Dahlberg Karin M, Waern Margda, Runeson Bo
Department of Clinical Neuroscience, Section for Psychiatry St, Göran, Karolinska Institute, Stockholm, Sweden.
BMC Public Health. 2008 Jan 9;8:8. doi: 10.1186/1471-2458-8-8.
Mental ill health is a common condition in the general population, yet only about half of those with a mental disorder have treatment contact. Personal experience may affect attitudes, which in turn influence the help-seeking process. This study investigated differences in mental health literacy and attitudes among mentally healthy persons and in persons with symptoms of mental illness with and without treatment contact.
A postal screening questionnaire was sent to a random sample of the general population aged 20-64 in the county of Skaraborg, Sweden in order to ascertain mental health status and history of treatment contact; 3538 responded (49%). Face-to-face interviews were carried out in random sub samples of mentally healthy persons (n = 128) and in mentally ill persons with (n = 125) and without (n = 105) mental health care contact. Mental health literacy and attitudes to treatment were assessed using questions based on a vignette depicting a person with depression. Past month mental disorder was diagnosed according to the Schedule for Clinical Assessment in Neuropsychiatry (SCAN).
Two thirds failed to recognize depression in a vignette; recognition was equally poor in mentally healthy persons and in persons with symptoms of mental illness with and without treatment contact. In response to an open-ended question concerning appropriate interventions, one third suggested counselling and only one percent proposed antidepressant treatment. Again, proportions were similar in all groups. Persons with a history of mental health contact more often suggested that a GP would provide the best form of help. When presented with a list of possible interventions, those with a history of mental health contact were more positive to medical interventions such as antidepressants, hypnotics, and inpatient psychiatric treatment. When asked about the prognosis for the condition described in the vignette, persons with treatment contact were less likely to believe in full recovery without intervention; mentally ill without treatment contact were more optimistic.
Mental health literacy, specially concerning attitudes towards interventions is associated with personal history of mental health care.
精神疾病在普通人群中很常见，但只有约一半的精神障碍患者接受治疗。个人经历可能会影响态度，进而影响求助过程。本研究调查了心理健康人群以及有和没有治疗经历的精神疾病症状患者在心理健康素养和态度方面的差异。
向瑞典斯卡纳堡县20 - 64岁的普通人群随机样本发送邮寄筛查问卷，以确定心理健康状况和治疗接触史；3538人回复（49%）。对心理健康人群（n = 128）以及有（n = 125）和没有（n = 105）精神卫生保健接触的精神疾病患者的随机子样本进行面对面访谈。使用基于描述抑郁症患者的 vignette 的问题评估心理健康素养和对治疗的态度。根据神经精神病学临床评估量表（SCAN）诊断过去一个月的精神障碍。
三分之二的人在 vignette 中未能识别出抑郁症；在心理健康人群以及有和没有治疗接触的精神疾病症状患者中，识别能力同样较差。对于一个关于适当干预措施的开放式问题，三分之一的人建议咨询，只有1%的人提议使用抗抑郁药治疗。同样，所有组的比例相似。有精神卫生接触史的人更常认为全科医生会提供最好的帮助形式。当列出一系列可能的干预措施时，有精神卫生接触史的人对抗抑郁药、催眠药和住院精神科治疗等医学干预措施更为积极。当被问及 vignette 中描述的病情的预后时，有治疗接触的人不太相信在不干预的情况下能完全康复；没有治疗接触的精神疾病患者则更为乐观。
心理健康素养，特别是关于对干预措施的态度，与精神卫生保健的个人史有关。
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