Psychology Department, Institute of Psychiatry, King's College, London, UK.
Int J Soc Psychiatry. 2011 Jul;57(4):362-74. doi: 10.1177/0020764009357400. Epub 2010 Mar 2.
The detection of psychological problems of black African people has been found to be substantially lower, compared with white British and black Caribbean people. This may be due to differences in patients' perceptions of illness. Little research has been carried out on factors that may influence the help-seeking behaviour of black Africans.
To assess differences in the perceptions of depression of black African and white British women that may influence lower detection and to investigate whether there are ethnic group differences in reasons for not seeking formal help.
A short quantitative illness perception measure, the Brief Illness Perception Questionnaire (BIPQ), was used in a community survey, using a standard text vignette methodology to control for variations in previous experiences of depression. Responses from women who indicated that they would not seek formal help for depressive symptoms were qualitatively analyzed.
Differences in perceptions of depression were found between black African (n = 73) and white British groups (n = 72) on five of the nine BIPQ dimensions. Black women were more likely to perceive depression to have less serious consequences; to be associated with fewer symptoms; to be less chronic; to be less amenable to treatment; and more frequently attributed depression to social factors. Over half the participants (n = 74) said they would not seek formal help for depressive symptoms. Six qualitative response categories emerged to explain non-consultation. The most common factor for both groups related to GP consultation difficulties. Significantly more white women cited preferring alternative help sources as a reason for non-consultation. The greater number of black women citing anti-medication beliefs was marginally significant. There were no differences between the ethnic groups in their use of the remaining three categories: illness characteristics; service constraints; and stigma/shame.
Differing perceptions of depression among black and white women could help explain GPs' lower detection rates of depressive problems of black women. Differences in views about the formal help available may explain ethnic differences in help-seeking.
与白种英国人和黑加勒比人相比，黑非洲人的心理问题检测率明显较低。这可能是由于患者对疾病的认知不同所致。针对可能影响黑非洲人寻求帮助行为的因素的研究较少。
评估黑非洲人和白种英国女性对抑郁症的认知差异，这些差异可能会导致检测率降低，并调查是否存在因种族群体不同而导致寻求正规帮助的意愿不同。
采用简短的定量疾病认知测量工具——Brief Illness Perception Questionnaire（BIPQ），在社区调查中使用标准文本案例方法，以控制抑郁既往经历的差异。对表示不会因抑郁症状寻求正规帮助的女性的回答进行定性分析。
在 BIPQ 的九个维度中，黑非洲组（n = 73）和白种英国组（n = 72）在五个维度上对抑郁的认知存在差异。黑人女性更倾向于认为抑郁的后果不那么严重；与较少的症状相关；更具慢性；更难治疗；更频繁地将抑郁归因于社会因素。超过一半的参与者（n = 74）表示不会因抑郁症状寻求正规帮助。出现了六个定性反应类别来解释不咨询的原因。两个组最常见的因素都与全科医生咨询困难有关。选择替代帮助来源作为不咨询的原因，在白种女性中更为常见。黑种女性中提到更多的抗药物信念的比例略高。在使用剩余的三个类别：疾病特征、服务限制和耻辱/羞耻方面，两组之间没有差异。
黑人和白人女性对抑郁症的不同认知可以帮助解释全科医生对黑人女性抑郁问题检测率较低的原因。对可用正规帮助的看法不同可能解释了寻求帮助的种族差异。
