Display options
Share it on

Eur Arch Psychiatry Clin Neurosci. 2016 Mar;266(2):139-54. doi: 10.1007/s00406-016-0678-5. Epub 2016 Feb 13.

EPA guidance on improving the image of psychiatry.

European archives of psychiatry and clinical neuroscience

A M Möller-Leimkühler, H-J Möller, W Maier, W Gaebel, P Falkai

Affiliations

  1. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstr. 7, 80336, Munich, Germany. [email protected].
  2. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstr. 7, 80336, Munich, Germany. [email protected].
  3. Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.
  4. Department of Psychiatry and Psychotherapy, Heinrich-Heine-University Düsseldorf, Bergische Landstraße 2, 40629, Düsseldorf, Germany.
  5. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstr. 7, 80336, Munich, Germany.

PMID: 26874959 DOI: 10.1007/s00406-016-0678-5

Abstract

This paper explores causes, explanations and consequences of the negative image of psychiatry and develops recommendations for improvement. It is primarily based on a WPA guidance paper on how to combat the stigmatization of psychiatry and psychiatrists and a Medline search on related publications since 2010. Furthermore, focussing on potential causes and explanations, the authors performed a selective literature search regarding additional image-related issues such as mental health literacy and diagnostic and treatment issues. Underestimation of psychiatry results from both unjustified prejudices of the general public, mass media and healthcare professionals and psychiatry's own unfavourable coping with external and internal concerns. Issues related to unjustified devaluation of psychiatry include overestimation of coercion, associative stigma, lack of public knowledge, need to simplify complex mental issues, problem of the continuum between normality and psychopathology, competition with medical and non-medical disciplines and psychopharmacological treatment. Issues related to psychiatry's own contribution to being underestimated include lack of a clear professional identity, lack of biomarkers supporting clinical diagnoses, limited consensus about best treatment options, lack of collaboration with other medical disciplines and low recruitment rates among medical students. Recommendations are proposed for creating and representing a positive self-concept with different components. The negative image of psychiatry is not only due to unfavourable communication with the media, but is basically a problem of self-conceptualization. Much can be improved. However, psychiatry will remain a profession with an exceptional position among the medical disciplines, which should be seen as its specific strength.

Keywords: Biopsychosocial models; Professional identity; Recruitment of medical students; Self-marketing; Self-stigma; Stigma

References

  1. BMJ. 2013 May 14;346:f2969 - PubMed
  2. World J Psychiatry. 2014 Sep 22;4(3):62-8 - PubMed
  3. BMC Med Educ. 2014 Jan 15;14:12 - PubMed
  4. BMJ. 2002 Apr 13;324(7342):886-91 - PubMed
  5. Ann Gen Psychiatry. 2013 Aug 13;12(1):26 - PubMed
  6. Neurosci Biobehav Rev. 2013 Sep;37(8):1680-91 - PubMed
  7. Acta Psychiatr Scand. 2007 Oct;116(4):235-7 - PubMed
  8. Front Public Health. 2015 Feb 11;3:25 - PubMed
  9. Psychiatr Bull (2014). 2014 Aug;38(4):175-9 - PubMed
  10. Acad Med. 2012 Mar;87(3):261-5 - PubMed
  11. Eur Psychiatry. 2014 Feb;29(2):101-6 - PubMed
  12. Psychiatr Prax. 2000 Oct;27(7):327-9 - PubMed
  13. Acta Psychiatr Scand. 2015 Jan;131(1):21-8 - PubMed
  14. Schizophr Res. 2008 Mar;100(1-3):20-38 - PubMed
  15. Br J Psychiatry. 2000 Nov;177:396-401 - PubMed
  16. Br J Psychiatry. 2013 Aug;203(2):146-51 - PubMed
  17. N Engl J Med. 2008 Jan 17;358(3):252-60 - PubMed
  18. Br J Psychiatry. 2008 Jul;193(1):6-9 - PubMed
  19. Eur Arch Psychiatry Clin Neurosci. 2015 Feb;265(1):5-18 - PubMed
  20. Br J Psychiatry. 2010 Mar;196(3):173-8 - PubMed
  21. Int Rev Psychiatry. 2007 Apr;19(2):137-55 - PubMed
  22. World Psychiatry. 2010 Feb;9(1):29 - PubMed
  23. World J Biol Psychiatry. 2007;8(3):141-74 - PubMed
  24. Philos Ethics Humanit Med. 2012 May 23;7:9 - PubMed
  25. Soc Psychiatry Psychiatr Epidemiol. 2014 May;49(5):673-82 - PubMed
  26. Psychiatry Res. 2015 Jan 30;225(1-2):14-30 - PubMed
  27. Am J Psychiatry. 2014 Apr;171(4):395-7 - PubMed
  28. Br J Psychiatry. 2012 Feb;200(2):97-106 - PubMed
  29. Nervenarzt. 2013 May;84(5):639-47; quiz 648-9 - PubMed
  30. Eur Arch Psychiatry Clin Neurosci. 2008 Dec;258(8):451-5 - PubMed
  31. J R Soc Med. 2014 Jun 9;107(6):224-227 - PubMed
  32. World Psychiatry. 2010 Feb;9(1):21-8 - PubMed
  33. Eur Arch Psychiatry Clin Neurosci. 2008 Nov;258 Suppl 5:60-5 - PubMed
  34. Acta Psychiatr Scand. 2015 Jan;131(1):2-3 - PubMed
  35. World Psychiatry. 2011 Feb;10(1):52-77 - PubMed
  36. Nervenarzt. 2014 Nov;85(11):1419-31 - PubMed
  37. World Psychiatry. 2014 Jun;13(2):105-6 - PubMed
  38. BMC Psychiatry. 2005 Sep 21;5:33 - PubMed
  39. Lancet Psychiatry. 2014 Jul;1(2):121-8 - PubMed
  40. J Psychosom Res. 2007 Apr;62(4):501-9 - PubMed
  41. Acad Psychiatry. 2012 May 1;36(3):197-204 - PubMed
  42. Can J Psychiatry. 2013 Jul;58(7):376-85 - PubMed
  43. Front Psychol. 2013 May 15;4:269 - PubMed
  44. Eur Arch Psychiatry Clin Neurosci. 2008 Aug;258(5):257-70 - PubMed
  45. J Psychosom Res. 2014 Mar;76(3):175-92 - PubMed
  46. Harv Rev Psychiatry. 2014 Jan-Feb;22(1):31-45 - PubMed
  47. BMC Med Educ. 2013 Oct 24;13:141 - PubMed
  48. Ann Gen Psychiatry. 2013 Apr 12;12(1):11 - PubMed
  49. BMC Fam Pract. 2014 Feb 19;15:35 - PubMed
  50. Curr Opin Psychiatry. 2009 Nov;22(6):582-6 - PubMed
  51. BMC Med Educ. 2011 Jul 29;11:51 - PubMed
  52. Eur Psychiatry. 2009 Sep;24(6):412-24 - PubMed
  53. Trends Neurosci. 2002 Aug;25(8):430-1 - PubMed
  54. World Psychiatry. 2014 Jun;13(2):201-2 - PubMed
  55. Br J Psychiatry. 2011 Dec;199(6):439-40 - PubMed
  56. Int J Soc Psychiatry. 2012 Sep;58(5):455-62 - PubMed
  57. Br J Psychiatry. 2013 Mar;202(3):228-34 - PubMed
  58. Psychol Med. 2015 Jan;45(2):439-46 - PubMed
  59. Br J Psychiatry. 2000 Jan;176:1-5 - PubMed
  60. N Engl J Med. 2005 Sep 22;353(12 ):1209-23 - PubMed
  61. Can J Psychiatry. 2011 Oct;56(10):1-9 - PubMed
  62. BMC Med Educ. 2013 Jun 14;13:85 - PubMed
  63. Epidemiol Psichiatr Soc. 2009 Oct-Dec;18(4):318-22 - PubMed
  64. Acta Psychiatr Scand. 2015 Jan;131(1):7-8 - PubMed
  65. Dtsch Arztebl Int. 2013 Nov 22;110(47):799-808 - PubMed
  66. Soc Sci Med. 2011 Sep;73(6):929-38 - PubMed
  67. World J Biol Psychiatry. 2006;7(2):126-7 - PubMed
  68. Schizophr Bull. 2011 Sep;37 Suppl 2:S5-12 - PubMed
  69. Acta Psychiatr Scand Suppl. 1994;382:39-45 - PubMed
  70. World Psychiatry. 2010 Feb;9(1):36-8 - PubMed
  71. Fortschr Neurol Psychiatr. 2002 Aug;70(8):410-7 - PubMed
  72. Neurosci Biobehav Rev. 2013 Dec;37(10 Pt 1):2404-9 - PubMed
  73. Int J Methods Psychiatr Res. 2014 Sep;23(3):289-303 - PubMed
  74. J Nerv Ment Dis. 2012 Jun;200(6):474-9 - PubMed
  75. Eur Arch Psychiatry Clin Neurosci. 2015 Mar;265(2):87-106 - PubMed
  76. Fortschr Neurol Psychiatr. 2004 Jan;72(1):36-44 - PubMed
  77. Dtsch Med Wochenschr. 2014 Jun;139(23):1249-52 - PubMed
  78. World Psychiatry. 2011 Feb;10(1):38-9 - PubMed
  79. Australas Psychiatry. 2014 Dec;22(6):579-84 - PubMed
  80. World Psychiatry. 2010 Oct;9(3):131-44 - PubMed
  81. Br J Psychiatry Suppl. 2013 Apr;55:s89-94 - PubMed
  82. World Psychiatry. 2014 Feb;13(1):43-4 - PubMed
  83. J Ment Health. 2015 Jun;24(3):126-8 - PubMed
  84. Lancet. 2009 Jan 3;373(9657):31-41 - PubMed
  85. Community Ment Health J. 2010 Oct;46(5):494-9 - PubMed
  86. Eur Psychiatry. 2014 Feb;29(2):83-100 - PubMed
  87. Int J Neuropsychopharmacol. 2014 Jul;17(7):983-96 - PubMed
  88. Lancet Psychiatry. 2014 Jul;1(2):102-4 - PubMed
  89. Br J Psychiatry. 2013 May;202(5):319-20 - PubMed
  90. Epidemiol Psichiatr Soc. 2008 Jan-Mar;17(1):14-9 - PubMed
  91. Curr Psychiatry Rep. 2012 Aug;14(4):328-35 - PubMed
  92. JAMA. 2010 Mar 24;303(12):1192-3 - PubMed
  93. Pharmacopsychiatry. 2003 Nov;36(6):288-91 - PubMed
  94. Community Ment Health J. 2015 Apr;51(3):329-37 - PubMed
  95. Ment Health Fam Med. 2012 Jun;9(2):77-90 - PubMed
  96. Psychiatr Prax. 2003 Jan;30(1):4-7 - PubMed
  97. Acta Psychiatr Scand. 2012 Jun;125(6):440-52 - PubMed
  98. J Health Soc Behav. 2012 Mar;53(1):17-32 - PubMed
  99. Yale J Biol Med. 2013 Jun 13;86(2):139-46 - PubMed
  100. Lancet. 2009 Aug 22;374(9690):609-19 - PubMed
  101. Asian J Psychiatr. 2013 Jun;6(3):263-5 - PubMed
  102. BMC Psychiatry. 2012 Aug 28;12:128 - PubMed
  103. World Psychiatry. 2013 Oct;12(3):185-6 - PubMed
  104. World Psychiatry. 2015 Feb;14(1):3-4 - PubMed

MeSH terms

Publication Types