S D Med. 2023 Sep;76(9):410.
ABSTRACT
INTRODUCTION: Stigma towards people struggling with depression is pervasive across society- even in health care. Many anti-stigma interventions have been tested across a variety of healthcare professionals in an attempt to decrease stigma levels. These interventions have generally elicited short-term change in stigma levels but failed to produce long-term destigmatization.
METHODS: This study sought to determine if literature could be used to decrease stigma levels and increase empathy/ kindness towards patients with depression in medical students at the University of South Dakota, Sanford School of Medicine. Students were administered a 51-question survey scored on a 6-point Likert scale designed largely from peer-reviewed surveys to measure stigma, empathy, and kindness levels towards patients with depression. Students then read a collection of autobiographical or semiautobiographical literature written by authors who had clinically diagnosed major depressive disorder (MDD). This literature was selected with the help of a medical student focus group. Immediately after reading this, students took the survey again. The survey was again administered one week later and 6 months later. A pre-intervention demographics questionnaire was administered to identify potential confounding variables, including personal experience with major depressive disorder and interest in psychiatry.
RESULTS: Twenty-five medical students completed all 3 phases. Statistical analysis comparing pre-intervention score to the three post-intervention composite scores were completed via one-tailed paired two-sample t-tests using Microsoft Excel software. The pre-intervention stigma score mean was 61.84. Although stigma scores did decrease from preintervention to all the post-intervention time points (immediate: 59.92, 1 week: 60.08, 6 months: 58.28), these differences were not statistically significant. Students who reported personal experience with MDD did not have a statistically significant drop in stigma; however, students who reported no personal experience with MDD did have a statistically significant decrease in stigma levels at 1-week post-intervention (mean=58.6, p=0.008) and 6-months post-intervention (mean=57.9; p=0.03) with a pre-intervention mean score was 66.2. The empathy pre-intervention mean score was 63.48. Empathy score changes were statistically significant at all three post-intervention time points (immediate: 66.62, 1 week: 66.92, 6 months: 67.24). The pre-intervention kindness score mean was 41.32. Kindness scores did not increase in a statistically significant manner at any of the post-intervention time points (immediate: 41.88, 1 week: 41.36, 6 months: 42.32).
CONCLUSION: A literature-based intervention significantly decreased stigma levels at the 1-week and 6-months postintervention time points in medical students who reported no personal experience with MDD. This intervention significantly increased empathy levels, irrespective of personal experience. It did not increase kindness levels. These results suggest that literature could be used as a long-term stigma reduction technique in medical students in the absence of personal experience with MDD. Additionally, it could be used to improve empathy levels in medical students, regardless of their personal experience with depression.
PMID:37738494
