Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
Psychol Med. 2013 Oct;43(10):2203-13. doi: 10.1017/S0033291713000135. Epub 2013 Feb 7.
Detailed population-based survey information on the relationship between the severity of common mental disorders (CMDs) and treatment for mental health problems is heavily based on North American research. The aim of this study was to replicate and expand existing knowledge by studying CMD severity and its association with treatment contact and treatment intensity in The Netherlands.
Data were obtained from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative face-to-face survey of the general population aged 18–64 years (n=6646, response rate=65.1%). DSM-IV diagnoses and disorder severity were assessed with the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0). Treatment contact refers to at least one contact for mental health problems made in the general medical care (GMC) or mental health care (MHC) sector. Four levels of treatment intensity were assessed, based on type and duration of therapy received.
Although CMD severity was related to treatment contact, only 39.0% of severe cases received MHC. At the same time, 40.3% of MHC users did not have a 12-month disorder. Increasing levels of treatment intensity ranged from 51.6% to 13.0% in GMC and from 81.4% to 51.1% in MHC. CMD severity was related to treatment intensity in MHC but not in GMC. Sociodemographic characteristics were not significantly related to having experienced the highest level of treatment intensity in MHC. CONCLUSIONS. Mental health treatment in the GMC sector should be improved, especially when policy is aimed at increasing the role of primary care in the management of mental health problems.
基于人群的常见精神障碍（CMD）严重程度与心理健康问题治疗关系的详细调查信息主要基于北美研究。本研究旨在通过研究荷兰 CMD 严重程度及其与治疗接触和治疗强度的关系来复制和扩展现有知识。
数据来自荷兰精神健康调查和发病率研究-2（NEMESIS-2），这是一项针对 18-64 岁普通人群的全国代表性面对面调查（n=6646，应答率=65.1%）。DSM-IV 诊断和疾病严重程度采用复合国际诊断访谈第 3.0 版（CIDI 3.0）进行评估。治疗接触是指在一般医疗保健（GMC）或精神卫生保健（MHC）部门至少因心理健康问题接受一次治疗。根据接受的治疗类型和持续时间，评估了四个级别的治疗强度。
尽管 CMD 严重程度与治疗接触有关，但只有 39.0%的严重病例接受 MHC。与此同时，40.3%的 MHC 使用者没有 12 个月的疾病。在 GMC 中，治疗强度从 51.6%到 13.0%不等，在 MHC 中从 81.4%到 51.1%不等。MHC 中的 CMD 严重程度与治疗强度有关，但在 GMC 中没有。社会人口统计学特征与 MHC 中经历最高治疗强度没有显著关系。结论。应改善 GMC 部门的精神卫生治疗，特别是当政策旨在增加初级保健在管理心理健康问题中的作用时。
