Department of Psychology, University of Quebec in Montreal, Montréal, QC, Canada.
Psychiatr Q. 2010 Jun;81(2):127-38. doi: 10.1007/s11126-010-9123-5.
The objectives of this study were to evaluate perceived unmet need for mental healthcare, determinants of unmet need, and barriers to care in individuals with social anxiety (SA) or panic disorder with agoraphobia (PDA) in Quebec. Data from 206 participants diagnosed with SA or PDA were collected using an online questionnaire. Correlational analyses and binary stepwise logistic regressions were conducted to explore determinants of perceived unmet need. Of the 206 participants, 144 (69.9%) reported instances of unmet need for treatment. Perceived unmet need was correlated with variables related to the severity of the disorder, such as comorbid depression, avoidance, duration of worry, interference with functioning, and time lapsed between the appearance of first symptoms and first consultation. Depression and avoidance emerged as predictors for perceived unmet need in the regression analysis. The most common barriers to treatment reported were concern about the cost of services (63.9%), not knowing where to go to get help (63.2%), lack of health insurance coverage (52.4%), and appointment wait times (52.1%). The results of this study demonstrate the need to overcome barriers to treatment engendered by avoidance behaviors associated with anxiety. Potential methods for achieving this objective include Internet outreach, support groups, and increased accessibility to public services.
本研究旨在评估魁北克地区社交焦虑症（SA）或广场恐惧症伴惊恐障碍（PDA）患者的精神卫生保健需求未满足程度、未满足需求的决定因素和护理障碍。使用在线问卷收集了 206 名确诊为 SA 或 PDA 的患者的数据。通过相关分析和二元逐步逻辑回归探讨了未满足需求的决定因素。在 206 名参与者中，有 144 名（69.9%）报告存在治疗需求未满足的情况。感知到的未满足需求与与疾病严重程度相关的变量有关，例如共病抑郁、回避、担忧持续时间、功能障碍和首次出现症状与首次咨询之间的时间间隔。抑郁和回避在回归分析中是未满足需求的预测因素。报告的最常见治疗障碍是对服务费用的担忧（63.9%）、不知道去哪里寻求帮助（63.2%）、缺乏健康保险（52.4%）和预约等待时间（52.1%）。本研究结果表明，需要克服与焦虑相关的回避行为引起的治疗障碍。实现这一目标的潜在方法包括互联网宣传、支持小组和增加公共服务的可及性。
