Department of Experimental Medicine, Second University of Naples, Italy.
Acad Med. 2011 Sep;86(9):1155-62. doi: 10.1097/ACM.0b013e318226708e.
Negative attitudes toward mental illness among medical professionals can influence the quality of medical care they provide. The authors examined the impact of causal explanations and diagnostic labeling on medical students' views of schizophrenia.
Medical students in their fifth and sixth years at the Second University of Naples (Italy) who attended lectures from April through June 2010 completed a self-report questionnaire regarding their beliefs about the mental disorder described (but not named) in a case vignette depicting a person who meets the International Classification of Diseases-10 criteria for schizophrenia.
Of the 232 students invited, 194 (84%) completed the questionnaire. Students most frequently cited heredity as the cause (81%), followed by stress (69%), psychological traumas (45%), and misuse of street drugs (44%). Most students (82%) labeled the case "schizophrenia"; a minority (24%) believed that persons with the case vignette disorder could be well again. Both labeling the case as "schizophrenia" and naming heredity as the cause were independently associated with pessimism about the possibility of recovery and with the perception that "others" keep their distance from persons with this diagnosis. Heredity was more frequently cited by respondents who labeled the case schizophrenia and was significantly associated with students' perception that people with this diagnosis are unpredictable.
These findings confirm that, in a sample of medical students, biogenetic causal explanations and diagnostic labeling have negative effects on beliefs about schizophrenia. They highlight the need to educate medical students about recovery from and stigma related to schizophrenia.
医疗专业人员对精神疾病的负面态度可能会影响他们提供的医疗质量。作者研究了因果解释和诊断标签对医学生对精神分裂症看法的影响。
2010 年 4 月至 6 月,那不勒斯第二大学(意大利)的五年级和六年级医学生参加了讲座,他们完成了一份自我报告问卷,内容涉及他们对案例描述中精神障碍的看法(但未命名),案例描述了一个符合国际疾病分类-10 精神分裂症标准的人。
在邀请的 232 名学生中,有 194 名(84%)完成了问卷。学生最常将遗传作为病因(81%),其次是压力(69%)、心理创伤(45%)和街头毒品滥用(44%)。大多数学生(82%)将案例标记为“精神分裂症”;少数学生(24%)认为有案例描述障碍的人可以康复。将案例标记为“精神分裂症”和将遗传作为病因与对康复可能性的悲观态度以及认为“他人”与该诊断的人保持距离有关。将案例标记为“精神分裂症”的受访者更频繁地引用遗传因素,这与学生认为该诊断的人不可预测的看法显著相关。
这些发现证实,在医学生样本中,生物遗传因果解释和诊断标签对精神分裂症的看法产生负面影响。它们强调了教育医学生了解精神分裂症的康复和与该诊断相关的耻辱感的必要性。