Revet Alexis, Raynaud Jean-Philippe, Marcelli Daniel, Falissard Bruno, Catheline Nicole, Benvegnu Grégoire
Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Toulouse, Toulouse, France.
UMR 1027, Inserm, Université Toulouse III, Toulouse, France.
Front Psychiatry. 2021 Feb 18;12:560141. doi: 10.3389/fpsyt.2021.560141. eCollection 2021.
The shortage of child and adolescent psychiatrists in France affects access to early interventions and mental health services and impacts therapeutic practices and prescribing trends. This study aimed to describe factors associated with choosing child and adolescent psychiatry (CAP) as a career specialty and with assessing the level of attractiveness of this discipline and its predictors. We generated a self-report questionnaire using a modified two-step Delphi approach. The survey was conducted from January 13 to February 16, 2020, and targeted French child and adolescent psychiatrists or psychiatrists, mainly working with children and/or adolescents. We used a logistic regression model to assess the factors associated with the perception of CAP as attractive. A thematic qualitative analysis of the free comments section of the questionnaire was performed. Of 863 doctors contacted by email, the response rate was 77.4% (668 respondents). Two-thirds of respondents were female and had an official specialization in CAP. One-third were aged between 31 and 40 years. The main reasons for choosing to specialize in CAP were interest in working with children (64.2%), interest in psychotherapy (52.8%), and influence of an internship in CAP during medical studies (46.0%), although only one-third of respondents actually did an internship. Over half of respondents (57.3%) identified personal factors as implicated in their choice of CAP, mainly personal psychotherapy (22.2%) and personal trauma (14.4%). Although only 58.4% of respondents perceived CAP as attractive, 97.8% had no regret about their choice, and 83.5% would make the same career choice today. A positive perception by respondents' surroundings for choosing CAP at the time of the choice was associated with a perception of CAP as currently attractive by respondents (odds ratio: 1.82; 95% confidence interval: 1.27-2.60; = 0.001). CAP is in crisis and faces many challenges in France, with an urgent need to redress its demographics. Many child and adolescent psychiatrists do not regret their choice and would choose the same specialty today. To increase its attractiveness, better visibility during medical school, enhanced academic recognition, and increased remuneration seem promising.
法国儿童和青少年精神科医生短缺，这影响了早期干预和心理健康服务的可及性，并对治疗实践和处方趋势产生影响。本研究旨在描述与选择儿童和青少年精神病学（CAP）作为职业专科相关的因素，以及评估该学科的吸引力水平及其预测因素。我们采用改良的两步德尔菲法生成了一份自填式问卷。该调查于2020年1月13日至2月16日进行，目标对象为法国儿童和青少年精神科医生或主要从事儿童和/或青少年工作的精神科医生。我们使用逻辑回归模型来评估与认为CAP有吸引力相关的因素。对问卷的自由评论部分进行了主题定性分析。通过电子邮件联系的863名医生中，回复率为77.4%（668名受访者）。三分之二的受访者为女性，且拥有CAP的官方专科资质。三分之一的受访者年龄在31至40岁之间。选择CAP专科的主要原因是对与儿童工作感兴趣（64.2%）、对心理治疗感兴趣（52.8%）以及医学学习期间CAP实习的影响（46.0%），尽管只有三分之一的受访者实际进行了实习。超过一半的受访者（57.3%）认为个人因素与他们选择CAP有关，主要是个人心理治疗（22.2%）和个人创伤（14.4%）。尽管只有58.4%的受访者认为CAP有吸引力，但97.8%的人对自己的选择不后悔，83.5%的人表示今天会做出相同的职业选择。受访者在做出选择时周围人对选择CAP的积极看法与受访者目前认为CAP有吸引力有关（优势比：1.82；95%置信区间：1.27 - 2.60；P = 0.001）。在法国，CAP正处于危机之中，面临诸多挑战，迫切需要调整其人员构成。许多儿童和青少年精神科医生对自己的选择不后悔，并且今天会选择相同的专科。为了提高其吸引力，在医学院期间提高知名度、增强学术认可度以及增加薪酬似乎很有前景。
