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

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.