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美籍拉丁裔和亚裔人群中身体症状与心理健康服务需求和使用的关联。

Associations of physical symptoms with perceived need for and use of mental health services among Latino and Asian Americans.

机构信息

Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.

出版信息

Soc Sci Med. 2012 Sep;75(6):1128-33. doi: 10.1016/j.socscimed.2012.05.004. Epub 2012 May 26.

Abstract

Although many believe that low rates of perceived mental health need and service use among racial/ethnic minorities are due, in part, to somatization, data supporting this notion are lacking. This study examined two hypotheses: (1) increased physical symptoms are associated with lower perceived need for mental health services and actual service use; and (2) physical symptoms are most strongly associated with perceived mental health need and service use among first-generation individuals. Data come from the National Latino and Asian-American Study, a nationally-representative household survey in the United States conducted from 2002 to 2003. Participants reported on the presence of fourteen physical symptoms within the past year. Perceived mental health need was present for individuals who endorsed having an emotional or substance use problem or thinking they needed treatment for such a problem within the past year. After adjusting for sociodemographic and clinical covariates, the number of physical symptoms was positively associated with perceived mental health need and service, an effect that differed by generation. Among first-generation individuals, physical symptoms were associated with increased perceived need and service use. Physical symptoms were not significantly associated with perceived need or service use among third-generation Latinos, but were associated with service use among third-generation Asian-Americans. Physical symptoms do not appear to interfere with mental health problem recognition or service use. In contrast, individuals, especially of the first-generation, with more physical symptoms were more likely to perceive need for and utilize mental health services. Our findings do not support the notion that physical symptoms account for low rates of perceived mental health need and service use among Latino and Asian-Americans.

摘要

尽管许多人认为,少数族裔的心理健康需求和服务利用率低部分归因于躯体化,但缺乏支持这一观点的数据。本研究检验了两个假设:(1)身体症状增加与心理健康服务需求和实际服务利用率降低有关;(2)躯体症状与第一代个体的心理健康需求和服务利用率最相关。本研究的数据来自于全国拉丁裔和亚裔美国人研究,这是一项 2002 年至 2003 年在美国进行的全国代表性家庭调查。参与者报告了过去一年中存在的 14 种身体症状。有心理健康需求的个体是指过去一年中曾有情绪或物质使用问题,或认为自己需要治疗此类问题的个体。在调整了社会人口统计学和临床协变量后,身体症状的数量与心理健康需求和服务的感知呈正相关,这种影响因代际而异。在第一代个体中,身体症状与增加的感知需求和服务利用有关。在第三代拉丁裔中,身体症状与感知需求或服务利用均无显著相关性,但与第三代亚裔美国人的服务利用有关。身体症状似乎并不干扰对心理健康问题的认识或服务利用。相比之下,身体症状较多的个体,特别是第一代个体,更有可能感知到对心理健康服务的需求并利用这些服务。我们的研究结果并不支持这样一种观点,即躯体症状可以解释拉丁裔和亚裔美国人的心理健康需求和服务利用率低的原因。

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