Attitudes towards mental illness among medical students in China: Impact of medical education on stigma

Zhu, Yifan; Zhang, Hanwen; Ge, Yang; Hu, Xing; Liu, Zhening; Guo, Na; He, Hongbo; Sun, Bin; Rosenheck, Robert A.

doi:10.1111/appy.12294

Cited by 28 publications

(25 citation statements)

References 19 publications

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“…Personal experience appeared to be a protective factor against increased social distance when exposed to the service user testimonial describing psychosis, but students who lacked personal experience were susceptible to the potential unintended increase in stigma following viewing of the depression and psychosis videos together. These findings support existing literature regarding the positive association between personal experience with mental illness and improved attitudes among medical students [11,[56][57][58]. Even compared to psychiatry educational experiences during medical school, personal experience has been found to be a greater predictor of attitudes towards mental illness [58], which is likely why it was a moderating factor in this study.…”

Section: Discussionsupporting

confidence: 90%

Impact of Service User Video Presentations on Explicit and Implicit Stigma toward Mental Illness among Medical Students in Nepal: A Randomized Controlled Trial

Tergesen

Gurung²,

Dhungana

et al. 2020

Preprint

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This study evaluated the impact of didactic videos and service user testimonial videos on mental illness stigma among medical students. Two randomized controlled trials were conducted in Nepal. Study 1 examined stigma reduction for depression. Study 2 examined depression and psychosis. Participants were Nepali medical students (Study 1:n=94, Study 2:¬n=213) randomized to three conditions: a didactic video based on the mental health Gap Action Programme (mhGAP), a service user video about living with mental illness, or a control condition with no videos. In Study 1, videos only addressed depression. In Study 2, videos addressed depression and psychosis. In Study 1, both didactic and service user videos reduced stigma compared to the control (F2,91=6.37, p=0.003). In Study 2 (depression and psychosis), there were no differences among the three arms (F2,210=2.07, p=0.13). When comparing Study 1 and 2, there was greater stigma reduction in the service user video arm with only depression versus service user videos with depression and psychosis (t(31)=-3.04, p=0.005). In summary, didactic and service user videos were associated with decreased stigma when content addressed only depression. However, no stigma reduction was seen when including depression and psychosis. This calls for different strategies based on types of mental illnesses. ClinicalTrials.gov identifier: NCT03231761

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Section: Discussionsupporting

confidence: 90%

Impact of Service User Video Presentations on Explicit and Implicit Stigma toward Mental Illness among Medical Students in Nepal: A Randomized Controlled Trial

Tergesen

Gurung²,

Dhungana

et al. 2020

Preprint

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“…In China, the general incidence of mental illness (except dementia) was 9.3%, and the individual lifetime prevalence was 16.6% (Huang et al, ). At the same time, there is still a stigma attached to mental disorders in China (J. Li, Zhang, Zhao, Li, & Zhang, ; Xu, Yin, Yang, & Tian, ; Zhu et al, ). There were many practical obstacles to social integration and rehabilitation to the patients.…”

Section: Discussionmentioning

confidence: 99%

“…These cognitive impairments reduced the individual's coping ability, triggered or amplified negative emotions such as depression and anxiety, and led to deviant behaviors such as a suicide attempt. Especially in China, there is still a stigma attached to mental disorders (J. Li et al, ; Xu et al, ; Zhu et al, ), and social rehabilitation has just started (Feng & Liu, ; N. N. Li, Du, Chen, Song, & Zheng, ; Xin & Ma, ). Consequently, a considerable number of patients have a poor quality of life (Chen et al, ; Qi, Wang, Hong, Zhao, & Xu, ), leading to depressive symptoms in patients with mental disorders, which contributes to the formation of suicide ideation.…”

Section: Discussionmentioning

confidence: 99%

From depressive symptoms to suicide risk: Roles of sense of belongingness and acquired capability for suicide in patients with mental disorders

Wang

Jia

et al. 2020

PsyCh Journal

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In order to prevent suicides in patients with mental disorders, it was critical to recognize the risk factors and explore the mechanism. Based on depressive symptoms, which were common in patients with mental disorders in consolidation period in China, we constructed a moderated mediating model under the framework of Integrated Motivational-Volitional Model of suicidal behaviour, and examined the mechanism of how depressive symptoms, thwarted belongingness, and acquired capability for suicide influenced suicide risk. In this study, data were collected from 164 patients through four questionnaires, and analyzed with PROCESS macro for SPSS (Hayes, 2008). The result showed that in the predictive effects of depressive symptoms on suicide risk, thwarted belongingness was a partial mediating variable, while acquired capability for suicide played a moderating role in the partial mediating model. Specifically, the predictive effects of depressive symptoms and thwarted belongingness, both as motivation variables, on suicide risk both occurred in the case of the high acquired capability of suicide, which was a volition variable. The research pointed out the interdependence of depressive symptoms and a sense of belongingness, and clarified the critical role of acquired capability for suicide. The integrated perspective could enhance the interpretation of reality, and enlightened those carrying out the practice of suicide intervention to patients with mental disorders.

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“… 10 11 21 Some authors argue that medical school education has little effect on nonstigmatized attitudes and long-term contact with people with mental illness does not necessarily modify negative attitudes. 22 23 24 Also, interventions have been shown not to reach enough people to modify the public stigma associated with a population. 4 12 …”

Section: Introductionmentioning

confidence: 99%

“…Negative views regarding psychiatry as a career and psychiatric illness have been found in studies from Nigeria, India, UK, 27 China, 22 Poland, 23 and Iran. 24 Conversely, students from Kenya and Pakistan, 27 USA, 17 Czech Republic, 14 Greece, 15 Canada, 16 Taiwan, 18 Singapore, 24 and Australia 27 reported more positive views regarding attitudes to psychiatry, and so psychiatric illness.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of mental health stigma on medical education: an observational study with Portuguese medical students

Pinto

Bernardo

Sousa

et al. 2020

Porto Biomedical Journal

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Background: The Portuguese mental health care plan emphasizes that health care professionals can be a source of stigma against people with mental illness enhancing self-stigma and leading to a decrease in the search for help and adherence to treatment. Methods: In this exploratory study, we surveyed 111 first and last year students from the Faculty of Medicine of the University of Porto, Portugal, using the Portuguese version of the Attribution Questionnaire AQ-27 to assess the attitudes toward mental illness. Results: The students showed a significant difference in the segregation dimension, and in some items related with pity and coercion in the end of the course. These results express a positive will to integrate people with mental illness in community, a decrease of pity and a valorization of the pharmacological treatment in this kind of disease. The previous personal experience of psychiatric problems decreases the level of segregation and psychological problems increase the motivation to help. Conclusion: Final-year students express more positive and less discriminatory attitudes toward people with severe mental illness than first-year students. This is likely due to education and contact opportunities promoted throughout the medical school, as well as due to the experience of having gone to a psychology or psychiatric consultation. Knowledge of stigma levels of future medical doctors is therefore crucial for the prevention of attitudes that could condition the provision of medical care.

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Attitudes towards mental illness among medical students in China: Impact of medical education on stigma

Cited by 28 publications

References 19 publications

Impact of Service User Video Presentations on Explicit and Implicit Stigma toward Mental Illness among Medical Students in Nepal: A Randomized Controlled Trial

Impact of Service User Video Presentations on Explicit and Implicit Stigma toward Mental Illness among Medical Students in Nepal: A Randomized Controlled Trial

From depressive symptoms to suicide risk: Roles of sense of belongingness and acquired capability for suicide in patients with mental disorders

Evaluation of mental health stigma on medical education: an observational study with Portuguese medical students

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