The Stigma Against Schizophrenia

A Negative Bias Against Schizophrenia From Healthcare Workers?

SchizophreniaStaff Psychiatrist with the Central Arkansas Veterans Healthcare System Dinesh Mittal, M.D., found that psychiatrists and psychiatric nurses are just as likely as primary care physicians to display a negative bias towards individuals with schizophrenia who seek medical care.[1] According to Mittal, a study that he and his colleagues completed determined this unfortunate truth.1

Mittal and colleagues found that cancer did not have a higher incidence in psychiatric patients than in the general population; however, psychiatric patients with cancer received poorer care.1 Also, psychiatric patients were less likely to undergo needed cardiac catheterization compared with patients without psychiatric illness.1

Mittal and colleagues presented a hypothetical two case vignettes to 55 primary care physicians, 91 primary care nurses, 62 psychiatrists, and 67 psychiatric nurses at five VA facilities.1 The first version of the vignette described a 34-year-old male with hypertension, obesity, insomnia, and chronic back pain.1 The patient was given naproxen, lisinopril, and fluoxetine and returned for a follow-up visit seeking stronger pain medicine.1 He did not have a history of substance abuse, and his job performance as a cafeteria cook was above average.1 He regularly attended church, went fishing, and enjoyed magazines.1 A second version of the vignette was created, with the patient diagnosed with schizophrenia and taking risperidone.1

Schizophrenia Stigma Affects Treatment

After reading the vignette, providers answered a series of questions regarding clinical expectations, treatment decisions, and attitudes relative to the patient.1 Mittal and colleagues found that all providers expected patients with schizophrenia to have lower medication adherence, although adherence rates among patients with chronic mental illness are similar to those with other chronic illnesses.1 Mittal and colleagues also found that obese patients with schizophrenia were less likely to be referred to an obesity clinic.1 They were also less likely to be referred to a sleep study.1 Patients with schizophrenia were viewed as being less competent when making treatment decisions, although data indicates that they have adequate decision-making skills unless they are psychotic.1

According to Mittal, interventions are needed for both mental health and primary care providers to break the stigma against those with schizophrenia.1 People with schizophrenia can function very well; however, many misperceptions exist stating the opposite.1 Unfortunately, people with severe psychiatric illnesses, such as schizophrenia, end up dying at an earlier age due to poor medical care stemming from the negative bias that comes from their psychiatric diagnosis.1 People with schizophrenia deserve the same care and treatment as anyone else.1

[1] Kaplan, A. (2013, June 13). Bias Against Schizophrenic Patients Seeking Medical Care. Psychiatric Times. Retrieved September 24, 2013, from www.psychiatrictimes.com/schizophrenia/bias-against-schizophrenic-patients-seeking-medical-care/page/0/1

One Comment

  • Kelly

    November 8, 2013, 10:35 am

    I loved your post.Thanks Again. Really Great.

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