School of Psychology, The University of Sydney, Brennan MacCallum Building (A18), Camperdown, NSW, 2006, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2012 Sep;47(9):1475-87. doi: 10.1007/s00127-011-0453-x. Epub 2011 Nov 25.
Epidemiological research has revealed that the utilisation of professional mental health services is low among rural Australians, despite a similar prevalence of mental illness to urban communities. However, the extent of this unmet need and the length of delay to first seek treatment in rural communities remain unclear. The aim of this study was to investigate the delay among rural Australians in seeking treatment for anxiety and depressive disorders.
A total of 124 participants with an anxiety or depressive disorder according to the Composite International Diagnostic Interview (CIDI) who were participants of the Australian Rural Mental Health Study (ARMHS) were included in this study. Multivariate methods examined the contribution of clinical (onset age, disorder type and comorbidity), attitudinal/demographic (perceived stigma and current age) and structural (rurality) variables to the delay to first seek help.
The average length of the delay was 18.7 years across disorders (range 0-67). The shortest delays were in depressive disorders (10.41 years) and the longest for social phobia (28.02 years). Multivariate analysis indicated that younger onset age, older current age, diagnosis of panic disorder or depressive disorder, and living in a remote (R) or very remote area (VR) were associated with delays of more than one year.
Delays to first seek treatment for anxiety and depressive disorders appear to be far more prolonged in rural compared to urban Australia. This is particularly the case for Australian residents living in R and VR areas. This is of particular concern due to the significant mental health needs of rural Australians.
流行病学研究表明,尽管农村地区澳大利亚人的精神疾病患病率与城市社区相似,但他们对专业心理健康服务的利用程度较低。然而,农村社区这种未满足的需求的程度和首次寻求治疗的延迟时间仍不清楚。本研究旨在调查澳大利亚农村地区寻求焦虑和抑郁障碍治疗的延迟情况。
本研究共纳入了 124 名根据复合国际诊断访谈(CIDI)被诊断为焦虑或抑郁障碍的参与者,他们是澳大利亚农村心理健康研究(ARMHS)的参与者。多变量方法检查了临床(发病年龄、疾病类型和共病)、态度/人口统计学(感知耻辱和当前年龄)和结构(农村)变量对首次寻求帮助的延迟的贡献。
各种障碍的平均延迟时间为 18.7 年(范围为 0-67 年)。抑郁障碍的延迟时间最短(10.41 年),社交恐惧症的延迟时间最长(28.02 年)。多变量分析表明,发病年龄较小、当前年龄较大、诊断为惊恐障碍或抑郁障碍以及居住在偏远(R)或非常偏远地区(VR)与超过一年的延迟有关。
与城市澳大利亚相比,农村地区首次寻求焦虑和抑郁障碍治疗的延迟时间似乎要长得多。对于居住在 R 和 VR 地区的澳大利亚居民来说,情况尤其如此。这令人担忧,因为澳大利亚农村地区有大量的心理健康需求。