ABSTRACT
Prejudice and stigma about mental illness is still present in society. Patients suffer both from the disease, and from the marginalization behavior exhibited by others towards them and their families. Psychiatric professionals may also become ill and suffer for the same reason. The authors of this international multicenter study have set themselves the question of whether there may be prejudice and/or stigma among psychiatric professionals towards their suffering colleagues, among patients towards nursing staff affected by the same disease and between patients themselves. Using two standardized questionnaires which have been tested, but have not been used before they have studied 207 mental health professionals and 407 patients, of Italian, Belgian, Hungarian and Croatian nationalities. The results show that there are in fact prejudices among Mental Health Professionals about colleagues suffering from mental illness because they responded that such persons cannot treat well patients with their own pathology. However Mental Health Professionals do not demonstrate behaviors which are not frankly marginalizing or stigmatizing towards colleagues suffering from mental illness. On the other hand, among patients the prevailing view was that psychiatric professionals who suffer from mental illness, can better understand the sick, because they are also suffering. This is in analogy with the Jungian theory of the "wounded healer" in the myth of the centaur Chiron. Patients did not demonstate rejection or marginalization behavior towards other sick patients. Finally both the professionals and the patients tend to be cautious in relating to healthy persons and tend not to disclose their suffering for fear of being misjudged or marginalized.
ABSTRACT
BACKGROUND: This article aims at determining the place of benzodiazepines in the current treatment of anxiety disorders in opposition to antidepressants, neuroleptics and anticonvulsants. Belgium and France are the only two European countries which prescribe the most benzodiazepines despite the dissuasion of the international guidelines (NICE) issued in the nineties concerning the high risk of dependance of these molecules. What about the respect of these guidelines and the use of benzodiazepines in general practice in 2014? METHODS: Review of the literature with the following key words "anxiety disorder, benzodiazepines, anxiolytic, treatment" in the international database of PubMed, Medline, PsycINFO, PsycARTICLES and consulting of various reference books. RESULTS: No class of molecules could measure up to benzodiazepines until now, neither from the point of view of efficiency, nor from the point of view of cost-efficiency. This is why the guidelines (NICE) discourage the few available alternatives in the general practice. International figures from Belgium and France show a continuous increase in the use of benzodiazepines in the treatment of anxiety disorders, even after the nineties. Given the fact that benzodiazepines differ from one another at the level of their action profile (graphical representation in "stars") and are therefore able to relieve several symptoms simultaneously, these molecules still respond nowadays to many expectations of the clinical practitioners. CONCLUSIONS: The divergence between the guidelines and the practice confirm the irreplaceability of benzodiazepines at the present time. Nevertheless, the expectation of new molecules with fewer side effects should be investigated in further research.
