Intensity of previous teaching but not diagnostic skills influences stigmatization of patients with substance use disorder by general practice residents. A vignette study among French final-year residents in general practice

Figures & data

Table 1. Number of residents registered in final year by medical school, who participated in the study and substance use disorder teaching included in compulsory teaching during the residency in general practice.

		Number of residents who participated		Substance use disorder teaching
Medical school	Number of residents registered in last year with a valid email address n = 1284	n = 303	Participation rate (%)	Number of hours	Position during the residency
Bordeaux	204	60	29.4	6	Second year
Brest	72	16	22.2	6	According to the choice of residents
Caen	75	22	29.3	6	First year
Clermont	59	24	40.7	4	Second year
Limoges	26	9	34.6	–	–
Nice	75	14	18.7	–	–
Paris Diderot	108	23	21.3	6	Second year
Paris Versailles	75	8	10.7	6	Second year
Poitiers	90	13	14.4	2	Third year
Rennes	215	37	17.2	6	According to the choice of residents
Strasbourg	140	30	21.4	12	Third year
Toulouse	145	46	31.7	6	Third year

Table 2. Criteria used to diagnose substance use disorder by 249 French final year residents in general practice who diagnosed substance use disorder correctly.

Substance use disorder criteria proposed	Number of residents having selectedthe corresponding criterion n = 249
Withdrawal Signs	240 (96.4%)
Tolerance	173 (69.5%)
Loss of Control	167 (67.1%)
Quantity Used	149 (59.8%)
Craving	131 (52.6%)
Harmful Consequences	92 (36.9%)
Somatic Complains	50 (20.1%)
Professional Context	24 (9.6%)
Age and Sex of the Patient	23 (9.2%)
Medical History	21 (8.4%)

Table 3. Results of the AMIQ score about the clinical vignette of an intravenous heroin user named Jean (n = 303 French final year residents in general practice answering).

	Strongly agree	Agree	Neutral	Disagree	Strongly disagree	Don’t know
	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
Do you think that this would damage Jean’s career?	194 (64.0)	101 (33.3)	8 (2.6)	0 (0)	0 (0)	0 (0)
I would be comfortable if Jean were my colleague at work.	6 (2.0)	34 (11.2)	74 (24.4)	130 (42.9)	47 (15.5)	12 (4.0)
I would be comfortable with inviting Jean to adinner party.	27 (8.9)	94 (31.1)	88 (29.0)	63 (20.8)	16 (5.3)	15 (5.0)
	Very likely	Quite likely	Neutral	Unlikely	Very unlikely	Don’t know
	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
How likely do you think it would be for Jean’s wife to leave him?	52 (17.2)	139 (45.9)	74 (24.4)	9 (3.0)	1 (0.3)	28 (9.2)
How likely do you think it would be for Jean to get introuble with the law?	93 (30.7)	164 (54.1)	33 (10.9)	8 (2.6)	1 (0.3)	4 (1.3)

Table 4. Illness representations towards substance use disorder and type 2 diabetes (n = 303 French final year residents in general practice).

	Substance use disorder (clinical vignette of a 26-year-old intravenous user of heroin)					Type 2 diabetes (clinical vignette of a 47-year-old patient with type 2 diabetes)
	Strongly agree	Agree	Neutral/ don’t know	Disagree	Strongly disagree	Strongly agree	Agree	Neutral/ don’t know	Disagree	Strongly disagree
	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
The patient is partly responsible of his disorder	21 (6.9)	153 (50.5)	87 (28.7)	30 (9.9)	12 (4.0)	57 (18.8)	189 (62.4)	38 (12.5)	15 (5.0)	4 (1.3)
The patient has to be managed the same way as patients with chronic diseases	178 (58.8)	90 (29.7)	9 (3.0)	24 (7.9)	2 (0.7)	208 (68.7)	81 (26.7)	6 (2.0)	6 (2.0)	2 (0.7)
Health expenditures concerning these patients are too high in comparison to other medical disorders	2 (0.7)	15 (5.0)	76 (25.1)	120 (39.6)	90 (29.7)	2 (0.7)	40 (13.2)	73 (24.1)	113 (37.3)	75 (24.8)