Academic journal article Hong Kong Journal of Psychiatry

Attitudes of Medical Students to Psychiatry at a Nigerian Medical School

Academic journal article Hong Kong Journal of Psychiatry

Attitudes of Medical Students to Psychiatry at a Nigerian Medical School

Article excerpt


Mental disorders have been recognised for millennia, being initially considered to be physical ailments of the heart or uterus and therefore carried no stigma as there was no demarcation then between psyche and soma. (1) Today, mental disorders carry a lot of stigmatising attitudes, which are often due to inaccurate information about mental illness or the lack of contact with individuals with mental illness. This was observed by Corrigan et al (2) who indicated that those with more knowledge about mental illness were less likely to endorse negative or stigmatising attitudes.

Due to advances in neurosciences, neuroimaging and social sciences, nowadays the understanding of mental disorders is much improved. Notwithstanding better understanding and more effective interventions, attitudes towards mental disorders among the general public are still inappropriate. (2) Medical students, being members of the larger general community, may also have such negative prejudices about mental disorders and psychiatric practice, despite having some contact with and knowledge of mental disorders. In 3 medical schools in North America, negative attitudes towards psychiatry were found to exist prior to formal medical training. (3) Similarly, Furnham (4) in London found that psychiatry was graded lowest among 8 other specialties and was given the most pejorative rating. It was considered the most ineffective, unscientific, and conceptually the weakest specialty. (4) Interestingly, Reddy et al (5) found that an 8-week clinical posting in psychiatry was associated with an increase in positive attitudes to mental illness and to psychiatry among female but not male students. Similarly, a study on Arabian Gulf University medical students also revealed moderately positive attitudes, which were also more evident in female than their male counterparts. (6)

Nigerian studies on the effect of the psychiatric clerkship on attitudes to psychiatry have indicated that over the period of posting to that specialty, attitudes were generally positive and remained fairly stable. (7,8) These studies were undertaken 2 decades ago, hence there was a need for a re-appraisal. This study aimed at reporting the attitudes to psychiatry of final-year medical students of a Nigerian University medical college, prior to and after their clerkship.


A 2-stage cross-sectional study was carried out among final-year medical students in 2005 at the College of Health Sciences, Ladoke Akintola University of Technology (LAUTECH), Osogbo, Southwest, Nigeria. This College serves Oyo and Osun, 2 of the 36 states in Nigeria, and the neighbouring Yoruba-speaking states, which forms the catchment area for the University. Students from other parts of Nigeria could also be admitted depending on merit.

The 6th-year psychiatric curriculum comprises 8 to 10 hours of didactic lectures per week. In addition, it includes 4 weeks of history taking, as well as sessions on mental status examination, communication skills, phenomenology, diagnostic classification, aetiology, clinical features, and the treatment of psychiatric disorders. Except when interviewing native Yoruba-speaking patients, all discussions and teaching materials were conducted in English. The psychiatry posting is in the final (6th) year, after exposure to other clinical specialties. These students formed the study population for this study. The department of psychiatry personnel included 4 board certified psychiatrists, physician psychiatrist trainees, psychiatric nurses, psychiatric social workers, and a clinical psychologist. Services rendered included: open inpatient acute--short stay assistance, substance abuse management, forensic psychiatry, child and adolescent psychiatric services, geriatric psychiatric services, outpatient, community services and home visits, psychotherapy and counselling, and electro-convulsive therapy. Chronic, long-stay patients were not usually admitted but referred to a nearby Wesley Guild Hospital mental health department, under the care of one of the authors. …

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