Effects of the diagnostic label 'schizophrenia', actively used or passively accepted, on general practitioners' views of this disorder.

BACKGROUND: General practitioners (GPs) play a key role in the care of somatic and psychiatric problems in people diagnosed with schizophrenia (PWS). It is probable that, like other health professionals, GPs are not all free of prejudices toward PWS. In clinical practice, GPs sometimes interact with clients diagnosed with schizophrenia by specialists, passively accepting this diagnosis. Other times, GPs interact with clients having symptoms of schizophrenia but who have not been diagnosed. In this case, GPs are expected to actively make a diagnosis. Giving the key role of GPs in the process of care, it is worthwhile examining whether passive acceptance and active usage of the diagnosis schizophrenia have differential effects on GPs' attitudes toward people with this disorder. AIMS: To investigate GPs' views of schizophrenia and whether they were influenced by a 'schizophrenia' label, passively accepted or actively used. METHODS: A total of 430 randomly selected GPs were invited to complete a questionnaire about their views of schizophrenia, either after reading a description of this disorder and making a diagnosis, or without being provided with a description but passively accepting the label 'schizophrenia' given in the questionnaire. RESULTS: The GPs who passively accepted the label schizophrenia ( n = 195) and those who actively identified schizophrenia from the description ( n = 127) had similar views. Compared to the GPs who did not identify schizophrenia in the description ( n = 65), those who used the diagnosis, actively or passively: more frequently reported heredity and less frequently psychosocial factors as causes of the disorder; were more skeptical about recovery; were more convinced of the need for long-term pharmacotherapies; believed more strongly that PWS should be discriminated against when in medical hospital; and perceived PWS as more dangerous and as kept at greater social distance. CONCLUSION: The diagnosis 'schizophrenia', however used, is associated with pessimistic views. Stigma education should be provided to GPs.

General practitioners' beliefs about people with schizophrenia and whether they should be subject to discriminatory treatment when in medical hospital: The mediating role of dangerousness perception.

This study explored the relationships between General Practitioners' (GPs) beliefs about People With Schizophrenia (PWS) and GPs' recommendations regarding restrictions for such people when in medical (nonpsychiatric) hospital, and whether these relationships were mediated by dangerousness perception. There were 322 randomly selected Italian GPs who completed a questionnaire measuring beliefs about PWS. Structural Equation Model (SEM) was used to explore the effects of these beliefs on the GPs' views about the need for restrictive rules in hospital. Thirty-1 percent of GPs firmly believed that, in medical wards, PWS should be supervised and 18% that they should be separated from other patients. SEM revealed that belief in such differential treatment was positively related to a belief that PWS need medication for the rest of their lives, and to perceptions of others' need for social distance, and of dangerousness. Dangerousness was, in turn, positively related to the belief that PWS need medication for their lives, and to a perception of the need for social distance, but negatively related to perceived capacity to report health problems. Analyses of indirect effects showed that the relationships of belief in discriminatory treatment with belief in medication for life and with perceived social distance were mediated by perceived dangerousness. GPs' attitudes about PWS appear closely with their beliefs on discriminatory behaviors in hospital, and the mediating role of dangerousness perceptions. Providing GPs with education about schizophrenia treatments and prognosis, and countering stereotypes about dangerousness, could be helpful to reduce GPs' beliefs in the need for discriminatory treatment of PWS. (PsycINFO Database Record