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公众对精神疾病患者治疗方法的看法及其对抗污名化策略的影响。

Lay beliefs about treatments for people with mental illness and their implications for antistigma strategies.

作者信息

Lauber Christoph, Carlos Nordt, Wulf Rössler

机构信息

Department of Social and Clinical Psychiatry, Psychiatric University Hospital, Zurich, Switzerland.

出版信息

Can J Psychiatry. 2005 Oct;50(12):745-52. doi: 10.1177/070674370505001203.

Abstract

OBJECTIVE

First, to describe factors influencing the public's attitude toward treatment recommendations for people with mental illness; second, to identify coherent belief systems about the helpfulness of specific interventions; and third, to discuss how to ameliorate mental health literacy and antistigma strategies.

METHOD

Participants of a representative telephone survey in the general population (n = 1737) were presented with a vignette depicting a person with either schizophrenia or depression. From a list of suggestions, they were asked to recommend treatments for this person. We used a factor analysis to group these proposals and used the factors as the dependent variables in a multiple regression analysis.

RESULTS

Treatment suggestions are summarized in 4 groups, each characterizing a specific therapeutic approach: 1) psychopharmacological proposals (that is, psychotropic drugs), 2) therapeutic counselling (from a psychologist or psychiatrist or psychotherapy), 3) alternative suggestions (such as homeopathy), and 4) social advice (for example, from a social worker). Medical treatments were proposed by people who had a higher education, who had a positive attitude toward psychopharmacology, who correctly recognized the person depicted in the vignette as being ill, who were presented with the schizophrenia vignette, who kept social distance, and who had contact with mentally ill people. The variables could explain alternative and social treatment proposals only to a small extent.

CONCLUSIONS

The public's beliefs about treatment for people with mental illness are organized into 4 coherent systems, 2 of which involve evidence-based treatments. Medical treatment proposals are influenced by adequate mental health literacy; however, they are also linked to more social distance toward people with mental illness. Additionally, efforts to better explain nonmedical treatment suggestions are needed. Implications for further antistigma strategies are discussed.

摘要

目的

其一,描述影响公众对精神疾病患者治疗建议态度的因素;其二,识别关于特定干预措施有效性的连贯信念体系;其三,探讨如何改善心理健康素养及消除污名化策略。

方法

对普通人群进行的具有代表性的电话调查(n = 1737)的参与者,会看到一个描述患有精神分裂症或抑郁症患者的 vignette(短文)。从一系列建议中,要求他们为这个人推荐治疗方法。我们使用因子分析对这些建议进行分组,并将这些因子作为多元回归分析中的因变量。

结果

治疗建议总结为4组,每组代表一种特定的治疗方法:1)精神药理学建议(即精神药物),2)治疗性咨询(来自心理学家或精神科医生或心理治疗),3)替代建议(如顺势疗法),4)社会建议(例如来自社会工作者)。提出医学治疗建议的人具有以下特点:受过高等教育、对精神药理学持积极态度、正确认识短文中所描述的人患有疾病、看到的是精神分裂症短文、保持社交距离以及与精神疾病患者有接触。这些变量仅能在较小程度上解释替代和社会治疗建议。

结论

公众对精神疾病患者治疗的信念被组织成4个连贯的系统,其中2个涉及循证治疗。医学治疗建议受到足够心理健康素养的影响;然而,它们也与对精神疾病患者更大的社交距离相关。此外,需要努力更好地解释非医学治疗建议。讨论了对进一步消除污名化策略的启示。

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