Department of Family Medicine, McMaster University, Hamilton, Ontario.
Can J Psychiatry. 2010 Mar;55(3):157-64. doi: 10.1177/070674371005500307.
To estimate the proportion of older adults who have used mental health services in the past 12 months among those who meet the criteria for one or more Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, 12-month psychiatric disorders. We also examine the factors associated with mental health care use in this population.
We used secondary data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). We first estimated the proportion of adults aged 55 years and older who used a range of mental health services. Next, using logistic regression, we examined the relative contribution of predisposing, enabling, and need characteristics in predicting any service use in this population.
Among the 12 792 adults aged 55 years and older in the CCHS 1.2, 513 (4.23%, 95% CI 3.89% to 4.95%) met the criteria for at least one 12-month DSM-IV disorder. Among these respondents, 37% (95% CI 31% to 43%) saw at least one type of mental health care provider in the past 12 months. Visits to a general health care provider for mental health reasons were most common, followed by specialist care. Only psychological distress was significantly and positively associated with using mental health care services.
Over 60% of the older adults who met the criteria for a DSM-IV disorder were not using mental health care services. Social and demographic factors did not predict service use in this population.
评估在过去 12 个月内符合《精神障碍诊断与统计手册》(DSM-IV)12 个月精神障碍标准的患者中,有多少人使用过心理健康服务。我们还研究了该人群中与心理健康护理使用相关的因素。
我们使用了加拿大社区健康调查:心理健康和幸福感(CCHS 1.2)的二级数据。我们首先估计了 55 岁及以上成年人使用一系列心理健康服务的比例。接下来,使用逻辑回归,我们研究了倾向因素、促成因素和需要特征在预测该人群中任何服务使用方面的相对贡献。
在 CCHS 1.2 中,12792 名 55 岁及以上的成年人中,有 513 人(4.23%,95%CI 3.89%至 4.95%)符合至少一种 12 个月 DSM-IV 障碍标准。在这些受访者中,37%(95%CI 31%至 43%)在过去 12 个月内至少看过一次心理健康护理提供者。因心理健康原因看全科医生的次数最为常见,其次是专科医生。只有心理困扰与使用心理健康护理服务显著正相关。
超过 60%符合 DSM-IV 障碍标准的老年人没有使用心理健康护理服务。社会人口因素并不能预测该人群的服务使用情况。