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

Abstract

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.