New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York, NY 10032
J Clin Psychiatry. 2013 Nov;74(11):1093-100. doi: 10.4088/JCP.13m08361.
Despite the high prevalence of anxiety disorders and the demonstrated efficacy of their treatment, most individuals with anxiety disorders never utilize mental health services.
To identify predictors of treatment-seeking for DSM-IV anxiety disorders from a range of sociodemographic factors and comorbid mental disorders.
Survival analysis with time-varying covariates was performed using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).
Face-to-face interviews conducted in the United States.
34,653 respondents, aged 18 years and older, from the 2004-2005 Wave 2 NESARC.
The cumulative probability of treatment-seeking (assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version, Wave 2 version) across the anxiety disorders in 1 year, 10 years, and lifetime and the median delay to the first treatment contact.
Most individuals with panic disorder sought treatment within the same year of disorder onset, whereas the median delays to first treatment contact for generalized anxiety disorder, specific phobia, and social anxiety disorder were 1 year, 13 years, and 16 years, respectively. Several personality disorders and earlier age at anxiety disorder onset decreased the probability of treatment contact. By contrast, younger cohort membership, a recent change in marital status, treatment for a psychiatric disorder other than substance use disorder, and comorbid anxiety disorders increased the lifetime probability of treatment contact.
Treatment-seeking rates for most anxiety disorders are low, are associated with long delays, and sometimes are hindered by co-occurrence of other psychopathology. These patterns highlight the complex interplay of personal characteristics, individual psychopathology, and social variables in the treatment-seeking process.
尽管焦虑障碍的患病率很高，且其治疗效果已得到证实，但大多数焦虑障碍患者从未使用过心理健康服务。
从一系列社会人口学因素和共病精神障碍中确定寻求 DSM-IV 焦虑障碍治疗的预测因素。
使用来自国家酒精和相关条件流行病学调查（NESARC）的 2004-2005 年第 2 波数据进行生存分析，其中包含时变协变量。
在美国进行的面对面访谈。
来自 2004-2005 年第 2 波 NESARC 的 34653 名年龄在 18 岁及以上的应答者。
在 1 年、10 年和终生，焦虑障碍治疗寻求（通过酒精使用障碍和相关障碍访谈时间表-DSM-IV 版本，第 2 波版本评估）的累积概率，以及首次治疗接触的中位数延迟。
大多数惊恐障碍患者在发病后同一年内寻求治疗，而广泛性焦虑障碍、特定恐惧症和社交焦虑障碍首次治疗接触的中位数延迟分别为 1 年、13 年和 16 年。一些人格障碍和焦虑障碍发病年龄较早会降低治疗接触的可能性。相比之下，较年轻的队列成员、最近婚姻状况的变化、除物质使用障碍以外的精神障碍治疗和共病焦虑障碍增加了终生治疗接触的可能性。
大多数焦虑障碍的治疗寻求率较低，与较长的延迟有关，并且有时会受到共病其他精神病理学的阻碍。这些模式突出了个人特征、个体精神病理学和社会变量在治疗寻求过程中的复杂相互作用。
