Bouyssi A, Prebois S, Rougé-Bugat M-E, Dupouy J, Driot D
Département universitaire de médecine générale, université Paul-Sabatier Toulouse III, 133, route de Narbonne, 31062 Toulouse, France.
Centre hospitalier universitaire Toulouse Purpan, service de psychiatrie, place du Dr-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
Encephale. 2023 Feb;49(1):65-71. doi: 10.1016/j.encep.2022.06.007. Epub 2022 Oct 14.
The objective was to assess the level of stigmatisation of psychiatric patients by medical interns specialising in general practice (GP), and to assess the influencing factors of stigmatisation.
A national survey was carried out among interns in general practice (GP) contacted through their local associations from December 10, 2019 to March 9, 2020. An online questionnaire was diffused. The validated French version of the Mental Illness Clinicians' Attitudes (MICA) was used to measure stigmatising attitudes towards psychiatry and persons with psychiatric disorder by the interns. This 16-item scale is designed to measure attitudes of health care professionals towards people with mental illness with scores ranging from 16 to 96 (the most stigmatizing). Several covariates were collected: socio-demographics, personal experiences with mental health, and mental health trainings during medical studies. All questionnaires were strictly anonymized. Comparative analyses of the MICA score by group were performed using Student's tests.
A total of 389 interns responded. The majority of respondents were female (n=277; 71%) and the mean age was 27years [standard deviation (SD)±2.39]. The mean MICA rate was 40.64 (SD±8.09) for a neutral score of 56, reflecting low overall stigmatizing attitudes. MICA scores were significantly lower among female interns (40.11 vs. 41.95; P=0.042), those who had benefited from personal psychological or psychiatric support (38.70 vs. 41.61; P=0.001), and those who had completed a psychiatric externship (39.47 vs. 42.16; P=0.001).
GP interns had an attitude that is generally not very stigmatizing even if its improvement should still be sought. This is particularly verified among those who have completed a psychiatric internship during their externship. This suggested association should be supported by other studies. The stakes are high for the future management of patients since stigmatisation by a physician is strongly implied in the worse healthcare management of patients with psychiatric disorders, leading them to a shorter lifespan.
评估全科医学实习医生对精神科患者的污名化程度，并评估污名化的影响因素。
于2019年12月10日至2020年3月9日通过当地协会联系全科医学实习医生进行全国性调查。发放在线问卷。使用经过验证的法语版《精神疾病临床医生态度量表》（MICA）来衡量实习医生对精神病学和精神疾病患者的污名化态度。这个包含16个条目的量表旨在测量医疗保健专业人员对精神疾病患者的态度，得分范围为16至96分（得分越高，污名化程度越高）。收集了几个协变量：社会人口统计学信息、个人心理健康经历以及医学学习期间的心理健康培训情况。所有问卷都严格匿名。使用学生检验对不同组的MICA得分进行比较分析。
共有389名实习医生回复。大多数受访者为女性（n = 277；71%），平均年龄为27岁[标准差（SD）±2.39]。MICA平均得分是40.64（SD±8.09），中性得分为56分，这表明总体污名化态度较低。女性实习医生的MICA得分显著更低（40.11对41.95；P = 0.042），那些曾获得个人心理或精神支持的实习医生得分更低（38.70对41.61；P = 0.001），以及那些完成过精神科实习轮转的实习医生得分也更低（39.47对42.16；P = 0.001）。
全科医学实习医生的态度总体上污名化程度不高，即便仍需寻求改善。在那些在实习轮转期间完成过精神科实习的医生中尤其如此。这种关联有待其他研究进一步证实。鉴于医生的污名化与精神疾病患者更糟糕的医疗管理密切相关，进而导致患者寿命缩短，因此这对患者未来的管理至关重要。
