Attitude of general practitioners faced to schizophrenia

##plugins.themes.academic_pro.article.main##

Elloumi Hend
Zalila Haifa
Kallel Ghada
Cheour Majda
Boussetta Afif

Abstract

Background: The chronic character of schizophrenia, the suffering that it generates, its triple social and human economic cost, make of it a major stake of public health. The general practitioners are the first actors in the tracking of onset schizophrenia and the follow-up of this chronic pathology.
Aim: To study knowledge, the attitudes and the practices of the general practitioners faced to schizophrenia.
Methods: A descriptive cross-sectional study, using an autoquestionnaire, including 300 general practitioners registered in the table of the order of the Doctors of the area of Large Tunis, exerting in private and public sectors.
Results: The rate of answer was 22.6% (68) of general practitioners. The middle age of the participants was 48.1 years (± 8.3). The sexratio was 1.6; including 58.8% exerting in the private sector. Meadows the fifth (19.1%) of them knew the exact prevalence of schizophrenia in the general population, whereas 77.9% did not have any idea of the rate of suicide among patients. 76.5% of the doctors estimated that prodromal signs preceded the emergence of schizophrenia. The odd behaviors, hallucinations/delirum and social withdrawal constituted the most evocative symptoms in respectively 80.8%; 79.4% and 64.7%. In case of onset- schizophrenia; 20.5% of the experts thought that it was not necessary to prescribe any treatment and 48.5% were unable to mention the exact drug to be prescribed in case of first episode psychotic.
Conclusion: Our results highlight gaps in knowledge and the practical conduits of the general practitioners faced to schizophrenia. Measurements aiming the improvements in education and the sensitizing of the general practitioners are necessary.

Keywords:

General practitioners, schizophrenia, attitude

##plugins.themes.academic_pro.article.details##

References

  1. Simon AE, Lauber C, Ludewig K, Braun-Scharm H, Umbricht S. General practitioners and schizophrenia: results from a Swiss survey. Br J Psychiatry 2005;187:274 -81.
  2. Simon AE, Lester H, Tait L et al. The International Study on General Practitioners and Early Psychosis (IGPS). Schizoph Res 2009;108:182-90.
  3. Edwards P, Roberts I, Clarke M et al. Increasing response rates to postal questionnaires: systematic review. BMJ 2002; 324:1183.
  4. Thomson C, Paterson-Brown S, Russell D et al. Short report: Encouraging GPs to complete postal questionnaires-one big prize or many small prizes? A randomized controlled trial. Fam Prac 2004; 21: 697-98.
  5. Verdoux H , Cougnard A, Grolleau S et al. A survey of general practitioners' knowledge of symptoms and epidemiology of schizophrenia. Eur Psychiatry 2006;21:238-44.
  6. Mossaheb N, Ropp M, Schloegelhofer M et al. General practictioners and psychosis: a survey in Austria. Schizoph Res 2006;86,1:125.
  7. Gavin B, Cullen W, O'Donoghue B et al. Schizophrenia in general practice: a national survey of general practitioners in Ireland. Ir J Med Science 2005;174,3:38-42.
  8. Carr VJ, Lewin TJ, Barnard RE et al. Attitudes and roles of general practitioners in the treatment of schizophrenia compared with community mental health staff and patients. Soc Psychiatry Psychiatr Epidemiol 2004;39:78-84.
  9. Murray RM, Jones P, Susser E, Van Os J, Cannon M. The Epidemiology of schizophrenia. Cambridge University Press; 2003.
  10. Van Os J, Kapur S. Schizophrenia. Lancet 2009;374: 635-45.
  11. Van Os J, Rutten BP, Poulton R. Gene-environment interactions in schizophrenia: review of epidemiological findings and future directions. Schizophr Bull 2008;34:1066-82.
  12. Casadebaig F, Philippe A. Mortalité chez des patients schizophrènes: trois ans de suivi d'une cohorte. Encéphale 1999;25:329-37.
  13. Lee C, McGlashan TH, Woods SW. Prevention of Schizophrenia. Can it be achieved? CNS Drugs 2005;19:193-206.
  14. Häfner H, An der Heiden W. Epidemiology of schizophrenia. Can J Psychiatry 1997;42:139-51.
  15. McGorry PD, Edwards J, Mikalopolos C, Harrigan SM, Jackson HJ. EPPIC: an evolving system of early detection and optimal management. Schizophr Bull 1996;22:305-26.
  16. McGorry PD, Krstev H, Harrigan S. Early detection and treatment delay: implications for outcome in early psychosis. Curr Opin Psychiatry 2000; 13:37-43.
  17. Haas GL, Garratt LS, Sweeney JA. Delay to first antipsychotic medication in schizophrenia: impact on symptomatology and clinical course of illness. J Psychiatr Res 1998;32:151-9.
  18. Häfner H, Riecher-Rossler A, Hambrecht M et al. IRAOS: an instrument for the assessment of onset and early course of schizophrenia. Schizophr Res 1992;6:209-23.
  19. Yung.AR, Phillips.LJ, Pan Yen.H et al. Psychosis prediction: a 12 month follow up study of a high risk prodromal group. Schizophr Res 2003;60:21-32.
  20. Häfner H, Maurer K, LöfflerW et al. The ABC schizophrenia study: a preliminary overview of the results. Soc Psychiatry Psychiatr Epidemiol 1998;33: 380-6.
  21. Loebel AD, Lieberman JA, Alvir JM et al. Duration of psychosis and outcome in first-episode schizophrenia. Am J Psychiatry 1992;149:1183-8.
  22. Wyatt R. Neuroleptics and the natural course of schizophrenia. Schizophr Bull 1991;17: 325-51.
  23. Schizophrenia National Clinical Guideline. National Institute for Clinical Excellence. Nice: Gaskell, 2003.
  24. McGlashan TH, Addington J, Cannon T et al. Recruitment and treatment practices for help seeking “prodromal” patients. Schizophr Bull 2007;33:715-26.
  25. Gleeson J, Larsen TK, McGorry P. Psychological treatment in pre and early psychosis. J Am Acad Psychoanal Dyn Psychiatry 2003;31:229-45.
  26. Lehman AF, Lieberman JA, Dixon LB et al. Practice guideline for the treatment of patients with schizophrenia, second edition. Am J Psychiatry 2004;161:1-56.
  27. Petitjean F, Marie-Cardine M. Schizophrénies débutantes : diagnostics et modalités thérapeutiques (conférence de consensus). Paris: Libbey Eurotext, 2003.
  28. Carpenter WT. Evidence-based treatement for first-episode schizophrenia. Am J Psychiatry 2001;158:1171-3.
  29. Verdoux H, Lengronne J, Liraud F et al. Medication adherence in psychosis: predictors and impact on outcome. A 2-year follow-up of first-admitted subjects. Acta Psychiatr Scand 2000;102:203-10.
  30. Loebel AD, Lieberman JA, Alvir JM, et al. Duration of psychosis and outcome in first-episode schizophrenia. Am J Psychiatry 1992;149:1183-8.
  31. Johnstone EC, Crow TJ, Johnson AL, et al. The Northwick Park Study of first episodes of schizophrenia. Presentation of the illness and problems relating to admission. Br J Psychiatry 1986;148:115-20.