Attitude towards psychiatry among final year medical students in Sri Lanka

Stigma towards psychiatry, a debilitating phenomenon worldwide, is likely to have engendered the longstanding lack of recruitment into psychiatry in Sri Lanka. However, recent expansion of the undergraduate training in psychiatry in Sri Lanka may have instigated favorable changes in students’ attitudes. We assessed the attitudes of final-year medical students in nine medical schools in Sri Lanka regarding psychiatry by administering the Attitude towards psychiatry-30 (ATP-30) scale. This 30-item questionnaire covers eight domains of psychiatry and is rated on a Likert scale, producing a total score out of 150. Each item on the ATP-30 is rated on a 5-point Likert scale ranging from “Strongly agree” to “Strongly disagree”. Fifteen of the 30 items are reverse coded. Background information about the participant including the name of the medical school, and information related to potential correlates identified in literature including gender, presence of a close person with mental illness and the total duration of exposure to clerkships in psychiatry are included. A multiple linear regression was performed to investigate associated factors. A total of 743 final-year students participated. Of them, 54 % were male. The mean attitude score was 107.7 (SD=12.3) and 92.2% showed an overall “positive” attitude. 22.2% of students considered psychiatry as a potential future career. Students with more than one month of clinical exposure to psychiatry showed a better attitude compared to those with shorter exposure. Female gender and the presence of a close person with mental illness were also associated with better attitudes and career interest.

精神科污名化是一种在全球范围内具有严重负面影响的现象，其很可能是导致斯里兰卡长期以来精神科领域人员招募不足的关键诱因。然而，近期斯里兰卡精神科本科培养项目的扩张，或许已推动医学生对精神科的态度出现积极转变。本研究采用《精神科态度量表-30（Attitude towards psychiatry-30, ATP-30）》，对斯里兰卡9所医学院校的临床医学专业应届毕业班学生的精神科态度展开评估。该量表共包含30个条目，涵盖精神科领域的8个维度，采用李克特量表进行评分，总分满分150分。ATP-30的每个条目均采用从“强烈同意”到“强烈反对”的5级李克特评分法，其中30个条目中有15个为反向计分条目。研究收集了受访者的背景信息，包括其就读的医学院校名称，同时纳入了文献中已证实的潜在关联因素相关数据：性别、是否存在亲密亲友罹患精神疾病，以及精神科临床轮转的总时长。本研究采用多元线性回归分析方法，对影响精神科态度的相关因素进行探究。本次研究共计纳入743名应届毕业班医学生参与，其中54%为男性受访者。受访者的精神科态度平均得分为107.7（标准差SD=12.3），92.2%的学生整体态度呈‘积极’倾向。22.2%的学生将精神科列为未来潜在的职业选择。精神科临床轮转时长超过1个月的学生，其对精神科的态度相较于轮转时长较短的学生更为积极。女性性别以及拥有罹患精神疾病的亲密亲友这两个因素，也与更积极的态度和更高的职业意向存在显著关联。