Prescribing stigma in mental disorders: A comparative study of Portuguese psychiatrists and general practitioners.

BACKGROUND: Physicians, including psychiatrists and general practitioners (GPs), have been reported as essential sources of stigma towards people diagnosed with a mental disorder (PDMDs), which constitutes an important barrier to recovery and is associated with poorer clinical outcomes. Therefore, psychiatrists and GPs are key populations where it is crucial to examine stigma, improve attitudes and reduce discrimination towards psychiatric patients. AIMS: This study is the first to explore mental health-related stigma among Portuguese psychiatrists and GPs, examining the differences between these two specialities and assessing whether sociodemographic and professional variables are associated with stigma. METHOD: A cross-sectional study was performed between June 2018 and August 2019. A consecutive sample of 55 Psychiatrists and 67 GPs working in Porto (Portugal) filled a 25-item self-report questionnaire to assess their attitudes towards PDMDs in clinical practice. The instrument was designed by the authors, based on previous mental health-related stigma studies and validated scales. The questionnaire includes 12 stigma dimensions (Autonomy, Coercion, Incompetence, Dangerousness, Permanence, Pity, Responsibility, Segregation, Labelling, Diagnostic Overshadowing, Shame and Parental Incompetence), and its total score was used to measure Overall Stigma (OS). Sample characteristics were examined using descriptive statistics, and the factors affecting stigma were assessed through regression analysis. RESULTS: GPs exhibit significantly higher OS levels than psychiatrists, and present higher scores in the dimensions of dangerousness, parental incompetence, diagnostic overshadowing and responsibility. Besides medical speciality, several other sociodemographic variables were associated with sigma, including age, gender, having a friend with a mental disorder, professional category, agreement that Psychiatry diverges from core medicine and physician's interest in mental health topics. CONCLUSIONS: Our data suggest that both psychiatrists and GPs hold some degree of stigmatizing attitudes towards PDMDs. Overall, these results bring new light to stigma research, and provide information to tailor anti-stigma interventions to Portuguese psychiatrists and GPs.

Is Football players' performance influenced by the quality of opposition? Application of the golden index formula in Club Atlético de Madrid 2016/2017

Aim: In this study, we sought to analyze the influence of the quality of opposition on players' performance of Club Atlético de Madrid (ATM) 2016/2017. For that, the Golden Index (GI) formula was applied to identify and rank the Golden Players of ATM when playing against opponents of different quality levels. Methods: GI formula variables were collected through notational analysis and three global adjacency matrices were constructed to record all successful ball-passing actions performed. Next, the matrices were imported to SocNetV to collect the network centrality metrics. To uniformize each variable, the statistical standardization technique was applied to all variables. ATM opponents were classified into three groups: high-level (n=4), medium-level (n=2) and low-level (n=2), according to their classification in La Liga and participation in the final stage of UEFA Champions League 2016/2017. Results: Koke was considered the Golden Player playing against high-level teams, while opposing low-level opponents he was ranked as second. Against medium- and low-level teams, Antoine Griezmann was considered the Golden Player, but was not classified in the three first positions against high-level opponents. Yannick Carrasco and Filipe Luís were ranked in the second and third positions, respectively, when playing against high- and medium-level opponents. Also, Saúl Ñíguez obtained the third higher index against low-level teams. Conclusions: This study evidenced that players' individual performance is influenced by the quality of the opposition. Additionally, the GI formula proved to be a potent tool in analyzing player's performance in attacking plays in Football.(AU)