Ponizovsky Alexander M, Geraisy Nabil, Shoshan Efrat, Kremer Ilana, Smetannikov Emma
Mental Health Services, Ministry of Health, Jerusalem, Israel.
Isr J Psychiatry Relat Sci. 2007;44(3):234-43.
The early recognition and timely treatment of psychiatric disorders helps reduce suffering, prevents mental disabilities and makes interventions more cost-effective.
To examine treatment lag among Arab- and Jewish-Israelis applying to psychiatric clinics for the first time, and the association of this lag with selected socio-demographic and mental health-related variables.
251 adult outpatients making their first-ever visit to a psychiatric clinic completed a self-administered questionnaire, including questions on the time elapsed since the onset of the current disorder, reasons for the treatment lag, source of referral, main complaints, current psychiatric problems (self-diagnosis), attitudes to psychiatric disorders and treatment, pathways to care, and standard sociodemographic information. Univariate and multivariate analyses were performed to compare Arab- and Jewish-Israelis on parameters of interest.
Compared with their Jewish counterparts, Arab-Israeli patients showed a two-fold delay in initial treatment contact (X2 = 4.00, df = 1, p < 0.05). Logistic regression analysis showed that this delay was associated with lower schooling, other-than-psychiatric attribution of mental symptoms, and a more pessimistic attitude to the successful treatment of mental disorders in general and for oneself in particular.
Since longer treatment delay was mostly associated with potentially modifiable knowledge and attitudes on mental disorders and treatment, educational programs targeting specific community sectors and community agents should be promoted to shorten this lag.
精神疾病的早期识别和及时治疗有助于减轻痛苦、预防精神残疾并使干预措施更具成本效益。
研究首次前往精神科诊所就诊的阿拉伯裔和犹太裔以色列人的治疗延迟情况，以及这种延迟与选定的社会人口统计学和心理健康相关变量之间的关联。
251名首次前往精神科诊所就诊的成年门诊患者完成了一份自填式问卷，其中包括关于当前疾病发作以来所经过的时间、治疗延迟的原因、转诊来源、主要症状、当前精神问题（自我诊断）、对精神疾病和治疗的态度、就医途径以及标准社会人口统计学信息的问题。对感兴趣的参数进行单变量和多变量分析，以比较阿拉伯裔和犹太裔以色列人。
与犹太裔患者相比，阿拉伯裔以色列患者在首次治疗接触方面延迟了两倍（X2 = 4.00，自由度 = 1，p < 0.05）。逻辑回归分析表明，这种延迟与受教育程度较低、对精神症状的非精神科归因以及对一般精神疾病尤其是自身精神疾病成功治疗的更悲观态度有关。
由于较长的治疗延迟大多与对精神疾病和治疗的潜在可改变的知识和态度有关，应推广针对特定社区部门和社区机构的教育项目，以缩短这种延迟。
