Pahl Kerstin, Brook Judith S, Zhang Chenshu, Brook David W
Department of Psychiatry, New York University School of Medicine, 215 Lexington Avenue, 15th Floor, New York, NY, 10016, USA.
J Behav Health Serv Res. 2016 Apr;43(2):143-54. doi: 10.1007/s11414-014-9414-y.
This prospective study examined the longitudinal pathways to the utilization of mental health services among women in their mid-sixties. Earlier educational level, psychological symptoms, cigarette use, and physical diseases and later psychological symptoms were examined as predictors of mental health services utilization. The sample consisted of a prospective cohort of women (N = 511) who were followed from young adulthood (mean age = 32) to late midlife (mean age = 65). Using structural equation modeling, the results supported a mediational model showing that earlier low educational level and greater psychological symptoms predicted increased cigarette smoking. Cigarette smoking predicted later physical diseases and symptoms. Physical diseases and symptoms were related to financial difficulty and later psychological symptoms and, ultimately, the use of mental health services by women in the mid-sixties.
这项前瞻性研究考察了65岁左右女性使用心理健康服务的纵向路径。研究将早期教育水平、心理症状、吸烟情况、身体疾病以及后期心理症状作为心理健康服务利用情况的预测因素进行了考察。样本包括一组前瞻性队列女性（N = 511），她们从青年期（平均年龄 = 32岁）开始被跟踪至中年后期（平均年龄 = 65岁）。使用结构方程模型，研究结果支持了一个中介模型，该模型表明早期低教育水平和更严重的心理症状预示着吸烟量增加。吸烟预示着后期身体疾病和症状。身体疾病和症状与经济困难、后期心理症状相关，最终与65岁左右女性使用心理健康服务有关。
