Bebbington P E, Meltzer H, Brugha T S, Farrell M, Jenkins R, Ceresa C, Lewis G
Department of Psychiatry and Behavioural Sciences, RF & UCL Medical School, Institute of Psychiatry and Office for National Statistics, London.
Psychol Med. 2000 Nov;30(6):1359-67. doi: 10.1017/s0033291799002950.
In this paper we use data from the National Survey of Psychiatric Morbidity to examine how many people with neurotic disorders receive professional evaluation, and how this is affected by clinical and sociodemographic differences. We hypothesized that psychiatric symptoms and attendant dysfunctions would both have an effect on contacting, and that key demographic variables would not.
The household component of the British National Surveys of Psychiatric Morbidity was based on a random sample of > 10,000 subjects. Psychiatric symptoms and ICD-10 diagnosis were established by lay interviewers using the CIS-R. Social dysfunction was tapped by asking about difficulties in performing seven types of everyday activity. We examined symptom score, ADL deficit score and demographic variables in relation to contact with primary care physicians for psychiatric symptoms.
The major determinant of contacting a primary care physician was severity, mainly due to the level of psychiatric symptoms, but with an independent contribution from social dysfunction. There were also significant contributions from sex, marital status, age, employment status and whether the subject had a physical condition as well.
The major influence on whether people seek the help of their family doctors for mental health problems is the severity of disorder. Although there are some social inequalities in access to family doctors, these are less important. The most salient finding from our study is that even people suffering from high levels of psychiatric symptoms very often do not have contact with professionals who might help them.
在本文中，我们使用来自全国精神疾病调查的数据，以研究有多少神经症患者接受了专业评估，以及这如何受到临床和社会人口统计学差异的影响。我们假设精神症状和伴随的功能障碍都会对寻求帮助产生影响，而关键人口统计学变量则不会。
英国全国精神疾病调查的家庭部分基于对10000多名受试者的随机抽样。精神症状和国际疾病分类第十版（ICD - 10）诊断由非专业访谈员使用综合国际诊断访谈修订版（CIS - R）确定。通过询问在进行七种日常活动方面的困难来衡量社会功能障碍。我们研究了症状评分、日常生活活动缺陷评分以及与因精神症状联系初级保健医生相关的人口统计学变量。
联系初级保健医生的主要决定因素是严重程度，主要归因于精神症状的水平，但社会功能障碍也有独立作用。性别、婚姻状况、年龄、就业状况以及受试者是否有身体疾病也有显著影响。
人们是否就心理健康问题寻求家庭医生帮助的主要影响因素是疾病的严重程度。虽然在获得家庭医生帮助方面存在一些社会不平等，但这些不太重要。我们研究中最显著的发现是，即使是患有严重精神症状的人也常常不与可能帮助他们的专业人员接触。
