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Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries

2025-04-11T06:38:44Z

Title: Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries Authors: Wasserman, D.; Apter, G.; Baeken, C.; Bailey, S.; Balazs, J.; Bec, C.; Bienkowski, P.; Bobes, J.; Bravo Ortiz, M. F.; Brunn, H.; Bôke, Ö.; Camilleri, N.; Carpiniello, B.; Chihai, Jana; Chkonia, E.; Courtet, P.; Cozman, D.; David, M.; Dom, G.; Esanu, Andrei; Falkai, P.; Flannery, W.; Gasparyan, K.; Gerlinger, G.; Gorwood, P.; Gudmundsson, O.; Hanon, C.; Heinz, A.; Heitor Dos Santos, M. J.; Hedlund, A.; Ismayilov, F.; Ismayilov, N.; Isometsä, E. T.; Izakova, L.; Kleinberg, A.; Kurimay, T.; Klæbo Reitan, S.; Lecic-Tosevski, D.; Lehmets, A.; Lindberg, N.; Lundblad, K. A.; Lynch, G.; Maddock, C.; Malt, U.F.; Martin, L.; Martynikhin, I.; Maruta, N. O.; Matthys, F.; Mazaliauskiene, R.; Mihajlovic, G.; Mihaljevic Peles, A.; Miklavic, V.; Mohr, P.; Munarriz Ferrandis, M.; Musalek, M.; Neznanov, N.; Ostorharics-Horvath, G.; Pajević, I.; Popova, A.; Pregelj, P.; Prinsen, E.; Rados, C.; Roig, A.; Rojnic Kuzman, M.; Samochowiec, J.; Sartorius, N.; Savenko, Y.; Skugarevsky, O.; Slodecki, E.; Soghoyan, A.; Stone, D. S.; Taylor-East, R.; Terauds, E.; Tsopelas, C.; Tudose, C.; Tyano, S.; Vallon, P.; Van der Gaag, R. J.; Varandas, P.; Vavrusova, L.; Voloshyn, P.; Wancata, J.; Wise, J.; Zemishlany, Z.; Öncü, F.; Vahip, S. Abstract: Background. Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care. Methods. The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions. Results. We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures. Conclusions. We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.

Stigmatizarea persoanelor cu tulburări psihice în rândul elevilor

2025-04-10T14:20:42Z

Title: Stigmatizarea persoanelor cu tulburări psihice în rândul elevilor Authors: Eșanu, Andrei

Stigma toward people with mental disorders in adolescents: comparison between Portugal and Moldova

2025-04-10T13:40:16Z

Title: Stigma toward people with mental disorders in adolescents: comparison between Portugal and Moldova Authors: Eșanu, Andrei; Morais, Vitor; Araújo, Joana; Ramos, Elisabete Abstract: Background: Mental disorders are one of the most significant public health challenges. Stigma toward people with mental disorders decreases help-seeking behaviors, and may be a cause of depression and anxiety. Research on the level of stigma and comparison between different countries in adolescence is scarce. We aim to study stigma toward people with mental disorders in adolescents, and to evaluate differences between Portugal and Moldova. Methods: In a cross-sectional analysis, we evaluated 657 high school students from Portugal and 612 from Moldova. Data were collected by a self-reported questionnaire that, beyond stigma, evaluated individual and family characteristics. Stigma was evaluated using the Attribution Questionnaire for Children (AQ-8-C) and the Depression Stigma Scale (DSS). Data were summarized using means and standard deviations, and comparison was performed using Student t test and analysis of variance. Results: The mean (standard deviation) level of mental disorder stigma measured by the AQ-8-C was 32.10 (8.77) in Moldova and 24.32 (9.20) in Portugal, P<.001. Adolescents from Moldova presented higher values for all items except for “Fear,” with higher mean value in Portugal and for “Help” with no significant differences between countries. Regarding the Depression Stigma Scale, adolescents from Moldova presented higher values, both for personal stigma [19.84 (4.78) vs 15.09 (5.08), P<.001] and for perceived stigma [26.43 (4.30) vs 22.62 (5.15), P<.001]. Stigma levels did not differ according to having or not someone with a mental disorder in the class or family. Conclusion: The level of stigma toward people with mental disorders is higher in Moldova than in Portugal.

Stigmatising attitudes towards mental health conditions among medical students in five south-eastern European countries

2025-04-10T13:35:52Z

Title: Stigmatising attitudes towards mental health conditions among medical students in five south-eastern European countries Authors: Harhaji, Sanja; Tomori, Sonila; Nakov, Vladimir; Chihai, Jana; Radić, Ivana; Mana, Tedi; Stoychev, Kaloyan; Eșanu, Andrei; Pirlog, Mihail Cristian Abstract: Introduction: Stigmatising attitudes towards mentally ill people are present among healthcare professionals. The aim of the study was to evaluate medical students’ attitudes in five medical schools from Albania, Bulgaria, Moldova, Romania and Serbia and to determine if psychiatry clerkship improves these attitudes. Methods: In the first stage, the study included students from the first and final years of medical school; in the second stage, only final-year students were included; The Mental Illness Clinicians’ Attitude Scale (MICA-2) and the Attribution Questionnaire (AQ-9) were used in this study. The total sample comprised 1,526 medical students in the first stage and 614 in the second stage. Results: The analysis of the average AQ-9 and MICA-2 scores between countries revealed significant differences (p<0.05). Multivariable analysis showed that female students were 30% more likely to have elevated AQ-9 scores than male students (p=0.029). Final-year students had a significantly lower chance of having a higher MICA-2 score compared to first-year students (OR=0.7; p<0.05). Conclusions: Psychiatry clerkship contributes to a decrease in the level of stigmatising attitudes among medical students. Further research is required to assess the curricula to achieve better results in reducing stigma among future doctors.; Uvod: Stigmatizirajoči odnos do duševno bolnih ljudi je prisoten tudi med zdravstvenimi delavci. Namen študije je bil oceniti stališča študentov medicine na petih medicinskih fakultetah v Albaniji, Bolgariji, Moldaviji, Romuniji in Srbiji ter ugotoviti, ali praksa na psihiatriji ta stališča izboljša. Metode: V prvi fazi je študija vključevala študente prvega in zadnjega letnika medicinske fakultete, v drugi fazi pa samo študente zadnjega letnika; v tej študiji sta bila uporabljena lestvica stališč zdravnikov do duševnih bolezni (MICA-2) in vprašalnik o atribuciji (AQ-9). Skupni vzorec je obsegal 1526 študentov medicine v prvi fazi študije in 614 v drugi fazi. Rezultati: Analiza povprečnih rezultatov AQ-9 in MICA-2 med državami je pokazala pomembne razlike (p < 0,05). Multivariatna analiza je pokazala, da je bila verjetnost, da bodo imele študentke za 30 % višji rezultat AQ-9 kot študenti (p = 0,029). Študenti zadnjega letnika so imeli v primerjavi s študenti prvega letnika bistveno manj možnosti za višji rezultat MICA-2 (OR = 0,7; p < 0,05). Zaključki: Psihiatrična praksa prispeva k zmanjšanju stopnje stigmatizirajočega odnosa med študenti medicine. Potrebne so nadaljnje raziskave za oceno učnih načrtov za doseganje boljših rezultatov pri zmanjševanju stigmatizacije med bodočimi zdravniki.