Intensity of previous teaching but not diagnostic skills influences stigmatization of patients with substance use disorder by general practice residents. A vignette study among French final-year residents in general practice
European Journal of General Practice. 2018-01-01; 24(1): 160-166
DOI: 10.1080/13814788.2018.1470239
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1. Eur J Gen Pract. 2018 Dec;24(1):160-166. doi: 10.1080/13814788.2018.1470239.
Intensity of previous teaching but not diagnostic skills influences
stigmatization of patients with substance use disorder by general practice
residents. A vignette study among French final-year residents in general
practice.
Dupouy J(1)(2), Vergnes A(1), Laporte C(3)(4), Kinouani S(5)(6)(7), Auriacombe
M(8)(9), Oustric S(1)(2), Rougé Bugat ME(1)(2).
Author information:
(1)a Département Universitaire de Médecine Générale , Université de Toulouse III
Paul Sabatier, Faculté de Médecine , Toulouse , France.
(2)b Inserm UMR1027, Université de Toulouse III Paul Sabatier, Faculté de
Médecine , Toulouse , France.
(3)c Département de Médecine Générale , Université de Clermont-Ferrand, Faculté
de médecine , Clermont-Ferrand , France.
(4)d EA 7280 NPsy-Sydo, Faculté de médecine de Clermont-Ferrand, Université
d’Auvergne , Clermont-Ferrand , France.
(5)e Université de Bordeaux , Bordeaux , France.
(6)f Inserm UMR1219, Neuroepidemiologie , Bordeaux , France.
(7)g Département de Médecine Générale , Université de Bordeaux , Bordeaux ,
France.
(8)h Pôle Addictologie , CH Charles Perrens et CHU de Bordeaux , Bordeaux Cedex ,
France.
(9)i Laboratoire SANPSY, CNRS USR 3413, Université de Bordeaux, PAC Carreire ,
Bordeaux Cedex , France.
BACKGROUND: High levels of stigma towards patients with substance use disorder
(SUD) have been found in health professionals and medical students.
OBJECTIVES: To assess the capability of residents in general practice to diagnose
SUD correctly; to assess their stigmatization of patients with SUD and to assess
the correlation between both variables. We hypothesized a negative correlation.
METHODS: In 2014, we conducted a cross-sectional survey among French residents in
general practice, using a self-administered questionnaire. First, a clinical case
of SUD (tramadol) was presented, to assess the diagnosis and retained diagnostic
criteria. A second clinical vignette was presented (intravenous heroin user) to
assess stigmatization with the Attitudes to Mental Illness Questionnaire (AMIQ).
Its score ranges from -10 (negative attitude) to +10 (positive attitude). AMIQ
scores of residents who diagnosed SUD correctly versus incorrectly, and who had
received at least six hours versus less than six hours of teaching on this topic,
were compared using Student’s t-test.
RESULTS: Of 1284 solicited residents, 303 participated (23.6%), 249 residents
diagnosed SUD correctly (82.2%). The mean AMIQ score was -3.91 (SD 2.4) without
significant difference regarding the correct diagnosis of SUD; but with a
significant difference between residents who had received training in SUD for at
least six hours versus residents less trained (AMIQ scores -3.76 (SD 2.46) versus
-4.50 (SD 2.27), p = .0354).
CONCLUSION: Residents in general practice had a good capacity to diagnose SUD
correctly but on average expressed negative attitudes toward people with SUD.
More SUD teaching seems to help in reducing stigmatizing attitudes.
DOI: 10.1080/13814788.2018.1470239
PMCID: PMC5974755
PMID: 29792534