Park Se Jin, Jeon Hong Jin, Kim Ju Young, Kim Sohye, Roh Sungwon
Department of Mental Health Research, Seoul National Hospital, Seoul, 143-711, Korea.
Depression Center, Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 135-710, Korea.
BMC Health Serv Res. 2014 Dec 20;14:645. doi: 10.1186/s12913-014-0645-7.
The aims of this study were to determine the utilization of mental health services (MHSs) by adults with a depressive mood and to identify the influencing sociodemographic factors, using a nationwide representative Korean sample.
The study included 2735 subjects, aged 19 years or older, who had experienced a depressive mood continuously for over 2 weeks within the previous year, using the data from the KNHANES IV (Fourth Korea National Health and Nutrition Examination Survey), which was performed between 2007 and 2009, and involved a nationally representative sample of the Korean community population who were visited at home. A multivariate logistic regression analysis was used to estimate the adjusted odd ratios (ORs) and 95% confidence intervals (CIs) for the use of MHSs, which was defined as using healthcare institutions, consulting services, and inpatient or outpatient treatments due to mental health problems.
MHSs had been used by 9.6% of the subjects with a depressive mood. The use of the MHSs was significantly associated with age, education level, and employment status, after adjusting for sociodemographic and health-related factors. Specifically, the OR for the nonuse of MHSs by the elderly (≥65 years) relative to subjects aged 19-34 years was 2.55 (95% CI = 1.13-5.76), subjects with a lower education level were less likely to use MHSs compared to those with a higher education level (7-9 years, OR = 2.35, 95% CI = 1.19-4.64; 10-12 years, OR = 1.66, 95% CI = 1.07-2.56; ≥13 years, reference), and the OR of unemployed relative to employed was 0.47 (95% CI = 0.32-0.67).
Among Korean adults with a depressive mood, the elderly, those with a lower education level, and the employed are less likely to use MHSs. These findings suggest that mental health policies should be made based on the characteristics of the population in order to reduce untreated patients with depression. Greater resources and attention to identifying and treating depression in older, less educated, and employed adults are warranted.
本研究旨在利用具有全国代表性的韩国样本，确定有抑郁情绪的成年人对心理健康服务（MHSs）的利用情况，并识别社会人口统计学影响因素。
本研究纳入了2735名年龄在19岁及以上的受试者，这些受试者在前一年中连续2周以上经历过抑郁情绪，数据来自2007年至2009年进行的韩国第四次全国健康与营养检查调查（KNHANES IV），该调查涉及韩国社区人口中有全国代表性的样本，他们接受了上门访问。采用多因素logistic回归分析来估计使用MHSs的调整后比值比（ORs）和95%置信区间（CIs），MHSs的使用定义为因心理健康问题使用医疗机构、咨询服务以及住院或门诊治疗。
有抑郁情绪的受试者中9.6%使用过MHSs。在调整社会人口统计学和健康相关因素后，MHSs的使用与年龄、教育水平和就业状况显著相关。具体而言，65岁及以上老年人相对于19 - 34岁受试者未使用MHSs的OR为2.55（95% CI = 1.13 - 5.76），教育水平较低的受试者与教育水平较高的受试者相比使用MHSs的可能性较小（7 - 9年，OR = 2.35，95% CI = 1.19 - 4.64；10 - 12年，OR = 1.66，95% CI = 1.07 - 2.56；≥13年，为参照），失业者相对于就业者的OR为0.47（95% CI = 0.32 - 0.67）。
在有抑郁情绪的韩国成年人中，老年人、教育水平较低者以及就业者使用MHSs的可能性较小。这些发现表明，应根据人群特征制定心理健康政策，以减少抑郁症未治疗患者。有必要投入更多资源并给予更多关注，以识别和治疗老年、受教育程度较低以及就业的成年人中的抑郁症。
