Vistorte Angel O Rojas, Ribeiro Wagner Silva, Jaen Denisse, Jorge Miguel R, Evans-Lacko Sara, Mari Jair de Jesus
1 Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.
2 Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.
Int J Psychiatry Med. 2018 Jul;53(4):317-338. doi: 10.1177/0091217418778620.
Objective To examine stigmatizing attitudes towards people with mental disorders among primary care professionals and to identify potential factors related to stigmatizing attitudes through a systematic review. Methods A systematic literature search was conducted in Medline, Lilacs, IBECS, Index Psicologia, CUMED, MedCarib, Sec. Est. Saúde SP, WHOLIS, Hanseníase, LIS-Localizador de Informação em Saúde, PAHO, CVSO-Regional, and Latindex, through the Virtual Health Library portal ( http://www.bireme.br website) through to June 2017. The articles included in the review were summarized through a narrative synthesis. Results After applying eligibility criteria, 11 articles, out of 19.109 references identified, were included in the review. Primary care physicians do present stigmatizing attitudes towards patients with mental disorders and show more negative attitudes towards patients with schizophrenia than towards those with depression. Older and more experience doctors have more stigmatizing attitudes towards people with mental illness compared with younger and less-experienced doctors. Health-care providers who endorse more stigmatizing attitudes towards mental illness were likely to be more pessimistic about the patient's adherence to treatment. Conclusions Stigmatizing attitudes towards people with mental disorders are common among physicians in primary care settings, particularly among older and more experienced doctors. Stigmatizing attitudes can act as an important barrier for patients to receive the treatment they need. The primary care physicians feel they need better preparation, training, and information to deal with and to treat mental illness, such as a user friendly and pragmatic classification system that addresses the high prevalence of mental disorders in primary care and community settings.
目的 通过系统评价，研究基层医疗专业人员对精神障碍患者的污名化态度，并确定与污名化态度相关的潜在因素。方法 通过虚拟健康图书馆门户（http://www.bireme.br网站），在Medline、Lilacs、IBECS、Index Psicologia、CUMED、MedCarib、Sec. Est. Saúde SP、WHOLIS、Hanseníase、LIS - Localizador de Informação em Saúde、PAHO、CVSO - Regional和Latindex中进行系统文献检索，截至2017年6月。通过叙述性综合对纳入综述的文章进行总结。结果 应用纳入标准后，在检索到的19109篇参考文献中，有11篇文章被纳入综述。基层医疗医生确实对精神障碍患者存在污名化态度，且对精神分裂症患者的态度比对抑郁症患者更消极。与年轻和经验不足的医生相比，年长且经验更丰富的医生对精神疾病患者的污名化态度更强。对精神疾病持更污名化态度的医疗服务提供者可能对患者坚持治疗的情况更悲观。结论 在基层医疗环境中，医生对精神障碍患者的污名化态度很常见，尤其是在年长且经验更丰富的医生中。污名化态度可能成为患者获得所需治疗的重要障碍。基层医疗医生认为他们需要更好的准备、培训和信息来处理和治疗精神疾病，例如一个用户友好且实用的分类系统，该系统应解决基层医疗和社区环境中精神障碍的高患病率问题。
