Attitude of an Egyptian Sample of Medical Students Toward Psychiatry in Comparison to Previous Studies Using the Attitudes Towards Psychiatry (ATP-30) Questionnaire

Medical students' attitude towards psychiatry: a comparison of past and present

Attitude to psychiatry influences motivation for medical students to successfully achieve in studying psychiatry. With a new generation of students, it would be interesting to investigate how attitudes have changed. This study aimed to compare the attitude of fifth-year medical students toward psychiatry in recent and in the past 24 years. Two samples of fifth-year medical students at Chiang Mai University completed the 30-item attitude to psychiatry (ATP-30); 118 students completed it in 1996, whereas 242 medical students completed it in 2019. Rasch analysis was employed for examining the differences between the total score and individual item scores between the two groups. The total score of ATP in the 2019 group was significantly higher than that in the 1996 group. After misfitting individuals and biased items were removed, only 15 items were valid and useful for a comparison. Of 15 items, 11 were found highly significantly different between two groups (p < 0.001). Negatively worded items, e.g., no strong evidence indicating effectiveness, became easier to score items (increased positive attitude) whereas some positively worded items, e.g., I would like to be a psychiatrist. Nine items, became more difficult (less positive attitude) comparing between 1996 and 2019. In a comparison between the two methods using the traditional t-test and Rasch analysis, only 5 of 30 items (16.7%) agreed with each other. The overall attitude to psychiatry was significantly higher at the present compared with that in the past. Most items did not differ between the two times. Further studies regarding improving the attitude scale using item response theory such as Rasch should be encouraged.

Attitudes of medical students toward psychiatry in Eastern Mediterranean Region: A systematic review

BACKGROUND

Psychiatry is facing one of the highest levels of shortages among medical specialties. Stigma toward psychiatry plays an influential role in medical students' decision to choose psychiatry as a career and has been reported to be prevalent in different parts of the world, particularly in low/middle-income countries.

OBJECTIVE

To systematically review the Eastern Mediterranean Region (EMR) medical students' attitudes toward psychiatry, to assess whether their attitudes are stigmatized or not, and the factors affecting their attitudes.

METHOD

PubMed, Scopus, Web of Science, and PsychInfo (PsycARTICLES) were searched using a combination of main terms "stigma," "psychiatry," "medical students," and the name of Eastern Mediterranean countries. Cross-sectional studies assessing the attitudes of EMR medical students toward psychiatry were included in this review.

RESULTS

Ten studies were eligible to be included in the result synthesis. These were from Pakistan (n = 3), Iran (n = 2), Saudi Arabia (n = 1), Lebanon (n = 1), Egypt (n = 1), Bahrain (n = 1), and Oman (n = 1). Most studies reported a combination of both positive and negative attitudes among medical students; however, the overall attitude was positive. Factors affecting medical students' attitude toward psychiatry included poor psychological well-being, having a friend with a psychiatric illness, involving in a romantic relationship with someone suffering from mental illness, young age, frequency of exposure to psychiatry clerkship/teaching, and quality of psychiatry clerkship. Nevertheless, the final positive or negative outcome of these factors on students' attitudes remained controversial.

CONCLUSION

Considering the lack of sufficient data from most EMR countries, we need to exercise caution in interpreting the results of this review. Nevertheless, our review indicates that psychiatry is not stigmatized among EMR medical students, and they have generally positive attitudes toward it. The findings of studies evaluating influencing factors are contradictory and demand further exploration.

Attitudes Towards Psychiatry in Lebanese Medical Students: What Are the Factors that Could Lead to a More Favorable Outlook?

OBJECTIVE

The authors aimed to assess the attitudes towards psychiatry of all Lebanese medical students, as well as the factors that could have led to these attitudes, whether favorable or not.

METHODS

In this cross-sectional study, the authors ran a questionnaire among a sample of Lebanese medical students from all medical faculties, regions in Lebanon, and years of medical school, using the ATP-30 scale and the WHO-5 well-being index. The answers from the 607 participants were statistically analyzed on SPSS version 23.0.

RESULTS

Among participants, 95.1% had a positive attitude towards psychiatry, reflecting a favorable outlook among Lebanese medical students overall. The average ATP-30 score in our sample was 111.95 out of 150 (SD = 12.55), which is in the range of countries of higher socio-economic level such as Germany and Switzerland. Also, 26.5% of participants reported that they consider psychiatry as a potential career choice. No demographic factor had any influence on the ATP-30 score. In the multivariate analysis, only two factors resulted in favorable attitudes: exposure to a patient with a diagnosed psychiatric illness in the student's surroundings and a lower WHO-5 well-being index.

CONCLUSION

This study's results do not fit into the traditional "developed vs. developing countries" paradigm. However, Lebanon still has a lot of challenges to face in order to provide quality mental healthcare.

A nationwide survey of attitudes towards psychiatry among final-year medical students in Sri Lanka

Stigma towards psychiatry, a debilitating phenomenon worldwide, is likely to have engendered the longstanding lack of recruitment into psychiatry in Sri Lanka (SL). However, as recent expansion of the undergraduate training in psychiatry in SL may have instigated favorable changes in students' attitudes, we assessed the attitudes of students regarding psychiatry by administering Attitude towards psychiatry-30 (ATP-30) scale to final-year medical students in nine medical schools in SL. This 30-item questionnaire covers eight domains of psychiatry and is rated on a Likert scale, producing a total score out of 150. A multiple linear regression was performed to investigate associated factors. A total of 743 fin. l-year students participated. Of them, 54 % were male. The mean attitude score was 107.7 (SD = 12.3) and 92.2 % showed an overall "positive" attitude. 22.2 % of students considered psychiatry as a potential future career. Students with more than one month of clinical exposure to psychiatry showed a better attitude compared to those with shorter exposure. Female gender and the presence of a close person with mental illness were also associated with better attitudes and career interest. The generally positive attitude towards psychiatry among medical students may be explained, at least partly, by recent advances in undergraduate psychiatry education in SL. Longer clinical exposure to psychiatry being associated with better attitudes indicates the need to ensure adequate duration of clinical training in psychiatry in the undergraduate curriculum.

Evaluating the effectiveness of video cases to improve patient-centeredness in psychiatry: a quasi-experimental study

OBJECTIVES

To evaluate the effectiveness of including interactive video-based patient cases in preparatory lectures on medical students' patient-centredness and attitudes towards psychiatry.

METHODS

This study was designed as a quasi-experimental intervention study. A preparatory lecture on diagnostic interviewing was given to 204 fourth-year medical students before a 4-week psychiatry clerkship. The students were divided into two groups. One group (n=102) received a preparatory lecture including an interactive video case portraying a doctor performing a diagnostic interview with a simulated patient (intervention group). The other group (n=102) received a conventional preparatory lecture using text-based instructional material (control group). We conducted a paired sample t-test to compare the students' confidence in exhibiting patient-centred communication and their attitudes towards psychiatry before receiving the preparatory lecture and after having completed a minimum of three weeks of clerkship training.

RESULTS

A total of 102 students, 51 in each group, completed a questionnaire at both measurement points. In the intervention group, we found a statistically significantly difference for the students' patient-centredness before (M=69.4, SD=10.0) and after (M=73.8, SD=8.6) the intervention t(97)=2.38, p= 0.02, but no changes in attitudes t(98) =1.07, p=0.28. In the control group, we found no changes in patient-centredness or attitudes.

CONCLUSIONS

Video cases in preparatory lectures appear to be better than text-based material at improving students' patient-centredness in psychiatry. However, neither video cases nor text-based material seem to influence the students' attitudes.