Estigma hacia los trastornos mentales entre estudiantes paquistaníes de medicina, farmacia y ciencias de la salud afines: un estudio transversal
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Resumen
Objetivo. Este estudio tuvo como objetivo evaluar el estigma que rodea a los trastornos mentales entre estudiantes pakistaníes de medicina, farmacia y ciencias de la salud afines.
Método. Se realizó una encuesta transversal entre estudiantes de medicina, farmacia y ciencias de la salud afines en la Universidad de Lahore, entre abril y mayo de 2022. El estigma de la salud mental se evaluó utilizando una versión modificada de la escala de Discriminación-Devaluación (D-D).
Resultados. Se incluyó a un total de 315 estudiantes en el estudio (edad media = 22,4 años, hombres = 51,1%). La mayoría de la muestra fueron estudiantes de farmacia (51,1%), seguidos de estudiantes de ciencias de la salud afines (35,2%) y estudiantes de medicina (13,7%). En un análisis de regresión múltiple, los estudiantes que tenían una relación o estaban casados obtuvieron puntuaciones más bajas en las escalas de estigma público percibido que los solteros (p = 0,024). En un modelo multivariable ajustado para el estigma personal percibido hacia los problemas de salud mental, los estudiantes de medicina mostraron actitudes significativamente mejores hacia estos problemas que otros estudiantes
Discusión y conclusión. El estigma en torno a los trastornos de salud mental es un problema importante en la sociedad pakistaní, incluso prevalente entre los estratos con mayor nivel educativo. Por lo tanto, se necesitan intervenciones educativas para mejorar la concienciación y las actitudes de los estudiantes universitarios hacia los trastornos de salud mental.
Referencias
Abdullah, M., Sethi, M. R., & Irfan, M. (2021). Gender differences regarding stigma toward mental illness among medical students of Peshawar. Journal of Ayub Medical College Abbottabad, 33(1), 120–124. https://www.jamc.ayubmed.edu.pk/index.php/jamc/article/view/7147
Ahad, A. A., Sanchez-Gonzalez, M., & Junquera, P. (2023). Understanding and Addressing Mental Health Stigma Across Cultures for Improving Psychiatric Care: A Narrative Review. Cureus. https://doi.org/10.7759/cureus.39549
Alloh, F. T., Regmi, P., Onche, I., Teijlingen, E. V., & Trenoweth, S. (2018). Mental Health in low-and middle income countries (LMICs): Going beyond the need for funding. Health Prospect, 17(1), 12–17. https://doi.org/10.3126/hprospect.v17i1.20351
Alloh, F. T., & Regmi, P. R. (2017). Effect of economic and security challenges on the Nigerian health sector. African Health Sciences, 17(2), 591–592. https://doi.org/10.4314/ahs.v17i2.37
Alvi, M. H., Ashraf, T., Naz, F., Sardar, A., Ullah, A., Patel, A., Kiran, T., Gumber, A., & Husain, N. (2023). Burden of mental disorders by gender in Pakistan: analysis of Global Burden of Disease Study data for 1990–2019. BJPsych Bulletin, 48(6), 333–340. https://doi.org/10.1192/bjb.2023.76
Choudhry, F. R., Khan, N., & Munawar, K. (2023). Barriers and facilitators to mental health care: A systematic review in Pakistan. International Journal of Mental Health, 52(2), 124–162. https://doi.org/10.1080/00207411.2021.1941563
Corrigan, P. W., & Watson, A. C. (2002). Understanding the impact of stigma on people with mental illness. World Psychiatry, 1(1), 16–20. https://pmc.ncbi.nlm.nih.gov/articles/PMC1489832/
Daniel, F., Ghani, N., Ali, S., & Suliman, M. (2021). Impact of Mental Disorders in Terms of Discrimination and Stigmatization: A Cross-Sectional Study in Peshawar, Khyber Pakhtunkhwa. Journal of Saidu Medical College Swat, 11(2), 96–102. https://doi.org/10.52206/jsmc.2021.11.2.96-102
GBD 2019 Mental Disorders Collaborators. (2022). Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Psychiatry, 9(2), 137–150. https://doi.org/10.1016/S2215-0366(21)00395-3
Getnet, A., Sintayehu Bitew, M., Iyasu, A. S., Afenigus, A. D., Haile, D., & Amha, H. (2022). Stigma and determinant factors among patients with mental disorders: Institution-based cross-sectional study. SAGE Open Medicine, 10. https://doi.org/10.1177/20503121221136400
Eisenberg, D., Downs, M. F., Golberstein, E., & Zivin, K. (2009). Stigma and Help Seeking for Mental Health Among College Students. Medical Care Research and Review, 66(5), 522–541. https://doi.org/10.1177/1077558709335173
Hossain, M. M., Purohit, N., Sultana, A., Ma, P., McKyer, E. L. J., & Ahmed, H. U. (2020). Prevalence of mental disorders in South Asia: An umbrella review of systematic reviews and meta-analyses. Asian Journal of Psychiatry, 51, 102041. https://doi.org/10.1016/j.ajp.2020.102041
Husain, M. O., Zehra, S. S., Umer, M., Kiran, T., Husain, M., Soomro, M., Dunne, R., Sultan, S., Chaudhry, I. B., Naeem, F., Chaudhry, N., & Husain, N. (2020). Stigma toward mental and physical illness: attitudes of healthcare professionals, healthcare students and the general public in Pakistan. BJPsych Open, 6(5). https://doi.org/10.1192/bjo.2020.66
Husain, W. (2020). Barriers in Seeking Psychological Help: Public Perception in Pakistan. Community Mental Health Journal, 56(1), 75–78. https://doi.org/10.1007/s10597-019-00464-y
Khan, M. N., Akhtar, P., Ijaz, S., & Waqas, A. (2021). Prevalence of Depressive Symptoms Among University Students in Pakistan: A Systematic Review and Meta-Analysis. Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.603357
Khan, S. I., & Irfan, M. (2023). Stigmatization and Self-Perception regarding issues related to Mental Health: A qualitative survey from a lower and middle-income country. Pakistan Journal of Medical Sciences, 39(5), 1411–1415. https://doi.org/10.12669/pjms.39.5.7487
Khan, R. Q., & Khan, A. M. (2021). Crime and punishment: Pakistan's legal failure to account for mental illness. BJPsych International, 18(4), 94–96. https://doi.org/10.1192/bji.2020.30
Lally, J., ó Conghaile, A., Quigley, S., Bainbridge, E., & McDonald, C. (2013). Stigma of mental illness and help-seeking intention in university students. The Psychiatrist, 37(8), 253–260. https://doi.org/10.1192/pb.bp.112.041483
Link, B. G. (1987). Understanding Labeling Effects in the Area of Mental Disorders: An Assessment of the Effects of Expectations of Rejection. American Sociological Review, 52(1), 96–112. https://doi.org/10.2307/2095395
Link, B. G., Struening, E. L., Neese-Todd, S., Asmussen, S., & Phelan, J. C. (2001). Stigma as a Barrier to Recovery: The Consequences of Stigma for the Self-Esteem of People With Mental Illnesses. Psychiatric Services, 52(12), 1621–1626. https://doi.org/10.1176/appi.ps.52.12.1621
Malik, A. (2023). Mental health making mental healthcare accessible. TNS. https://www.thenews.com.pk/tns/detail/1061020-mental-health-making-mental-healthcare-accessible#:~:text=An%20estimated%2024%20million%20people,ranges%20between%20500%20and%20600
Mallhi, T. H., Ahmad, N., Salman, M., Tanveer, N., Shah, S., Butt, M. H., Alatawi, A. D., Alotaibi, N. H., Rahman, H. U., Alzarea, A. I., Alanazi, A. S., Alzahrani, M. S., Alshehri, S., Aljabri, A., & Khan, Y. H. (2022). Estimation of Psychological Impairment and Coping Strategies during COVID-19 Pandemic among University Students in Saudi Arabia: A Large Regional Analysis. International Journal of Environmental Research and Public Health, 19(21). https://doi.org/10.3390/ijerph192114282
Mansoor, N., & Warsi, A. (2023). Battling the social stigma of mental illnesses in Pakistan; what needs to be done?. Journal of the Pakistan Medical Association, 73(9), 1943–1943. https://doi.org/10.47391/jpma.9095
Newnham, E. A., Pearson, R. M., Stein, A., & Betancourt, T. S. (2015). Youth mental health after civil war: The importance of daily stressors. British Journal of Psychiatry, 206(2), 116–121. https://doi.org/10.1192/bjp.bp.114.146324
Ojagbemi, A., & Gureje, O. (2022). Mental health in low- and middle-income countries. In D. Bhugra, D. Moussaoui, & T. J. Craig (Eds.), Oxford Textbook of Social Psychiatry (pp. 699–712). Oxford University Press.
Rana, S. (2023). 95m Pakistanis live in poverty: World Bank. The Express Tribune. https://tribune.com.pk/story/2437352/95m-pakistanis-live-in-poverty-world-bank
Rössler, W. (2016). The stigma of mental disorders. The EMBO Reports, 17(9), 1250–1253. https://doi.org/10.15252/embr.201643041
Salman, M., Mustafa, Z. U., Shehzadi, N., Mallhi, T. H., Asif, N., Khan, Y. H., Khan, T. M., & Hussain, K. (2022a). Evaluation of knowledge and practices about administration and regulations of high alert medications among hospital pharmacists in Pakistan: findings and implications. Current Medical Research and Opinion, 38(11), 1967–1975. https://doi.org/10.1080/03007995.2022.2124063
Salman, M., Mustafa, Z. U., Asif, N., Zaidi, H. A., Hussain, K., Shehzadi, N., Khan, T. M., & Saleem, Z. (2020a). Knowledge, attitude and preventive practices related to COVID-19: a cross-sectional study in two Pakistani university populations. Drugs & Therapy Perspectives, 36, 319–325. https://doi.org/10.1007/s40267-020-00737-7
Salman, M., Mustafa, Z. U., Rao, A. Z., Khan, Q., Asif, N., Hussain, K., Shehzadi, N., Khan, M. F. A., & Rashid, A. (2020b). Serious Inadequacies in High Alert Medication-Related Knowledge Among Pakistani Nurses: Findings of a Large, Multicenter, Cross-sectional Survey. Frontiers in Pharmacology, 11. https://doi.org/10.3389/fphar.2020.01026
Salman, M., Asif, N., Mustafa, Z. U., Khan, T. M., Shehzadi, N., Tahir, H., Raza, M. H., Khan, M. T., Hussain, K., Khan, Y. H., Butt, M. H., & Mallhi, T. H. (2022b). Psychological Impairment and Coping Strategies During the COVID-19 Pandemic Among Students in Pakistan: A Cross-Sectional Analysis. Disaster Medicine and Public Health Preparedness, 16(3), 920–926. https://doi.org/10.1017/dmp.2020.397
Salman, M., Shehzadi, N., Mustafa, Z. U., Mallhi, T. H., Khan, Y. H., Khan, T. M., & Hussain, K. (2023). Self-harm and suicidal ideation in Pakistani youth amid COVID-19 pandemic: findings of a large, cross-sectional study. Psychology, Health & Medicine, 28(8), 2225–2233. https://doi.org/10.1080/13548506.2022.2119483
Shafiq, S. (2020). Perceptions of Pakistani community towards their mental health problems: a systematic review. Global Psychiatry, 3(1), 28–50. https://doi.org/10.2478/gp-2020-0001
Sikander, S. (2020). Pakistan. The Lancet Psychiatry, 7(10), 845. https://doi.org/10.1016/s2215-0366(20)30387-4
Sultan, S. (2012). Perceived public stigma and attitudes toward seeking psychological help among Turkish and Pakistani people. Pakistan Journal of Psychology, 43(1). 42.
Tomczak, M., & Tomczak, E. (2014). The need to report effect size estimates revisited. An overview of some recommended measures of effect size. TRENDS in Sport Sciences, 21(1), 19–25.
Mustafa, Z. U., Salman, M., Rao, A. Z., Khan, U. A., Asif, N., Shehzadi, N., Hussain, K., & Khan M. F. A. (2020). Awareness of H1N1 influenza among Pakistani pharmacy students. Russian Open Medical Journal, 9(3), 303.
Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54(1), 40–50. https://doi.org/10.1037/0022-0167.54.1.40
Waqas, A., Zubair, M., Ghulam, H., Wajih Ullah, M., & Zubair Tariq, M. (2014). Public stigma associated with mental illnesses in Pakistani university students: a cross sectional survey. PeerJ, 2, e698. https://doi.org/10.7717/peerj.698
