Mojtabai Ramin
Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Psychiatr Serv. 2009 Mar;60(3):297-305. doi: 10.1176/ps.2009.60.3.297.
This study examined the extent and correlates of perceived unmet need for treatment among individuals with depression in the U.S. general population.
Analyses were based on a representative sample of 6,510 adult participants in the 2005 and 2006 National Surveys on Drug Use and Health who reported a major depressive episode in the past 12 months.
A total of 3,568 (62.4%) participants had sought mental health treatment in the past 12 months, and 2,942 (37.6%) had not; 34.9% and 26.8% of these groups, respectively, reported unmet need for treatment. In both groups, older age was associated with a lower likelihood of reporting unmet need for treatment, whereas greater distress and impairment and higher education were associated with a greater likelihood of reporting unmet need. Among treatment seekers, treatment from general medical providers was associated with greater likelihood of unmet need, and more outpatient visits and insurance coverage for the full year were associated with a lower likelihood of unmet need. The most common reason for not seeking needed treatment was a concern about costs (cited as a reason by 46.0% of the total sample).
Even though rates of treatment seeking have increased, many persons with major depression continue to experience unmet need for treatment, which in this study was mainly attributable to concerns about treatment costs.
本研究调查了美国普通人群中抑郁症患者感知到的未满足治疗需求的程度及其相关因素。
分析基于2005年和2006年全国药物使用和健康调查中的6510名成年参与者的代表性样本，这些参与者报告在过去12个月中有过一次重度抑郁发作。
在过去12个月中，共有3568名（62.4%）参与者寻求过心理健康治疗，2942名（37.6%）未寻求过；这些组中分别有34.9%和26.8%的人报告有未满足的治疗需求。在两组中，年龄较大与报告未满足治疗需求的可能性较低相关，而更大的痛苦和功能损害以及更高的教育程度与报告未满足需求的可能性更大相关。在寻求治疗者中，从普通医疗提供者处接受治疗与未满足需求的可能性更大相关，而更多的门诊就诊次数和全年的保险覆盖与未满足需求的可能性较低相关。不寻求所需治疗的最常见原因是担心费用（占总样本的46.0%提及）。
尽管寻求治疗的比例有所增加，但许多重度抑郁症患者仍存在未满足的治疗需求，在本研究中，这主要归因于对治疗费用的担忧。
