Changes in psychiatry residents' attitudes towards individuals with substance use disorders over the course of residency training
Changes in psychiatry residents' attitudes towards individuals with substance use disorders over the course of residency training
复制标题
DOI：
10.1111/ajad.12406
复制
发表时间：
2017-01-01
影响因子：
3.7
通讯作者：
Penzner, Julie B.
中科院分区：
文献类型：
--
作者：
Avery, Jonathan;Han, Bernadine H.;Penzner, Julie B.
背景与目的精神科住院医师为诊断为精神疾病和物质使用障碍（sud）共存的个体提供护理。小型研究表明，临床医生通常对这些双重诊断的个体持消极态度。这是一个严重的问题，因为临床医生对精神疾病患者的污名化态度可能对治疗产生特别严重的不利影响。摘要本研究旨在探讨精神科住院医师对精神分裂症、多发性猝死症、精神分裂症合并猝死症及重度抑郁症患者的态度。方法对全国159名精神科住院医师进行问卷调查。报告由两部分组成：(i)人口资料，其中包括关于培训水平的资料；（ii）针对四种不同诊断的个体的11项医疗状况关注量表（MCRS）。结果精神科住院医师对合并和不合并精神分裂症的sud患者的污名化态度高于对单独诊断为精神分裂症或重度抑郁症患者的污名化态度。老年住院医师对sud患者的负面态度高于初级住院医师。讨论与结论精神科住院医师对患有和不患有精神分裂症的sud患者的态度均为消极态度，其中老年住院医师的态度更差。这些发现有很多潜在的原因，包括在为这些人提供护理时反复出现的负面经历。精神科住院医师对sud患者的负面态度令人担忧。未来的工作需要更好地了解这些态度，并制定干预措施来改善这些态度。（Am J Addict 2017;26:75-79）
Background and ObjectivesPsychiatry residents provide care for individuals diagnosed with co-occurring mental illness and substance use disorders (SUDs). Small studies have shown that clinicians in general possess negative attitudes towards these dually diagnosed individuals. This is a serious concern, as clinicians' stigmatizing attitudes towards individuals with mental illnesses may have a particularly potent adverse impact on treatment. The goal of this study was to examine the attitudes of psychiatry residents towards individuals with diagnoses of schizophrenia, multiple SUDs, co-occurring schizophrenia and SUDs, and major depressive disorder.MethodsA questionnaire was sent to psychiatry residents (N=159) around the country. It was comprised of two sections: (i) demographic information, which included information about level of training; and (ii) the 11-item Medical Condition Regard Scale (MCRS) for individuals with the four different diagnoses.ResultsPsychiatry residents had more stigmatizing attitudes towards individuals with diagnoses of SUDs with and without schizophrenia than towards those individuals with diagnoses of schizophrenia or major depressive disorder alone. Senior residents possessed more negative attitudes towards individuals with SUDs than junior residents.Discussion and ConclusionsThe attitudes of psychiatry residents' towards individuals with SUDs with and without schizophrenia were negative and were worse among senior residents. There were many potential reasons for these findings, including repeat negative experiences in providing care for these individuals.Scientific SignificanceThe negative attitudes of psychiatry residents towards individuals with SUDs are worrisome. Future work is needed to better understand these attitudes and to develop interventions to improve them. (Am J Addict 2017;26:75-79)