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Relation Between Physicians’ Emotional Response and Stigma Around Suicide

Published online by Cambridge University Press:  26 August 2025

R. T. Monteiro*
Affiliation:
Universidade Federal de Ciências da Saúde de Porto Alegre Serviço de Psiquiatria, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Brazil
P. B. Bolzan
Affiliation:
Universidade Federal de Ciências da Saúde de Porto Alegre
T. P. Comissoli
Affiliation:
Universidade Federal de Ciências da Saúde de Porto Alegre
G. I. Zanella
Affiliation:
Vrije Universiteit Amsterdam, Amsterdam, Netherlands
Y. A. Ferrão
Affiliation:
Universidade Federal de Ciências da Saúde de Porto Alegre Serviço de Psiquiatria, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, Brazil
*
*Corresponding author.

Abstract

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Introduction

Suicide is a global health issue. Clinicians still have difficulties to differentiate patients who will or not commit suicide. This process is influenced by emotional and rational factors. Emotional responses (also known as countertransference) refers to what emotions clinicians experience. When working with suicidal patients, clinicians frequently experience negative emotions, such as fear, guilt and hopelessness. Clinicians’ negative emotions responses contribute to their assessment of risk. Possible factors that influence emotional responses are myths and beliefs around suicide, contributing to stigma.

Objectives

This study aims to investigate the relationship between emotional responses, knowledge and stigma about suicide when providing care to suicidal patients.

Methods

An anonymous web-based survey was implemented through the software REDCap. Data were collected by snowball sampling. Participation was voluntary and participants had the ability to opt out at any time. The study was approved by the University Ethics Committee. The survey consisted of the Informed Consent Form (ICF), Sociodemographic Questionnaire, Scale of Myths, Beliefs and Attitudes About Suicide (SMBAS) - which evaluates stigma about suicide trough true or false questions. We also included the Rating Scale for Countertransference (RSCT) which evaluates the main emotional responses towards suicidal patients, divided in approach, indifference or rejection. Other questionnaires were included for future research, beyond the scope of this study.

Results

From 210 respondents, 179 (85.2%) completed the questionnaire. Sociodemographics: 108 (60.3%) were female; 166 (92.7%) were self-declared white-colored skin; The mean age was 37.22 (SD = 12.33), with 6 (0 to 48) median years of professional life [65(36.3%) were medical residents; 112(62.6%) were already specialists, 54(48.2%) of those declared to be psychiatrists]. Psychiatrists had highest rate of correct answers (M = 28,96, SD = 1,84) in SMBAS when compared with non-psychiatrists (M = 27,86, SD = 2,39 , p = 0,008); Psychiatrists presented more emotional responses of interest (M = 2,58, SD 0,68, p < 0,001), solidarity (M = 2,81, SD 0,45, p < 0,001) and desire to help (M = 2,83, SD 0,38, p = 0,010). Non-psychiatrists presented more emotional responses of hostility (M = 0,06, SD 0,25, p = 0,040) and distance (M = 0,32, SD 0,56, p = 0,002). Psychiatrists presented more approach (p=0,03) and non-psychiatrist indifference (p=0,03).

Conclusions

We find preliminary evidence that psychiatrist present higher knowledge around suicide theme, having lower stigma around suicide. Psychiatrists also present more countertransference of approach and less of indifference.

Disclosure of Interest

None Declared

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Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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