Title: Attitudes and beliefs of the French public about schizophrenia and major depression. Results from a vignette-based population survey

Transcription

1 Reviewer's report Title: Attitudes and beliefs of the French public about schizophrenia and major depression. Results from a vignette-based population survey Version: 2 Date: 18 July 2013 Reviewer: Lori Nabors Reviewer's report: Discretionary revisions: Abstract: Results: The first sentence states, defined by the vast majority as I am assuming this refers to the vast majority of the sample collected, but may be beneficial to clarify. Introduction: Page 3: using the concept of social representations as theoretical framework should it read as a theoretical framework? It seems like a word may be missing. Also, the end of that sentence I would double check about the placement of the comma and the period to see if they should in fact be on the inside of the quotation marks. Same thing on page 5-6 Page 3 - instead of employing as stimulus I think this sentence could drop that as, to make it clearer, but seems like a discretionary revision. Page 4 such as rejecting a job application or refusing to rent an apartment perhaps clarifying this part with something like rejecting their job application or refusing to rent them an apartment. Page 4 in research, this is most frequently measured you can drop the the in measured by the desire for social distance. Methods: Statistical analyses: Page 8 and can be read as percentages should it just be read as percentage? Not plurarl? Discussion: Page 12 - similar to the abstract the first sentence here states vast majority, I assume it means the sample/general public but it may be beneficial to clarify this here as well. Page 12 second sentence about depression, states, and current stress plays here a dominant role it s a little confusing to read this part, may be beneficial to reword it a little bit (I think it was written this way one other place too which you may want to be changed as well if you do choose to reword this part

2 here). Minor Essential revisions: Abstract: Results: In the eyes of the public, psychiatrists needs the comma in this sentence. were considered most frequently as source for help something about this part of the sentence does not read right. Perhaps it should be a source for help instead of as source for help or as the source for help? Conclusion: this applies equally to beliefs about both disorders as to attitudes towards persons suffering from them something in this sentence is not clear, is it supposed to read about both disorders AND to attitudes towards? Introduction: Page 3 - moreover, 75% of respondents seems like it would be clearer to have it read associated the words insane and mentally ill WITH violent and dangerous behaviors. rearranging the current placement of the word with. Also, at the end of that sentence there should be a comma after isolation, before and suicide. Page 3 for the study of the public s knowledge and beliefs there should be a comma here before Anthony Jorm. Again, at the end of the sentence should it say as the theoretical framework? Something does not sound quiet right just stating as theoretical framework. This is something written throughout the paper so I will not repeat it every time it pops up, but it seems like something that should be considered to make reading the manuscript clearer. Page 4- expected prognosis, help-seeking preferences and treatment beliefs. there should be a comma after help-seeking preferences, before the and treatment beliefs. Same thing in the next sentence, a comma after emotional reactions and before and desire for social distance. Methods Survey: years old, same with demographic descriptions, years old, instead of just years. Page 5 gender, age and family status there should be a comma after age and before and family status. This is something I have mentioned previously, there are instances where you do have a comma before the and, and others where you do not. Whichever way you choose, make sure it is consistent. Generally speaking though the commas should be there. Interview: Page 5 been developed in Germany and had there move the there, it

3 seems out of place and unclear where it is currently at, perhaps, and had been successfully been employed there in several surveys. Page 5 for use in this study COMMA it was translated. Page 6 were grouped together to the categories into the categories? To make the categories? A word seems to be missing. Same thing at the end of the next few paragraphs. Page 6: as concerns attitudes towards treatment there should be a comma here before a distinction also consider changing the beginning of the sentence as as concerns is a little awkward sounding. Perhaps considering attitudes towards treatment or in regards to attitudes towards treatment Page 6 should be a comma after the internet and before and confidant. Page 6 the respondents were asked to indicate asked to indicate their or their level of endorsement or rejection? As it is their attitudes they are rating, correct? Page 6 plus A don t know category. Page 7 after assessment of respondents there should be a comma after mental health literacy and before questions on their attitudes. Page 7 there should also be a comma after Hayward and Bright and before the four most Page 7 there should also be a comma after that they are responsible for their illness COMMA and that this goes back to my previous statement about choosing if you want a comma before the and or not and making it consistent throughout the paper as it is different at times. Page 7 measure of attitudes towards people with mental disorders, with the help of A five-point Likert scale add an A, get rid of the s at the end of scales same thing in the next paragraph on tendency to separate oneself from the person in the vignette. Page 7 emotional reactions nine, five-point Likert scale I believe there should be a comma there. Also in this paragraph, fear, anger COMMA and pro-social relations. And then the last sentence about grouping into categories (see above comment about that). Page 7 desire for social distance have as A neighbor, a needs to be added. with the help of five-point Likert scales with the help of A five-point Likert scale, it s only one scale just multiple questions. Also the grouping into groups comment as mentioned above. Results: Page 8 beliefs about schizophrenia and major depression suffers from an illness in the medical sense COMMA I believe there should be a comma there and after 58%. Page 9 casual beliefs to be endorsed as cause to be endorsed as A cause of schizophrenia than as A cause of major depressive disorder. Also with depression COMMA ; four out of five respondents COMMA ; as a cause

4 (65%) comma Page 9 anticipated prognosis rather optimistic concerning as concerns sounds awkward to read. Page 9 help seeking recommendations followed by psychotherapists (77%) comma ; I m not sure what you mean by making a cure in a spa perhaps this should be reworded to be more clear. The last sentence also uses as concerns in the middle of it which sounds awkward again to read. Comma after joining a self-help group and before or visiting the internet. Page 10 treatment recommendations as concerns depression COMMA; was endorsed by only 20% of the respondents COMMA relaxation techniques natural remedies COMMA or acupuncture Page 10 stereotypes among the four stereotypes COMMA were shared each by only less than this part sounds awkward and I am not sure if you are referring to both of those stereotypes together accounting for less than 10% of the respondents, or if each on their own were less than 10% of the respondents; Page separation of us from them in case of major depressive disorder should be in THE case of major depressive disorder; Page 11 emotional reactions followed by fear and related feelings (uncomfortable, insecure) COMMA annoyance COMMA and amusement ; although the difference between both disorders was here less pronounced I think the was and here should be switched to read both disorders here was less pronounced to help make the statement flow better/clearer; as concerns anger, annoyance COMMA or amusement COMMA no differences EXISTED between both disorders. Page 11 desire for social distance except for the most distance relationships it seems this sentence might be served better/clearer by breaking it up into two sentences instead of one. Perhaps ending the first sentence with over half of respondents rejected him or her in closer relationships. Then starting a new sentence making what you mean about the depressed person more clear regarding rejection/indecisiveness. Last sentence it seems that were opposed to not was opposed to is more clear/grammatically correct, and stating what they were opposed to, currently it just reads was opposed to no matter which which is unclear. Discussion: Page 12 in the eyes of the public COMMA psychiatrists Page 12 - were considered most frequently as source for help something about this part of the sentence does not read right. Perhaps it should be a source for help instead of as source for help or as the source for help? Page 12 apart from formal help COMMA there is also Page 12 the sentence relaxation techniques and alternative methods appear better suited for treatment of major depression than psychotropic medication is this referring to the samples beliefs? I would add something in their stating so

5 otherwise it kind of sounds like the literature states these treatments are better. Page 12 thus, although there exists a certain overlap between both disorders COMMA the French public Page 12 I d check your citations, in the paragraph starting with in 2001, a similar survey has the period coming BEFORE the [10, 17, 18] reference number, but earlier in the article it comes after (which is how I believe it should be). Page 12 the divide between both disorders as regards as regards sounds awkward, perhaps regarding? Page 12 for instance, work stress was seen as cause of depression was seen as A cause of depression? The cause of depression? Same with the rest of the sentence about as cause of schizophrenia. Page 13 perhaps rewording to be was larger in France than in Germany having it state was in France larger than in Germany sounds awkward to me. Page 13 was even more pronounced as regards the treatment of schizophrenia something about this as regards sounds awkward, regarding? Page 13 is contra-intuitive a word? Do you mean counterintuitive? Page 13 was there not as marked perhaps was not as marked there as in France, sounds a bit clearer to me this way. Page 13 and only 37% for medication COMMA whereas in Germany Page 14 which is in France higher than in Germany perhaps which is higher in France than in Germany to sound clearer. Page 14 as regards depression reword, as regards sounds awkward here too. That same sentence, was in France twice as high as in Germany perhaps was twice as high in France as in Germany to make it clearer. Page 14 another reason may be that medication still tends this sentence is unclear to me, I am not sure what you mean by causal treatment, but it seems to need to be reworded to make it clear. Page 14 finally, also the also sounds redundant, I d drop it. Page 14 across all attitude components studied COMMA schizophrenia Page 14 for instance, as concerns the as concerns part sounds awkward to me, also there should be a comma after dangerousness and before the discrepancy in this sentence. Page 15 last sentence before the limitations sections, perhaps make it state as AN expression of some sort of depression instead of just as expression of. It s clearer to me that way. Limitations: Page 15 before concluding COMMA some limitations Page 15 with only less than ideal accuracy I d drop the only. It s not needed.

6 Page 15 using them as proxy proxy should be plural as them is plural, or maybe it needs to be as A proxy if they are being used collectively to predict behavior, not individually. And add a comma after individual behaviors before public attitudes in this sentence. Page 15 such conceptions the way how we behave this doesn t make sense, there seems to be an extra word in this part of the sentence. Either way we behave or how we behave, but not both. Page 15 as Link et al have pointed out COMMA as context Page 15 the quotation mark before (p. 255) appears to be backwards (compared to all other ending quotation marks) this may be a spacing issue or something. Page 15 last sentence of the limitations when you have it as has only recently should be thought about. It seems, considering the previous statement/the point it sounds like you are trying to make, that the only should be taken out in order to give evidence of the utility/usefulness of the survey. Otherwise keeping the only recently in makes it sound like this was a terrible methodological choice, which I don t believe it was/is the point you are trying to make. Conclusions: Page 15 in conclusion COMMA as concerns, again sounds awkward, perhaps just use concerning. Page 15 thus, despite theoretical and methodological differences COMMA our results Page 15 what they have found drop the have. Authors contributions: There should be a comma after organized the survey, and before and helped drafting the manuscript. And change drafting to draft. Tables: The spacing in table 2 is off for the disturbance of brain metabolism and troubles in family/partnership these may be things that are fine in the final formatting/for publication, but I wanted to make you aware of them in this document in case they do need to be changed. Table 4 the title in case of schizophrenia in cases of? As recommendations in the first part is plural. It sounds weird as it currently is. There is also the strange spacing issue as mentioned for table 2 for practitioner of complementary medicine and I think complementary is spelled incorrectly in this instance too. Spacing seems strange again for table 6 when listing the stereotypes. Table 7 the title has two commas in a row next to each other, although it seems like it was an attempt to put them in quotations. And the same comment as mentioned for table 4 about in case of.

7 Spacing seems strange again for table 8 as well when listing the emotional reactions, specifically the one for I feel uncomfortable. Table 9 spacing for introduce to a friend and take care of children. Major compulsory revisions: Why did you use DSM-III-R instead of DSM-IV or DSM-IV-TR? Level of interest: An article of outstanding merit and interest in its field Quality of written English: Needs some language corrections before being published Statistical review: No, the manuscript does not need to be seen by a statistician. Declaration of competing interests: I declare that I have no competing interests.