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Introduction: This study explores burden and social and professional support in families of young patients with muscular dystrophies (MDs) in Italy. Methods: The study was carried out on 502 key relatives of 4‐ to 25‐year‐old patients suffering from Duchenne, Becker, or Limb‐Girdle MD who were living with at least 1 adult relative. Results: A total of 77.1% of relatives reported feelings of loss, 74.0% had feelings of sadness, and 59.1% had constraints in leisure activities. Burden was higher among relatives of patients with higher disability and who spent more daily hours in caregiving. Practical difficulties were higher among relatives who perceived lower help in patient emergencies and less practical support by their social network. Psychological burden was higher in those relatives who were unemployed, those with poorer support in emergencies, and those with lower social contacts. Conclusions: Caring for patients with MDs may be demanding for relatives even in the early stages of these disorders, especially when social support is poor and the patient's disability increases. Muscle Nerve 52: 13–21, 2015

This paper focuses on the psychological benefits of caregiving in key relatives of patients with muscular dystrophies (MD), a group of rare diseases characterized by progressive weakness and restriction of the patient's functional abilities. We describe whether relatives perceived caregiving to be a positive experience and test whether relatives' perceptions vary in relation to their view of the patient as a valued person, the degree of involvement in care, and the level of support provided by social network and professionals. The study sample included 502 key relatives of patients aged 4-25 years, suffering from Duchenne, Becker, or limb-girdle MD, in treatment for at least 6 months to one of the eight participating centers, living with at least one relative aged 18-80 years. Of key relatives, 88 % stated that they had gotten something positive out of the situation, 96 % considered their patients to be sensitive, and 94 % viewed their patients as talented. Positive aspects of caregiving were more recognized by key relatives who were more convinced that the patient was sensitive and who perceived that they received higher level of professional help and psychological social support. These results suggest that most key relatives consider that their caregiving experience has had a positive impact on their lives, despite the practical difficulties of caring for patients with MD. Professionals should help relatives to identify the benefits of caregiving without denying its difficulties. Clinicians themselves should develop positive attitudes towards family involvement in the care of patients with long-term diseases.

PURPOSE: Negative attitudes toward mental illness among medical professionals can influence the quality of medical care they provide. The authors examined the impact of causal explanations and diagnostic labeling on medical students' views of schizophrenia. METHOD: Medical students in their fifth and sixth years at the Second University of Naples (Italy) who attended lectures from April through June 2010 completed a self-report questionnaire regarding their beliefs about the mental disorder described (but not named) in a case vignette depicting a person who meets the International Classification of Diseases-10 criteria for schizophrenia. RESULTS: Of the 232 students invited, 194 (84%) completed the questionnaire. Students most frequently cited heredity as the cause (81%), followed by stress (69%), psychological traumas (45%), and misuse of street drugs (44%). Most students (82%) labeled the case "schizophrenia"; a minority (24%) believed that persons with the case vignette disorder could be well again. Both labeling the case as "schizophrenia" and naming heredity as the cause were independently associated with pessimism about the possibility of recovery and with the perception that "others" keep their distance from persons with this diagnosis. Heredity was more frequently cited by respondents who labeled the case schizophrenia and was significantly associated with students' perception that people with this diagnosis are unpredictable. CONCLUSIONS: These findings confirm that, in a sample of medical students, biogenetic causal explanations and diagnostic labeling have negative effects on beliefs about schizophrenia. They highlight the need to educate medical students about recovery from and stigma related to schizophrenia.

Resumen: El artículo parte de la preocupación por los efectos negativos, constatados en múltiples publicaciones internacionales, que el estigma tiene sobre la calidad de la atención que reciben las personas con esquizofrenia en el ámbito de los servicios sanitarios y en relación con su salud física, frecuentemente deteriorada. Como consecuencia del desconocimiento sobre las causas y características de esta enfermedad y las ideas erróneas que muchos profesionales comparten con la población general sobre la peligrosidad e incurabilidad de las personas afectadas por este trastorno, son habitualmente objeto de falta de respeto y mala atención en los servicios sanitarios generales. Un momento importante para mejorar la información y corregir las ideas erróneas es el periodo de formación de los profesionales y a ese respecto se presentan los primeros resultados de una experiencia piloto, desarrollada entre estudiantes de Medicina de una Universidad italiana, consistente en la inclusión de un curso breve sobre el estigma y la esquizofrenia. Aunque los resultados deben ser confirmados por otros estudios, permiten constatar los evidentes cambios positivos que se producen en el conocimiento y las actitudes de los estudiantes con una breve intervención educativa, asociada a la participación de usuarios, confirmando también otros estudios internacionales. To counteract stigma towards people with schizophrenia in the health sector: a pilot experience in a sample of Italian students of medicine Abstract: The article is based of the concern about the negative effects, found in many international publications, that stigma has on the quality of care that people with schizophrenia receive in the field of health services, in connection with their physical health, often deteriorated. As a result of the lack of knowledge about the causes and characteristics of this disease and the misconceptions that many professionals share with the general population about the dangerousness and lack of recovery of the people affected by this disorder, they are usually subject of lack of respect and poor care into general health services.Very important to improve the information and correct erroneous attitudes is the period of training of professionals and in this regard are presented the first results of a pilot project, developed between students of Medicine of an Italian University, consisting in a brief course on stigma and schizophrenia. Although the results must be confirmed by other studies, they noted the evident positive changes occurring in the knowledge and attitudes of students with a brief educational intervention, associated with the participation of users, also confirming other international studies.

This study explored the influence of an educational intervention addressing common prejudices and scientific evidence about schizophrenia on medical and psychology students’ views of this disorder. The intervention - consisting in two three-hour lessons with an interval of a week between - was run at first for medical students and then for psychology students. Participants’ views of schizophrenia were assessed at baseline vs. at post intervention by matched questionnaires. At medical school, participation was voluntary and also included a six-month online re-assessment, while at psychology school, participation was mandatory. A total of 211 students attended the educational initiative. At post intervention assessment, students more frequently mentioned psychosocial causes of schizophrenia, and more firmly believed that recovery in schizophrenia is possible and that persons with this disorder are not unpredictable and dangerous vs. their baseline assessment. The online six-month assessment confirmed favourable changes in medical students’ views found at post intervention. These results confirm that an educational intervention including personal experiences and scientific evidence can be successful in reducing students’ prejudices toward persons with schizophrenia.

This study examines whether medical students' views of treatments for ‘schizophrenia’ and of patients' rights to be informed about their condition and their medication were influenced by diagnostic labeling and causal explanations and whether they differed over medical training. Three hundred and eighty-one Italian students attending their first or fifth/sixth year of medical studies read a vignette portraying someone who met diagnostic criteria for ‘schizophrenia’ and completed a self-report questionnaire. The study found that labeling the case as ‘schizophrenia’ and naming heredity among its causes were associated with confidence in psychiatrists and psychiatric drugs. Naming psychological traumas among the causes was associated with confidence in psychologists and greater acknowledgment of users' right to be informed about drugs. Compared to first year students, those at their fifth/sixth-year of studies more strongly endorsed drugs, had less confidence in psychologists and family support, and were less keen to share information on drugs with patients. These findings highlight that students' beliefs vary during training and are significantly related to diagnostic labeling and belief in a biogenetic causal model. Psychiatric curricula for medical students should include greater integration of psychological and medical aspects in clinical management of ‘schizophrenia’; more information on the psychosocial causes of mental health problems.

Purpose. This study explored medical students’ causal explanations and views of schizophrenia, and whether they changed during medical education.Method. The survey was carried out on medical students of the Second University of Naples, Italy, who attended their first-year and their fifth- or sixth-year of lessons. The 381 who accepted were asked to read a case-vignette describing a person who met the ICD-10 criteria for schizophrenia and then fill in the Opinions on mental illness Questionnaire. Results. The most frequently cited causes were psychological traumas (60 %) and stress (56 %), followed by misuse of street drugs (47 %), and heredity (42 %). 28 % of students stated that persons with the disorder could be well again, and 28 % that they were unpredictable. Labeling the case as ‘‘schizophrenia’’ and naming heredity among the causes were associated with pessimism about recovery and higher perception of social distance. First-year students more frequently reported psychological traumas among the causes(76 vs. 45 %), and less frequently heredity (35 vs. 81 %) and stress (42 vs. 69 %), and they perceived less social distance from the ‘‘schizophrenics’’ than fifth/sixth-year students. In particular, 18 %percent of first-year versus 38 %of fifth/sixth-year students believed that these persons were kept at a distance by the other, and 45 versus 57 % felt frightened by persons with the condition. Conclusions. These results indicate a need to include education on stigma and recovery in schizophrenia in the training of medical students.