Park Jee Eun, Cho Seong-Jin, Lee Jun-Young, Sohn Jee Hoon, Seong Su Jeong, Suk Hye Won, Cho Maeng Je
Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine and Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.
Soc Psychiatry Psychiatr Epidemiol. 2015 May;50(5):757-66. doi: 10.1007/s00127-014-0991-0. Epub 2014 Dec 10.
This study compared the factors associated with the utilization of mental health services across various age cohorts, with a particular focus on the differential influence of the stigma placed on mental illness on the use of these services.
The present study used data from a Korean national epidemiological survey of mental disorders among community-dwelling adults aged 18-74 years (n = 3,055). The subjects were categorized into three age groups: young (18-39), middle-aged (40-59), and late adulthood (60-74). The Perceived Devaluation-Discrimination scale was used to assess the stigma placed on mental disorders in each group. The influence of perceived stigma on lifetime utilization of mental health services was examined according to age cohort using multiple logistic regression analyses that were adjusted for various sociodemographic factors (p < 0.006 with a Bonferroni correction).
The late-adulthood cohort was more likely to have perceived stigma of mental illness than were the other two groups, and the utilization of mental health services by the elderly cohort was more strongly affected by this perceived stigma than was such utilization by younger cohorts [adjusted odds ratio (AOR) 4.14, 95 % confidence interval (CI) 1.86-9.22]. In the middle-aged cohort, being female or never being married was a significant determinant of use of mental health services (female, AOR 3.80, 95 % CI 2.17-6.65; unmarried, AOR 3.09, 95 % CI 1.43-6.70).
It is important to reduce the perceived stigma placed on mental illness to improve access to mental health care among the current population of elderly people in Korea.
本研究比较了不同年龄组中与心理健康服务利用相关的因素,特别关注对精神疾病的污名化对这些服务使用的差异影响。
本研究使用了来自韩国一项针对18 - 74岁社区居住成年人的全国精神障碍流行病学调查的数据(n = 3,055)。受试者被分为三个年龄组:青年组(18 - 39岁)、中年组(40 - 59岁)和老年组(60 - 74岁)。使用感知贬值 - 歧视量表来评估每组中对精神障碍的污名化程度。根据年龄组,采用多元逻辑回归分析来检验感知污名对心理健康服务终身利用率的影响,并对各种社会人口学因素进行了调整(经Bonferroni校正,p < 0.006)。
老年组比其他两组更有可能感知到精神疾病的污名,并且老年组对心理健康服务的利用比年轻组更受这种感知污名的强烈影响[调整后的优势比(AOR)为4.14,95%置信区间(CI)为1.86 - 9.22]。在中年组中,女性或从未结婚是使用心理健康服务的重要决定因素(女性,AOR为3.80,95% CI为2.17 - 6.65;未婚,AOR为3.09,95% CI为1.43 - 6.70)。
减少对精神疾病的感知污名对于改善韩国当前老年人群获得心理健康护理的机会很重要。