Attitudes des médecins omnipraticiens et des résidents en médecine familiale à l’endroit des personnes souffrant d’un trouble de personnalité limite Attitudes of general physicians and family medicine residents towards patients with Borderline Personality Disorder Abstract

Résumé

Plusieurs études suggèrent que les professionnels de la santé entretiennent des attitudes négatives à l’égard des personnes présentant un trouble de personnalité limite (TPL). Cette recherche vise à évaluer les attitudes des omnipraticiens et des résidents en médecine familiale à l’endroit des personnes présentant ce trouble. Quarante résidents en médecine familiale et trente-cinq omnipraticiens ont été comparés à trente-neuf professionnels de la santé mentale à l’aide de l’Échelle d’attitudes à l’égard des personnes présentant un TPL (ÉA-TPL ; Bouchard, 2001). Les résultats démontrent que les omnipraticiens et les résidents en médecine familiale endosseraient des attitudes similaires à celles des professionnels de la santé mentale envers les personnes présentant ce trouble et que moins les cliniciens sont expérimentés, moins ils auraient tendance à présenter des attitudes positives à l’égard des personnes ayant un TPL.

Mots-clés :

• trouble de personnalité limite,
• attitudes,
• médecins omnipraticiens,
• résidents,
• médecine familiale

Abstract

Objectives. Several studies suggest that health professionals show negative attitudes towards people with Borderline Personality Disorder (BPD). Many publications have focused on the attitudes of nurses or other type of clinicians like social workers or psychologists. Few researches concern the attitudes of general physicians towards BPD even if they are the main professionals involved in the evaluation and treatment of these patients. Additionally, patients with BPD frequently consult general physicians and, because of the difficulties interacting with these patients, they do not always receive the treatments required by their condition. This research aims to assess the attitudes of general physicians and family medicine residents regarding patients presenting with this disorder.

Method. Forty family medicine residents and thirty-five general physicians were compared to thirty-nine mental health professionals using the Attitudes toward people with BPD Scale (ABPDS; Bouchard, 2001). This measure has two subscales labeled Comfort when interacting with someone who has BPD and Positivesperceptions about BPD. The internal consistency of the scale as well as the two distinct factors are satisfactory. The participants also complete a socio-demographic questionnaire.

Means, t tests, ANOVAs and factorial ANOVAs are completed in order to compare the three groups on the ABPDS and explore the influence of variables such as sex, age, years of experience, and professional setting (urban or rural) on the results.

Results. The results show that general physicians have similar attitudes than mental health professionals towards people presenting with BPD and that family medicine residents present less positive attitude than the other two groups. In addition, clinicians with less experience tend to have less positive attitudes towards people with BPD and clinicians from urban settings seem to have more positive attitude. It was difficult to determinate which variables influence the results because the years of experience, the professional settings and the title of the participants are extremely related. The factorial ANOVAs show no interaction effect between these three variables.

Conclusion. Several studies show that health professionals present negative attitudes toward patients with BPD. This study reveals that general physicians and family medicine residents show respectively similar attitudes or less positive attitudes than other mental health professionals. These results underline the importance of providing specific training about BPD to family medicine residents. Because general physicians guide the evaluations and interventions concerning these patients and mental health professionals interact regularly with BPD, it will be helpful if all the clinicians receive more specific training regarding this disorder.

Keywords:

• Borderline Personality Disorder,
• attitudes,
• general physicians,
• family medicine resident