Using selected scenes from Brazilian films to teach about substance use disorders, within medical education

Abstract

CONTEXT AND OBJECTIVES: Themes like alcohol and drug abuse, relationship difficulties, psychoses, autism and personality dissociation disorders have been widely used in films. Psychiatry and psychiatric conditions in various cultural settings are increasingly taught using films. Many articles on cinema and psychiatry have been published but none have presented any methodology on how to select material. Here, the authors look at the portrayal of abusive use of alcohol and drugs during the Brazilian cinema revival period (1994 to 2008). DESIGN AND SETTING: Qualitative study at two universities in the state of São Paulo. METHODS: Scenes were selected from films available at rental stores and were analyzed using a specifically designed protocol. We assessed how realistic these scenes were and their applicability for teaching. One author selected 70 scenes from 50 films (graded for realism and teaching applicability > 8). These were then rated by another two judges. Rating differences among the three judges were assessed using nonparametric tests (P < 0.001). Scenes with high scores (> 8) were defined as "quality scenes". RESULTS: Thirty-nine scenes from 27 films were identified as "quality scenes". Alcohol, cannabis, cocaine, hallucinogens and inhalants were included in these. Signs and symptoms of intoxication, abusive/harmful use and dependence were shown. CONCLUSIONS: We have produced rich teaching material for discussing psychopathology relating to alcohol and drug use that can be used both at undergraduate and at postgraduate level. Moreover, it could be seen that certain drug use behavioral patterns are deeply rooted in some Brazilian films and groups.

Cinema and Psychiatry’s relationship through time and its role in current medical education

“…remaining terrifying nearly a century after it first appeared on the screen 2, (1975), where they use unmodified electro-convulsive therapy and lobotomy as treatment for the main character's illness 3,[8][9][10][11][12][13] . One of the downsides of using psychiatryrelated topics in films has been the fact that the majority of depictions tended to be negative and to perpetuate myths and stereotypes, thus contributing to the stigmatization of mental illness.…”

“…There was a lack of detailed studies into film techniques used in the representation of mental illness. As said by M. Anderson, «contemporary cinema has a difficult task on its hands in attempting to depict the experience of mental illness» 4,[8][9][10][11][12][13][14] .…”

The antisocial personality disorder in the Brazilian movies

“…With regard to psychiatry and psychology teaching, several studies have already broached the use of movies as didactic and pedagogical learning of mental disorders 4,5 . The cinema around the world is interested in showing the different aspects of psychopathology, which indicates that most mental disorders have somehow already been illustrated on the big screen [6][7][8][9] .…”

Adolescent Characters and Alcohol Use Scenes in Brazilian Movies, 2000–2008

“…However, most of the previous studies in this area have investigated the content related to the use of alcohol and drugs with focus on teaching psychiatry through the use of films or for discussion of certain diagnoses. [4][5][6] Others have also recommended using films for teaching purposes in general psychiatry. [7][8][9][10] Of course, cinema is an art form which not only imitates life but also can modify it and influence it through the creative process.…”