Movahedi Sana, Shariat Seyed Vahid, Shalbafan Mohammadreza
Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Front Psychiatry. 2022 Jul 28;13:961538. doi: 10.3389/fpsyt.2022.961538. eCollection 2022.
The stigma of mental illness has a negative impact on the diagnosis and treatment of these disorders. Considering the high prevalence of mental illness, the attitude of medical specialists toward mental disorders, who are front liners in diagnosing and treating these patients, is critical. Therefore, we examined the attitude of Iranian medical specialty trainees toward providing health care services for patients with mental illness.
We included 143 residents in the fields that have the most interactions with patients with mental disorders, including internal medicine, surgery, neurology, cardiovascular diseases, and psychiatry. A demographic checklist, as well as the opening minds scale for health care providers stigma assessment questionnaire, was provided, which measures five dimensions of improvement, social responsibility, social distance, exposure, and other (such as risk) in health care providers toward delivering the healthcare services to patients with mental disorders.
The mean score of stigma for mental illness in medical specialty trainees was 61.36 ± 4.83 out of 100. Psychiatric residents have the least stigmatizing attitude (58.38 ± 3.54), and internal medicine and cardiology residents have the highest score, respectively, (62.96 ± 6.05, 62.45 ± 3.80). As for comparing subscales between specialties, only the social responsibility subscale showed a significant difference, with psychiatry having less stigma toward social responsibility (12.93 ± 2.01) than cardiology (15.09 ± 1.50) trainees.
The attitude of medical specialty trainees toward providing health care services for patients with mental illness is not uniform; internal medicine and cardiology residents have more stigmatizing attitude, while psychiatric residents have less stigmatizing attitude. It seems that not every contact could be useful in making a better attitude toward mental illness, but it needs preconditions, like a structured contact that leads to positive outcomes. Anti-stigma interventions are needed to improve the attitude of medical specialty trainees toward providing health care services to patients with mental illness.
精神疾病的污名化对这些疾病的诊断和治疗产生负面影响。鉴于精神疾病的高患病率，医学专家作为诊断和治疗这些患者的一线人员，他们对精神障碍的态度至关重要。因此，我们研究了伊朗医学专业实习生对为精神疾病患者提供医疗服务的态度。
我们纳入了143名在与精神障碍患者互动最多的领域的住院医师，包括内科、外科、神经科、心血管疾病科和精神科。提供了一份人口统计学清单以及医疗服务提供者污名评估问卷的开放思维量表，该量表测量医疗服务提供者在为精神障碍患者提供医疗服务时的改善、社会责任、社会距离、接触和其他（如风险）五个维度。
医学专业实习生对精神疾病的污名化平均得分为61.36±4.83（满分100分）。精神科住院医师的污名化态度最少（58.38±3.54），内科和心内科住院医师的得分最高，分别为（62.96±6.05，62.45±3.80）。至于各专业之间子量表的比较，只有社会责任子量表显示出显著差异，精神科住院医师对社会责任的污名化程度（12.93±2.01）低于心内科住院医师（15.09±1.50）。
医学专业实习生对为精神疾病患者提供医疗服务的态度并不一致；内科和心内科住院医师的污名化态度更强，而精神科住院医师的污名化态度较弱。似乎并非每一次接触都有助于对精神疾病形成更好的态度，而是需要一些前提条件，比如结构化的接触并产生积极结果。需要开展反污名化干预措施，以改善医学专业实习生对为精神疾病患者提供医疗服务的态度。
