Mojtabai Ramin, Olfson Mark
Beth Israel Medical Center, New York, New York 10003, USA.
Psychiatr Serv. 2006 May;57(5):631-9. doi: 10.1176/ps.2006.57.5.631.
Cross-country comparisons of patterns of mental health treatment seeking provide insights into the impact of contextual factors on mental health service use. This study aimed to compare prevalence and predictors of mental health treatment seeking among adults with major depression in Canada and the United States.
Data for 751 participants with a probable major depressive episode in the past 12 months were drawn from the 2002-2003 Joint Canada/United States Survey of Health: 304 were from Canada and 447 were from the United States. Probable major depressive episodes were ascertained by the Composite International Diagnostic Interview-Short-Form. Patterns of contacts with mental health and general health providers for mental health reasons were compared.
Prevalence of contacts with any provider for mental health problems was similar among participants with a probable major depressive episode in Canada and the United States (181 Canadians, or 56 percent, compared with 245 Americans, or 52 percent). Canadian participants were more likely than those in the United States to seek treatment for mental health problems from family doctors and general practitioners, and among participants who sought such treatment, Canadians were more likely to also seek treatment from mental health professionals. In both countries, racial or ethnic minorities were less likely than Caucasians to seek treatment. Depression severity was more closely associated with treatment seeking in Canada than in the United States.
Although studies from the early 1990s showed higher rates of treatment seeking for depression in Canada than in the United States, the more recent data presented here do not show such a gap. However, differences persist in the use of various providers. Compared with the United States, Canada had a closer match between depression severity and treatment, which suggests more efficient allocation of mental health care resources for treatment of depression in Canada.
对寻求心理健康治疗模式进行跨国比较，有助于深入了解背景因素对心理健康服务利用的影响。本研究旨在比较加拿大和美国成年重度抑郁症患者寻求心理健康治疗的患病率及预测因素。
选取2002 - 2003年加拿大/美国联合健康调查中751名在过去12个月可能患有重度抑郁发作的参与者的数据：304名来自加拿大，447名来自美国。通过综合国际诊断访谈简表确定可能的重度抑郁发作。比较了因心理健康问题与心理健康提供者和普通健康提供者的接触模式。
在加拿大和美国可能患有重度抑郁发作的参与者中，因心理健康问题与任何提供者接触的患病率相似（181名加拿大人，即56%，相比245名美国人，即52%）。加拿大参与者比美国参与者更有可能从家庭医生和全科医生处寻求心理健康问题的治疗，并且在寻求此类治疗的参与者中，加拿大人也更有可能同时从心理健康专业人员处寻求治疗。在两国，少数族裔比白种人寻求治疗的可能性更小。在加拿大，抑郁严重程度与寻求治疗的关联比在美国更为紧密。
尽管20世纪90年代初的研究表明加拿大抑郁症的治疗寻求率高于美国，但此处呈现的最新数据并未显示出这种差距。然而，在各类提供者的使用方面仍存在差异。与美国相比，加拿大在抑郁严重程度与治疗之间的匹配度更高，这表明加拿大在抑郁症治疗的心理健康护理资源分配方面更为高效。
