The prevalence, determinants and the role of empathy and religious or spiritual beliefs on job stress, job satisfaction, coping, burnout, and mental health in medical and surgical faculty of a teaching hospital: A cross-sectional survey.

OBJECTIVE: Systematically ascertained data on job stress and burnout and their antecedents and mediators in health professionals from low- and middle-income countries are scant. METHODS: This cross sectional survey, conducted from July 2007 to August 2008, of consenting medical and surgical faculty of a large, charitable, teaching hospital aimed to evaluate: 1) the prevalence and sources of job stress and job satisfaction, and the ways used to cope with stress; 2) the prevalence of burnout and mental distress; and 3) the influence of age, gender, empathy and religious or spiritual beliefs on job stress, satisfaction, mental health and burnout. RESULTS: Of 345 respondents, high job stress on the Physician Stress and Satisfaction questionnaire were reported by 23%. However, 98% of faculty reported high levels of job satisfaction with deriving intellectual stimulation from teaching and a high level of responsibility identified as important contributory sources. Significantly more respondents aged<45 years compared to older faculty achieved moderate or high scores on Emotional Exhaustion and Depersonalization. General Health Questionnaire-12 scores suggested psychiatric morbidity in 21%, particularly in younger faculty. High job stress was associated with high scores for Emotional Exhaustion and Depersonalization. High scores on the Jefferson Scale of Physician Empathy correlated with high scores of Emotional Exhaustion. Religious or spiritual beliefs strongly influencing attitudes to work were significantly associated with high levels of Personal Accomplishment. CONCLUSIONS: This study provides data that will inform the design and implementation of interventions to reduce job stress and burnout and improve retention of faculty.

Prevalence of HIV infection in psychiatric patients attending a general hospital in Tamil Nadu, south India.

An anonymous, unlinked study was conducted to detect antibodies to HIV-1 or HIV-2 infections in 1,160 consecutive, newly registered, adult psychiatric outpatients at a general hospital in South India to determine whether psychiatric patients presenting to general hospitals are a population at high risk for HIV infection and should be routinely screened. The seroprevalence of HIV infection (12/1160; 1.03%; 95% CI = 0.4-1.6%) did not approximate rates expected of a high-risk group compared to the national (0.7%) or regional community (1.8%) prevalence. It did not differ significantly from HIV seroprevalence in non-psychiatric patients (233/35450; 0.7%; 95% CI = 0.57-0.74%) who were systematically screened (relative risk = 1.57; 95% CI = 0.88-2.80) during the same period, but was greater than the seroprevalence in healthy blood donors (0.5%; p = 0.02; relative risk = 2.15 95% CI = 1.17-3.95). Non-psychiatric patients were also more likely to be HIV infected than blood donors (p = 0.02; relative risk = 1.37; 95% CI = 1.05-1.78). These findings have implications for HIV testing policies among psychiatric and non-psychiatric patients presenting to general hospitals in India.

Attitudes of 'tomorrow's doctors' towards psychiatry and mental illness.

BACKGROUND: Attitudes to psychiatry and mental illness among medical undergraduates are key factors in determining their choice of psychiatry as a career and willingness to deal with psychiatric disorders in general practice. METHODS: The responses of 108 medical students from the first and fourth year batches not exposed to psychiatry were compared with those of 139 final year students and interns who had completed varying components of psychiatric training using validated questionnaires that assessed their attitudes to psychiatry and mental illness, and their interest in psychiatry as a career choice. RESULTS: A greater proportion of students exposed to psychiatric training endorsed positive attitudes to mental illness than those not exposed (odds ratio=0.4; 95% confidence intervals: 0.21-0.71; p=0.002). The overall attitude towards psychiatry did not differ between students before or after psychiatric education. Women students were more likely to consider a career in psychiatry (odds ratio=2.9; 95% confidence intervals: 1.36-6.21; p = 0.004), but the proportion of students of either gender wishing to pursue psychiatry as a career option did not differ significantly with psychiatric training. CONCLUSION: Psychiatric education positively influences the attitudes of medical students towards mental illness and some aspects of psychiatry but does not increase the number of students wishing to pursue psychiatry as a career. Urgent and radical changes in psychiatric education for undergraduate medical students are required to meet current and future requirements of medical personnel trained to deal with psychiatric disorders.

An experiment in psychotherapy training.

Group supervision was initiated in order to meet the training needs of psychiatric postgraduates. The experience of the group was surveyed at the end of one year. It was found that the use of groups as an adjunct to individual supervision was an eminently practical and acceptable method of facilitating training, accessing peer group support and auditing clinical care.

Insight and psychopathology in schizophrenia.

Among a group of patients with schizophrenia, severity of psychopathology was significantly correlated with dimensional measures of awareness of the abnormal experiences whereas a similar relationship with global measures of insight could not be demonstrated. The awareness of the abnormal nature of individual items of psychopathology does not necessarily overlap with insight as measured by awareness of the concept or consequences of mental illness or the need for treatment.

The correlates of the syndrome of depression in schizophrenia.

A depressive syndrome as identified by subjectively volunteered dysphoria occurred in 17.4% of a group of 45 DSM III-R schizophrenics, studied initially in a medication free state. Among the 24 patients who could be followed up for six months, another 25% developed depressive symptoms while on treatment. Mild depressive syndromes occurred more frequently in older patients, in association with retained insiglu and lower negative symptoms scores. While depressive symptoms occurred both in the medicated and unmedicated state, depressed medicated schizophrenics differed from non-depressed medicated schizophrenics on variables of total medication dosage, presence of extrapyramidal symptoms and insight.

Undergraduate training in psychiatry an evaluation.

With the recognition of the inadequacy of psychiatric services in India, maximinig health care delivery has become apriority. Tliere is therefore need to concentrate upon undergraduate psychiatric training as means to increase the availabe numbers of professionals equipped to treat psychiatric disorders (Channabasavanna, 1986). Towards this end the present M.B.B.S. Psychiatric Training Programme of Unit I Department of Psychiatiy Christian Medical College was evaluated, mainly with regard to gain in theoretical and clinical skills, but also with regard to change in attitude.