Kostic Milutin, Radanovic Ana, Jovanovic Sonja
University of Belgrade, Belgrade, Serbia.
Institute of Mental Health, Belgrade, Serbia.
Acad Psychiatry. 2022 Apr;46(2):202-209. doi: 10.1007/s40596-021-01515-x. Epub 2021 Aug 4.
The aim of this study was to explore how changes in biologically based narratives versus socially focused ones affect medical students' perceptions of causes, treatment strategies, and social distance towards patients and their beliefs that patients can improve.
The sample consisted of 1652 medical students of 18 to 32 years of age from the Faculty of Medicine at the University of Belgrade. Three text passages describing a female with standard symptoms of depression were randomly assigned. Within the text, additional information about different circumstances was included: information about personal problems (group S), family mental disorder history (group B), or both (group BS).
Although family history of mental illness does not necessarily imply heredity, group B assumed a biological cause of depression to be more probable and identified medication prescription as a more effective treatment approach than the other groups did. Changes in views towards treatment strategies from the first year to later years were observed with the medical model becoming more dominant.
The results of this study warn us of a tendency towards thinking less about social causes and more about medication prescription when an indication of biological causes is present. Implications for the medical education of future doctors and clinical practitioners are discussed.
本研究旨在探讨基于生物学的叙述与关注社会的叙述的变化如何影响医学生对病因、治疗策略的看法,以及他们与患者的社会距离感,还有他们对患者能够改善的信念。
样本包括来自贝尔格莱德大学医学院的1652名年龄在18至32岁之间的医学生。随机分配了三段描述一名有标准抑郁症状女性的文字段落。在文本中,包含了关于不同情况的额外信息:关于个人问题的信息(S组)、家族精神病史(B组)或两者皆有(BS组)。
尽管精神疾病家族史不一定意味着遗传,但B组认为抑郁症的生物学病因更有可能,并且比其他组更认同药物处方是一种更有效的治疗方法。从第一年到后期观察到对治疗策略看法的变化,医学模式变得更加占主导地位。
本研究结果提醒我们,当存在生物学病因迹象时,存在一种较少考虑社会病因而更多考虑药物处方的倾向。讨论了对未来医生和临床从业者医学教育的启示。