Prim Care Companion J Clin Psychiatry 2009;11(4):177
© Copyright 2014 Physicians Postgraduate Press, Inc.
General practitioners (GPs), past research has shown, have
negative attitudes toward patients with schizophrenia, attitudes that do not
merely acknowledge the nature or chronic aspects of the illness. This study
sought to characterize the attitudes and predicted conduct of medical students
toward patients with mental illness in a primary care setting and to examine if
the students’ level of training influenced these attitudes.
Method: One of 4 case vignettes was given to a sample of 1239 students from
the University of Birmingham Medical School. The vignettes were identical
except that the patient involved was characterized as having been diagnosed
previously with either schizophrenia, depression, diabetes, or no illness. Students
rated their level of agreement with 12 attitudinal statements relating to the
Results: A total of 1081 students (88%) responded to the questionnaire. Patients
with either schizophrenia or depression elicited responses from students
that were generally less favorable. The students would be less happy to have
such individuals as patients, believed they would consume more time, and
thought that they would be less likely to comply with advice and treatment. The
risk of violence, the potential welfare of children, and the possibility of illegal
drug and excessive alcohol use were expressed concerns. These reactions were
affected very little by general clinical and psychiatric training.
Conclusions: Patients with mental illness provoke less favorable responses
in medical students, responses that are not a function of education. That students
develop an empathetic and positive approach to mental health patients and their
treatment should be ensured by re-evaluating undergraduate primary care–based
mental health education.