Stigma about mental disease in Portuguese medical students: a cross-sectional study

Abstract

Background: The stigma about mental diseases is common in the population and also in medical students, where it may condition their future practice and the way they deal with these patients.

Aim: To evaluate and characterize the stigma on mental diseases in Portuguese sixth-year medical students, based on a clinical scenario of a classmate suffering from a mental disorder.

Methods: Observational cross-sectional study, involving sixth-year students of all Portuguese medical schools. We applied an online self-response questionnaire, using the Portuguese version of the Attribution Questionnaire AQ-9, and a vignette of a classmate colleague, presenting mental illness symptoms. Stigma scores were calculated. We used logistic regression to estimate the effect of social determinants on stigma pattern, and we analysed the correlation between 9 variables evaluated by the AQ-9 and total stigma.

Results: A total of 501 participants were included for analysis (69.5% females, median age of 24 years old). Medical students were available to help in the proposed clinical scenario (6.93/9.00; 95%CI:6.77-7.10), if necessary using coercion for treatment (3.85; 95%CI:3.63-4.07), because they felt pity (6.86; 95%CI:6.67-7.06) and they perceived some kind of dangerousness (4.06; 95%CI:3.84-4.28). Stigma was lower in students having a personal history of mental illness (OR:0.498; 95%CI:0.324-0.767; p = 0.002) and in those with positive familial history (OR: 0.691; 95%CI:0.485-0.986; p = 0.041).

Conclusion: Our results show the importance of implementing anti-stigma education, to improve medical students' attitudes towards peers living with mental diseases.

Keywords: Empathy; Medical education (undergraduate); Medical schools; Mental disorders; Social stigma.

Fig. 1

Relation between stigma and sociodemographic factors. OR: odds ratio