiatry: Attitude survey of teaching medical specialists of India. Ind Psychiatry J 2017; 26:52-55. [PMID: 29456322 PMCID: PMC5810168 DOI: 10.4103/ipj.ipj_36_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
CONTEXT Attitude of teaching medical specialists shapes those of future doctors. Region-specific data on teaching medical specialists' attitudes toward psychiatry (ATP) are lacking from India. AIMS This study aimed to assess the attitudes of teaching medical specialists toward psychiatry and its association with sociodemographic profile and career stage. SETTINGS AND DESIGN This is a cross-sectional descriptive survey. MATERIALS AND METHODS Attitude towards psychiatry (ATP) was assessed from 188 specialists from All India Institute of Medical Sciences (AIIMS) Bhubaneswar and AIIMS Jodhpur using modified ATP scale-30. STATISTICAL ANALYSIS Descriptive statistical analysis was done using SPSS version 16.0. Associations of ATP with sociodemographic status, career stage, and family history of psychiatric illness were done using logistic regression analysis. RESULTS Overall response rate was 81.68%, and gender (confidence interval [C.I.]: 2.026-7.410, P = 0.000) and super-specialization (C.I.: 2.167-19.479, P = 0.021) were independent significant predictors for difference in attitudes. Female gender and super-specialization were associated with better attitudes. Ninety percent of participants had favorable attitude toward psychiatric illness. Four-fifth felt psychiatric patients to be as human as other patients and found psychiatric treatments effective. More than half felt that psychiatry does not stand among the three most exciting specialties and psychiatrists get less work satisfaction. Only one third said that they would have liked to be a psychiatrist. CONCLUSIONS Attitudes were favorable toward patients and psychiatric interventions whereas unfavorable toward psychiatry as a discipline.
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Affiliation(s)
- Suravi Patra
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Binod Kumar Patro
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Naresh Nebhinani
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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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: 1.1] [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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Ebsworth SJ, Foster JLH. Public perceptions of mental health professionals: stigma by association? J Ment Health 2016; 26:431-441. [DOI: 10.1080/09638237.2016.1207228] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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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: 2.4] [Reference Citation Analysis] [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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Catthoor K, Hutsebaut J, Schrijvers D, De Hert M, Peuskens J, Sabbe B. Preliminary study of associative stigma among trainee psychiatrists in Flanders, Belgium. World J Psychiatry 2014; 4:62-68. [PMID: 25250223 PMCID: PMC4171138 DOI: 10.5498/wjp.v4.i3.62] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 07/14/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To study the degree of stigmatization among trainee psychiatrists, individual characteristics potentially leading to higher associative stigma, and coping mechanisms.
METHODS: Two hundred and seven trainee psychiatrists in Flanders (Belgium), all member of the Flemish Association of Trainee Psychiatrists, were approached to participate in the survey. A non-demanding questionnaire that was specifically designed for the purpose of the study was sent by mail. The questionnaire consisted of three parts, each emphasizing a different aspect of associative stigma: devaluing and humiliating interactions, the focus on stigma during medical training, and identification with negative stereotypes in the media. Answers were scored on a Likert scale ranging from 0 to 3. The results were analyzed using SPSS Version 18.0.
RESULTS: The response rate of the study was 75.1%. The internal consistency of the questionnaire was good, with a Cronbach’s α of 0.71. Seventy-five percent of all trainee psychiatrists confirmed hearing denigrating or humiliating remarks about the psychiatric profession more than once. Additionally, more than half of them had had remarks about the incompetence of psychiatrists directed at them. Only 1.3% remembered having stigma as a topic during their psychiatric training. Trainees who had been in training for a longer period of time had experienced a significantly higher level of stigmatization than trainees with fewer years of experience (mean total stigma scores of 16.93 ± SD 7.8 vs 14.45 ± SD 6.1, t = -2.179 and P < 0.05). In addition, senior trainees effectively kept quiet about their profession significantly more often than their junior colleagues (mean item score 0.44 ± SD 0.82 vs 0.13 ± SD 0.48, t = 2.874, P < 0.01). Comparable results were found in trainees working in adult psychiatry as were found in those working in child or youth psychiatry (mean item score 0.38 ± SD 0.77 vs 0.15 ± SD 0.53, t = -2.153, P < 0.05). Biologically oriented trainees were more inclined to give preventive explanations about their profession, which can be seen as a coping mechanism used to deal with this stigma (mean item score 2.05 ± SD 1.05 vs 1.34 ± SD 1.1, t = -3.403, P < 0.01).
CONCLUSION: Associative stigma in trainee psychiatrists is underestimated. More attention should be paid to this potentially harmful phenomenon in training.
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Damra JKM, Nassar YH, Ghabri TMF. Trauma-focused cognitive behavioral therapy: Cultural adaptations for application in Jordanian culture. COUNSELLING PSYCHOLOGY QUARTERLY 2014. [DOI: 10.1080/09515070.2014.918534] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
OBJECTIVE Graduate entry medical students' views of psychiatry may differ from those of school leavers. This study hypothesised that (i) exposure to a psychiatry attachment is associated with a positive change in attitudes towards psychiatry in both graduate entry and non-graduate entry students, (ii) graduate entry students exhibit a more positive attitude to psychiatry compared to non-graduate entry students and (iii) graduate entry students are more interested in a career in psychiatry than non-graduate entry students. METHODS In this study 247 medical students (118 females and 129 males) completing their psychiatry rotation were invited to complete questionnaires examining career choice, attitudes to psychiatry and career attractiveness for a range of specialties including surgery, medicine, general practice and psychiatry before and after their psychiatry attachment. Questionnaires were distributed prior to commencement of their attachment and redistributed on the final day of the attachment. RESULTS Of the 165 participants in the study, 75 students entered medicine via the traditional route (without a primary degree), 49 entered via the graduate entry programme and 41 had a primary degree. Overall, medical students displayed positive attitudes towards psychiatry. However, while there was an improvement in attitudes towards psychiatry and the career attractiveness of psychiatry on completion of the rotation, no differences were found between graduate and non-graduate entry students. Psychiatry and general practice had lower ratings for career attractiveness than other specialities. No significant changes were found in the first and second choice of specialty. CONCLUSION Our results show that improvements in attitude and career attractiveness do not necessarily correlate with increased choice of psychiatry as a specialty. Graduate entry has been considered a possible opportunity for increasing recruitment in psychiatry but our results suggest that this may not be the case. Follow-up studies are required to determine whether career attractiveness correlates with future career choice.
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Sartorius N, Gaebel W, Cleveland HR, Stuart H, Akiyama T, Arboleda-Flórez J, Baumann AE, Gureje O, Jorge MR, Kastrup M, Suzuki Y, Tasman A. WPA guidance on how to combat stigmatization of psychiatry and psychiatrists. World Psychiatry 2010; 9:131-44. [PMID: 20975855 PMCID: PMC2948719 DOI: 10.1002/j.2051-5545.2010.tb00296.x] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
In 2009 the WPA President established a Task Force that was to examine available evidence about the stigmatization of psychiatry and psychiatrists and to make recommendations about action that national psychiatric societies and psychiatrists as professionals could do to reduce or prevent the stigmatization of their discipline as well as to prevent its nefarious consequences. This paper presents a summary of the Task Force's findings and recommendations. The Task Force reviewed the literature concerning the image of psychiatry and psychiatrists in the media and the opinions about psychiatry and psychiatrists of the general public, of students of medicine, of health professionals other than psychiatrists and of persons with mental illness and their families. It also reviewed the evidence about the interventions that have been undertaken to combat stigma and consequent discrimination and made a series of recommendations to the national psychiatric societies and to individual psychiatrists. The Task Force laid emphasis on the formulation of best practices of psychiatry and their application in health services and on the revision of curricula for the training of health personnel. It also recommended that national psychiatric societies establish links with other professional associations, with organizations of patients and their relatives and with the media in order to approach the problems of stigma on a broad front. The Task Force also underlined the role that psychiatrists can play in the prevention of stigmatization of psychiatry, stressing the need to develop a respectful relationship with patients, to strictly observe ethical rules in the practice of psychiatry and to maintain professional competence.
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Affiliation(s)
- Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
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Bell JS, Aaltonen SE, Airaksinen MS, Volmer D, Gharat MS, Muceniece R, Vitola A, Foulon V, Desplenter FA, Chen TF. Determinants of mental health stigma among pharmacy students in Australia, Belgium, Estonia, Finland, India and Latvia. Int J Soc Psychiatry 2010; 56:3-14. [PMID: 19861340 DOI: 10.1177/0020764008097621] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Healthcare professionals commonly exhibit negative attitudes toward people with mental disorders. Few international studies have sought to investigate the determinants of stigma. OBJECTIVE To conduct an international comparison of pharmacy students' stigma towards people with schizophrenia, and to determine whether stigma is consistently associated with stereotypical attributes of people with schizophrenia. METHOD Students (n = 649) at eight universities in Australia, Belgium, India, Finland, Estonia and Latvia completed a seven-item Social Distance Scale (SDS) and six items related to stereotypical attributes of people with schizophrenia. RESULTS Mean SDS scores were 19.65 (+/- 3.97) in Australia, 19.61 (+/- 2.92) in Belgium, 18.75 (+/- 3.57) in India, 18.05 (+/- 3.12) in Finland, and 20.90 (+/- 4.04) in Estonia and Latvia. Unpredictability was most strongly associated with having a high social distance in Australia (beta = -1.285), the perception that people will never recover in India (beta = - 0.881), dangerousness in Finland (beta = -1.473) and the perception of being difficult to talk to in Estonia and Latvia (beta = -2.076). Unpredictability was associated with lower social distance in Belgium (beta = 0.839). CONCLUSION The extent to which students held stigmatizing attitudes was similar in each country, however, the determinants of stigma were different. Pharmacy education may need to be tailored to address the determinants of stigma in each country.
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Affiliation(s)
- J S Bell
- Division of Social Pharmacy, University of Helsinki, Finland.
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Public Attitudes to the Quality of Psychiatric Treatment, Psychiatric Patients, and Prevalence of Mental Disorders. Nord J Psychiatry 2009. [DOI: 10.3109/08039489409078149] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Volmer D, Mäesalu M, Bell JS. Pharmacy students' attitudes toward and professional interactions with people with mental disorders. Int J Soc Psychiatry 2008; 54:402-13. [PMID: 18786902 DOI: 10.1177/0020764008090427] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Health professionals frequently exhibit negative attitudes toward people with mental disorders. It is not known whether stigmatising attitudes among pharmacy students predict less positive attitudes toward consumer participation in decision-making about medications. AIMS (1) To assess the attitudes of pharmacy students toward people with schizophrenia, and (2) to determine whether stigma predicts less positive attitudes toward concordant medication counselling. METHOD All pharmacy students enrolled in a five-year degree program were invited to participate. Students completed the seven-item Social Distance Scale, six items related to stereotypical attributes of people with schizophrenia and the 14-item Leeds Attitudes Toward Concordance Scale. RESULTS Completed survey instruments were received from 157 students (94% response rate). Previous employment in a pharmacy and personal experience of a mental disorder were associated with low social distance. Later year of study, believing that people with schizophrenia are difficult to talk to, and believing people with schizophrenia have themselves to blame were predictive of high social distance. Low social distance and later year of study were associated with positive attitudes toward providing concordant medication counselling. CONCLUSION Mental health stigma was common and predictive of less positive attitudes toward consumer participation in decision-making about medications.
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Affiliation(s)
- Daisy Volmer
- Faculty of Medicine, University of Tartu, Estonia
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Holm-Petersen C, Vinge S, Hansen J, Gyrd-Hansen D. The impact of contact with psychiatry on senior medical students' attitudes toward psychiatry. Acta Psychiatr Scand 2007; 116:308-11. [PMID: 17803761 DOI: 10.1111/j.1600-0447.2007.01036.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the attitudes of Danish medical students as to the attractiveness of psychiatry as a career possibility and to asses the impact on such attitudes of actual contact with psychiatry. METHOD A base-line survey included 222 senior medical students, of whom 160 were also surveyed subsequent to a 4-week psychiatric affiliation. RESULTS The base-line survey shows that psychiatry is rated as less attractive than other specialization groups, and that working as health assistants in psychiatric wards contributes to the problematic image. However, a 4-week psychiatric affiliation resolves a number of image issues, and following such an affiliation more medical students were considering specializing in psychiatry. CONCLUSION The findings of this study suggest that psychiatric affiliations can influence students' attitudes to psychiatry. The observed changes in attitudes lead to the presumption that some aspects of the image problem of psychiatry stem from inadequate knowledge of psychiatry as a specialty and the actual work psychiatrists perform.
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Affiliation(s)
- C Holm-Petersen
- DSI Danish Institute for Health Services Research, Copenhagen, Denmark.
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Stip E, Sepehry AA, Tempier A, Brochu-Blain A. Différences et similitudes dans la perception de la schizophrénie entre les omnipraticiens et la population générale québécoise. SANTE MENTALE AU QUEBEC 2006; 31:189-200. [PMID: 17111066 DOI: 10.7202/013692ar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Le rôle potentiel des omnipraticiens à l’égard d’une maladie comme la schizophrénie a été redéfinie lors du dernier Plan d’organisation de la santé mentale au Québec en 2006. Dans cet article les auteurs présentent des résultats concernant la perception et les attitudes des omnipraticiens du Québec vis-à-vis des patients souffrant de cette affection. Les résultats obtenus à travers un sondage sont comparés à ceux obtenus grâce à 5 questions communes posées à la population québécoise en général. Un court questionnaire, composé de 5 items choisis à partir d’un questionnaire plus élargi et présenté à la population générale, a été proposé aux omnipraticiens du Québec. Ces items sondaient la perception et l’attitude des médecins à l’égard de la schizophrénie. À partir d’un échantillon aléatoire de 3 500 omnipraticiens, un taux de 29 %, soit un peu plus de mille (1003, 46 % de femmes et 54 % d’hommes), répondants a été observé. Les auteurs ont constaté des différences significatives entre les omnipraticiens et la population québécoise générale dans la tendance à vouloir offrir de l’aide aux personnes souffrant de schizophrénie (omnipraticiens = 58 % versus population générale : 45 %). Également, un plus haut pourcentage d’omnipraticiens (72 %) a dit ressentir de la compassion envers les patients souffrant de schizophrénie versus 27 % dans la population en général. Les omnipraticiens ont dit se sentir moins à l’aise de discuter ouvertement de la maladie à un membre de la famille si ce dernier était affligé de la schizophrénie (26 % versus 48 %). Il n’y avait pas de différence entre les deux populations en ce qui concerne le jugement de la sévérité de la schizophrénie dans le champ des maladies y compris des maladies mentales.
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Affiliation(s)
- Emmanuel Stip
- Centre de recherche Fernand-Seguin, Département de psychiatrie, Faculté de médecine, Hôpital Sacré-Coeur de Montréal, Université de Montréal
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Abstract
This study examines the personal and attitudinal variables that are associated with helping behavior in a hypothetical general practice setting. We explored the effect of an antistigma seminar during a psychiatric clerkship on medical students' attitudes toward the mentally ill. We randomly assigned three rotations of students (81 students) to receive the seminar and three rotations (85 students) as controls. The students expressed views about patients with schizophrenia or depressive disorder portrayed in video vignettes. How dangerous the students perceived target individuals to be was the major determinant of helping behavior. The students' gender, religious affiliation, affective reaction, skill assessment, and controllability attribution were less consistent in predicting behavior. Exposure to the seminar and clerkship experience significantly improved attitudes, but attributes of responsibility and readiness to provide medical care for psychiatric patients were the most resistant to change. We identified certain issues that should be highlighted in future antistigma programs.
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Affiliation(s)
- Ka Fai Chung
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
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Putkonen H, Holi M, Kaltiala-Heino R, Korkeila J, Eronen M. Psychiatric trainees in Finland 2001. Nord J Psychiatry 2005; 59:148-51. [PMID: 16195113 DOI: 10.1080/08039480510018841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined Finnish psychiatric trainees' views on their education. This was a survey study of nationwide data on Finnish psychiatric trainees in 2001. The quality of training was considered at least moderate by 84% of the respondents. Training on epidemiology, on taking history and status, and on psychopharmacology was considered the best. Quality was rated bad for training in leadership and administration, and educating the community. Research was done by 20%, and a personal clinical supervisor was appointed to 52% of the respondents. Offensive treatment had been experienced by 49% of the trainees in this study. Generally, studies of training also reflect strengths and weaknesses of the profession. Based on our results, it seems especially that training in leadership and in educating the community need to be improved; both of these are quintessential skills to survive in the struggle for economic and human resources. Furthermore, treatment of the trainees could still be better; attention should be paid to supervision of all trainees. Moreover, research must become more attractive. Psychiatry can be developed by the development of psychiatric training.
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Malhi GS, Parker GB, Parker K, Carr VJ, Kirkby KC, Yellowlees P, Boyce P, Tonge B. Attitudes toward psychiatry among students entering medical school. Acta Psychiatr Scand 2003; 107:424-9. [PMID: 12752018 DOI: 10.1034/j.1600-0447.2003.00050.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To survey the attitudes of Australian medical students to determine their views about the relative attractiveness of psychiatry as a career compared with other specialties, and against findings from a North American study. METHOD We surveyed 655 first-year medical students attending six Australian Universities. RESULTS Responses indicated that Australian medical students view psychiatry as distinctly less 'attractive' than other career options, as reported in the North American sample. In comparison with other disciplines, psychiatry was regarded as more interesting and intellectually challenging, but also as lacking a scientific foundation, not being enjoyable and failing to draw on training experiences. CONCLUSION Our findings suggest that psychiatry has an image problem that is widespread, reflecting community perceptions and the specialist interests of medical students on recruitment. If psychiatry is to improve its 'attractiveness' as a career option, identified image problems need to be corrected and medical student selection processes re-considered.
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Affiliation(s)
- G S Malhi
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
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Freudenreich O, Stern TA. Clinical experience with the management of schizophrenia in the general hospital. PSYCHOSOMATICS 2003; 44:12-23. [PMID: 12515833 DOI: 10.1176/appi.psy.44.1.12] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
On the basis of experience with 74 psychiatric consultations involving patients with schizophrenia admitted to a general hospital medical or surgical ward over a 17-month period (3% of the psychiatric consultations during that period), the authors identified 10 types of problems leading to requests for consultation. The authors used these categories to organize recommendations for management of patients with schizophrenia in the general medical hospital. In addition to conducting conventional consultations, the consultation psychiatrist in such cases often has a role in educating hospital staff about schizophrenia and in serving as a physician for the mentally ill.
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Affiliation(s)
- Oliver Freudenreich
- Massachusetts General Hospital Schizophrenia Program, Harvard Medical School, Boston, MA 02114, USA.
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Affiliation(s)
- Alison J Gray
- Queen Elizabeth Psychiatric Hospital, Edgbaston, Birmingham B15 2QZ, UK
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Caldwell TM, Jorm AF. Mental health nurses' beliefs about interventions for schizophrenia and depression: a comparison with psychiatrists and the public. Aust N Z J Psychiatry 2000; 34:602-11. [PMID: 10954391 DOI: 10.1080/j.1440-1614.2000.00750.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The main objective of this paper was to investigate and compare mental health nurses' beliefs about interventions for schizophrenia and depression with those of psychiatrists and the public. Factors affecting nurses' beliefs were also investigated. METHOD This research used methods employed in previous surveys of professional and public beliefs. A postal survey of 673 Australian mental health nurses was carried out. The survey was comprised of a vignette describing a person with either depression or schizophrenia. Participants rated whether particular medical, psychological and lifestyle interventions were helpful, harmful or neither. Factors examined included: nurses' age, sex, degree of contact with similar problems, work setting, level of highest qualification and whether their education was hospital-based or completed within the tertiary sector. RESULTS The nurses agreed with psychiatrists (but not the public) about the interventions most likely to be helpful, such as antidepressants for depression and antipsychotic medication for schizophrenia. However, there were many differences between nurses, psychiatrists and the public. Nurses were more likely than psychiatrists to believe that certain non-standard interventions such as vitamins, minerals and visiting a naturopath would be helpful. Nurses' beliefs tended to form a bridge between the attitudes of psychiatrists and the public for some of these non-standard interventions. Age, work setting and qualifications were related to nurses' intervention beliefs. CONCLUSIONS Mental health practitioners need to be aware of a range of beliefs within mental health services. The acknowledgement of differing belief systems is important for high quality, integrated care.
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Affiliation(s)
- T M Caldwell
- Centre for Mental Health Research, The Australian National University, Canberra, Australian Capital Territory.
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Abstract
BACKGROUND As the availability of mental hospital beds has fallen, so the number of people in prison has risen. AIMS To review current policy trends in British forensic psychiatry and put them in an international context. METHOD Literature on the prevalence rates of psychiatric disorder in prisons and jails has been examined for the USA, England & Wales and New Zealand. RESULTS All studies show a high prevalence of mental disorder in prisons and jails. Authors in the USA suggest that prisons are replacing mental hospitals. In England & Wales rates of psychosis are reported as 4-10% for remanded prisoners and 2-7% for sentenced prisoners. Substance misuse among prisoners is a major problem. Prison is the preferred place of disposal for large numbers of mentally disordered people. Does this matter? Why should this be the case? Is this the cheapest option? Politicians are considering new powers to direct more people into institutions (presumably prisons) on the grounds of public protection. CONCLUSIONS We need more information about attitudes and their formation. We need more interprofessional dialogue about the best arrangements for people with mental disorders, and inter-disciplinary education.
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Affiliation(s)
- J Gunn
- Institute of Psychiatry, King's College, London.
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Beal G. The constitution of community: how individuals diagnosed with schizophrenia and their friends achieved community. Psychiatry 1999; 62:173-86. [PMID: 10420429 DOI: 10.1080/00332747.1999.11024863] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This article describes a qualitative research project, based on a grounded theory design, that addressed the processes involved in how individuals with schizophrenia were able to use their own abilities to form a self-authored community. The article offers a perspective on community integration that takes into account the importance of relationships, and in the case of individuals with schizophrenia, the importance of day-to-day relationships. The assumption is that the constitution of community is an outcome of the processes involved in learning and practicing being social (Cohen 1985, p. 15). These relationships do not necessarily have to be strong or numerous in order for community integration to be realized. In this article it is argued that an element in the establishment of such relationships for individuals with schizophrenia is the ready availability of others on a day-to-day basis. Relationships and friendships grew for individuals diagnosed with schizophrenia when such access occurred in a place where the context of what was likely to happen in an interaction was relatively well understood.
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Affiliation(s)
- G Beal
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
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Affiliation(s)
- P Byrne
- Department of Psychiatry, St. Vincent's Hospital, Dublin, Ireland
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Yamamoto K, Randall M, Takeda M, Leelamanit W. Attitudes of medical students towards persons with mental disorders: a comparative study between Japan and Thailand. Psychiatry Clin Neurosci 1996; 50:171-80. [PMID: 9201772 DOI: 10.1111/j.1440-1819.1996.tb02738.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study was conducted at three universities, two in Japan and one in Thailand, in order to elucidate the effects of medical education, especially with regard to contact experience on medical students' attitudes toward persons with mental disorders. Questionnaires, which included the Attitudes Towards Disabled Persons Scale (ATDP) and the Contact with Disabled Persons Scale (CDP), were distributed to 1st year students prior to the commencement of their medicine/psychiatry studies and distributed to 6th (or 5th) year students who had completed their psychiatric curriculum. The ATDP scores were lower for 6th year students at all universities, suggesting that post-education students had a more unfavorable attitude than pre-education students. Thai students indicated more unfavorable attitudes than did the Japanese students. Three factors were extracted from the ATDP scale and termed: negation of character, negation of ability and affirmation of normality. Four factors from the CDP scale were extracted and labeled intimate contact experience, ordinary contact experience, unpleasant contact experience and pleasant contact experience. Greater negative attitudes of post-education students than pre-education students were thought to attribute mainly to an increase in factor score of negation of ability and this result was correlated with an increase in factor score of ordinary contact experience in post-education students. Of the three ATDP factor scores, the higher score of Thai students for negation of character contributed to their overall unfavorable attitude scores. The cross-national similarities and differences of students' attitudes towards and contact experience with mentally disordered persons were discussed from the viewpoint of medical education.
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Affiliation(s)
- K Yamamoto
- Department of Neuropsychiatry, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
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Abstract
1. What is usually taught as biological psychiatry in psychiatric residency training is mainly psychopharmacology, but biology has a lot more to offer to psychiatry educators. 2. The main thesis of this article is that an introductory course on the applications to psychiatry based on the theory of the evolution of the species by natural selection and mutation, along with a comprehensive theory of mind, may contribute to: (i) helping young physicians to integrate the diverse and extensive knowledge acquired during the residency training; (ii) aid in keeping the psychiatrist within the medical approach to mental illnesses while promoting the specific features of the specialty, and (iii) perhaps developing a general theoretical framework that allows psychiatrists to maintain a prominent role in the mental health staff. 3. The author describes how he has conducted such training in Venezuela. It is expected that the author's ideas will serve as a forum for discussion of this pivotal subject.
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Affiliation(s)
- T Baptista
- Department of Physiology, Universidad de Los Andes, Merida, Venezuela
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Baptista T, Pérez CS, Méndez L, Esqueda L. The attitudes toward psychiatry of physicians and medical students in Venezuela. Acta Psychiatr Scand 1993; 88:53-9. [PMID: 8372696 DOI: 10.1111/j.1600-0447.1993.tb03413.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Attitudes toward psychiatry were assessed in 490 medical students and 362 physicians from two universities in Venezuela: Universidad de Los Andes (ULA) and Universidad Centro-Occidental Lisandro Alvarado (UCLA). A modified version of the Attitude Toward Psychiatry-30 scale was used. The attitude toward psychiatry of all the students and physicians was moderately positive. Students from ULA displayed a more positive attitude than UCLA students, whereas physicians from UCLA displayed a more positive attitude than ULA physicians. The most negative attitude toward psychiatry was observed in students planning to select obstetrics and gynecology (ULA + UCLA), in physicians working in Surgery, obstetrics and gynecology (ULA + UCLA) and in basic sciences (ULA). Female students tended to display a more positive attitude than male students. The attitude toward psychiatry was similar in students with low and high academic achievement in the courses in psychiatry. A large number of years in the profession did not modify the attitude of the physicians. It is recommended to improve teaching and communication with the students and physicians that displayed the most negative attitudes toward psychiatry.
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Affiliation(s)
- T Baptista
- Department of Physiology, Faculty of Medicine, Universidad de Los Andes, Mérida, Venezuela
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