Jorm Anthony F, Nakane Yoshibumi, Christensen Helen, Yoshioka Kumiko, Griffiths Kathleen M, Wata Yuji
ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia.
BMC Med. 2005 Jul 9;3:12. doi: 10.1186/1741-7015-3-12.
Surveys of the public in a number of countries have shown poor recognition of mental disorders and beliefs about treatment that often diverge from those of health professionals. This lack of mental health literacy can limit the optimal use of treatment services. Australia and Japan are countries with very different mental health care systems, with Japan emphasising hospital care and Australia more oriented to community care. Japan is also more collectivist and Australia more individualist in values. These differences might influence recognition of disorders and beliefs about treatment in the two countries.
Surveys of the public were carried out in each country using as similar a methodology as feasible. In both countries, household interviews were carried out concerning beliefs in relation to one of four case vignettes, describing either depression, depression with suicidal thoughts, early schizophrenia or chronic schizophrenia. In Australia, the survey involved a national sample of 3998 adults aged 18 years or over. In Japan, the survey involved 2000 adults aged between 20 and 69 from 25 regional sites spread across the country.
The Japanese public were found to be more reluctant to use psychiatric labels, particularly for the depression cases. The Japanese were also more reluctant to discuss mental disorders with others outside the family. They had a strong belief in counsellors, but not in GPs. They generally believe in the benefits of treatment, but are not optimistic about full recovery. By contrast, Australians used psychiatric labels more often, particularly "depression". They were also more positive about the benefits of seeking professional help, but had a strong preference for lifestyle interventions and tended to be negative about some psychiatric medications. Australians were positive about both counsellors and GPs. Psychiatric hospitalization and ECT were seen negatively in both countries.
There are some major differences between Australia and Japan in recognition of disorders and beliefs about treatment. Some of these may relate to the different health care systems, but the increasing openness about mental health in Australia is also likely to be an explanatory factor.
一些国家的公众调查显示，人们对精神障碍的认知较差，且在治疗观念上往往与卫生专业人员存在分歧。这种心理健康素养的缺乏可能会限制治疗服务的最佳利用。澳大利亚和日本拥有截然不同的精神卫生保健系统，日本更强调住院治疗，而澳大利亚则更倾向于社区护理。在价值观方面，日本更具集体主义，而澳大利亚更具个人主义。这些差异可能会影响两国对精神障碍的认知和治疗观念。
在每个国家采用尽可能相似的方法对公众进行调查。在两国，均针对四个病例 vignette 之一进行了关于信念的家庭访谈，这些 vignette 描述了抑郁症、伴有自杀念头的抑郁症、早期精神分裂症或慢性精神分裂症。在澳大利亚，调查涉及全国范围内 3998 名 18 岁及以上成年人的样本。在日本，调查涉及来自全国 25 个地区的 2000 名年龄在 20 至 69 岁之间的成年人。
发现日本公众更不愿意使用精神科标签，尤其是在抑郁症病例方面。日本人也更不愿意与家庭以外的其他人讨论精神障碍。他们非常信任咨询师，但不信任全科医生。他们普遍相信治疗的益处，但对完全康复并不乐观。相比之下，澳大利亚人更频繁地使用精神科标签，尤其是“抑郁症”。他们也对寻求专业帮助的益处更为积极，但强烈偏好生活方式干预，并且往往对某些精神科药物持负面态度。澳大利亚人对咨询师和全科医生都持积极态度。在两国，精神科住院治疗和电休克疗法都被视为负面。
澳大利亚和日本在精神障碍认知和治疗观念方面存在一些重大差异。其中一些差异可能与不同的卫生保健系统有关，但澳大利亚在心理健康方面日益开放的态度也可能是一个解释因素。
