Fleury Marie-Josée, Ngui André Ngamini, Bamvita Jean-Marie, Grenier Guy, Caron Jean
Department of Psychiatry, McGill University, Montreal, QC H3A 0G4, Canada.
Montreal Addiction Rehabilitation Centre-University Institute (CRDM-IU), Montreal, QC H2M 2E8, Canada.
Int J Environ Res Public Health. 2014 Oct 15;11(10):10559-86. doi: 10.3390/ijerph111010559.
This study was designed to identify: (1) predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2) correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior) and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care.
(1)在一个流行病学集水区的人群队列中,以安德森模型为框架,因心理健康原因导致的12个月医疗服务利用的预测因素;以及(2)分别在患有和未患有精神障碍的个体中,与因心理健康原因导致的医疗服务利用相关的因素。分析包括单变量、双变量和多元回归分析。男性、生活质量差、对身体健康有较好的自我认知、患有重度抑郁发作、惊恐障碍、社交恐惧症和情绪问题可预测因心理健康原因导致的医疗服务利用。在患有精神障碍的个体中,需求因素(心理困扰、冲动性、情绪问题、暴力受害者和攻击行为)以及就医情况与因心理健康原因导致的医疗服务利用相关。在未患有精神障碍的个体中,因心理健康原因导致的医疗服务利用与社会支持、收入、环境变量和对邻里的自我认知等促成因素密切相关。在邻里环境中促进社会凝聚力和社会团结的干预措施可能会减少未患有精神障碍的个体寻求帮助的需求。此外,作为一线专业人员,全科医生在日常初级保健中预防、发现和治疗精神障碍时应更加敏感。