Seedat Soraya, Stein D J, Herman A, Kessler R, Sonnega J, Heeringa S, Williams S, Williams D
MRC Unit on Anxiety Disorders, University of Stellenbosch, PO Box 19063, Tygerberg, 7505, Cape Town, South Africa.
Soc Psychiatry Psychiatr Epidemiol. 2008 Nov;43(11):889-97. doi: 10.1007/s00127-008-0399-9. Epub 2008 Aug 2.
The proportion of people with mental disorders in treatment is relatively small in low and middle income countries. However, little is known about patterns of recent service use in a country like South Africa.
A nationally representative household survey of 4,351 adult South Africans was carried out. Twelve-month DSM-IV disorders were determined using the WHO composite international diagnostic interview (CIDI). Prevalence and correlates of treatment were assessed among respondents with anxiety, mood and substance use disorders.
One-fourth (25.5%) of respondents with a 12-month disorder had received treatment in the past 12 months either from a psychiatrist (3.8%), nonpsychiatrist mental health specialist (2.9%), general medical provider (16.6%), human services provider (6.6%), or complementary-alternative medical (CAM) provider (5.9%). Only 27.6% of severe cases had received any treatment. In addition, 13.4% of respondents with no disorder had accessed services in the past year. Blacks were significantly more likely than other racial groups to access the CAM sector while Whites were more likely to have seen a psychiatrist.
The majority of South Africans with a 12-month mental disorder have unmet treatment needs. In addition to a greater allocation of resources to mental health services, more community outreach and awareness initiatives are needed.
在低收入和中等收入国家，接受治疗的精神障碍患者比例相对较小。然而，对于南非这样一个国家近期的服务使用模式却知之甚少。
对4351名成年南非人进行了一项具有全国代表性的家庭调查。使用世界卫生组织综合国际诊断访谈（CIDI）确定过去12个月内的DSM-IV障碍。在患有焦虑、情绪和物质使用障碍的受访者中评估治疗的患病率及相关因素。
在过去12个月内患有某种障碍的受访者中，四分之一（25.5%）在过去12个月内接受过治疗，治疗提供者包括精神科医生（3.8%）、非精神科心理健康专家（2.9%）、普通医疗服务提供者（16.6%）、人类服务提供者（6.6%）或补充替代医学（CAM）提供者（5.9%）。只有27.6%的重症患者接受过任何治疗。此外，在过去一年中，13.4%没有障碍的受访者也使用过服务。黑人比其他种族群体更有可能使用补充替代医学领域的服务，而白人则更有可能看过精神科医生。
大多数患有12个月精神障碍的南非人有未得到满足的治疗需求。除了增加对心理健康服务的资源分配外，还需要更多的社区外展和提高认识的举措。
