Younes Nadia, Chollet Aude, Menard Estelle, Melchior Maria
Centre Hospitalier de Versailles, Le Chesnay, France.
J Med Internet Res. 2015 May 15;17(5):e123. doi: 10.2196/jmir.4254.
The Internet is widely used by young people and could serve to improve insufficient access to mental health care. Previous information on this topic comes from selected samples (students or self-selected individuals) and is incomplete.
In a community sample of young adults, we aimed to describe frequency of e-mental health care study-associated factors and to determine if e-mental health care was associated with the use of conventional services for mental health care.
Using data from the 2011 wave of the TEMPO cohort study of French young adults (N=1214, aged 18-37 years), we examined e-mental health care and associated factors following Andersen's behavioral model: predisposing factors (age, sex, educational attainment, professional activity, living with a partner, children, childhood negative events, chronic somatic disease, parental history of depression), enabling factors (social support, financial difficulties, parents' income), and needs-related factors (lifetime major depression or anxiety disorders, suicidal ideation, ADHD, cannabis use). We compared traditional service use (seeking help from a general practitioner, a psychiatrist, a psychologist; antidepressant or anxiolytics/hypnotics use) between participants who used e-mental health care versus those who did not.
Overall, 8.65% (105/1214) of participants reported seeking e-mental health care in case of psychological difficulties in the preceding 12 months and 15.7% (104/664) reported psychological difficulties. Controlling for all covariates, the likelihood of e-mental health care was positively associated with 2 needs-related factors, lifetime major depression or anxiety disorder (OR 2.36, 95% CI 1.36-4.09) and lifetime suicidal ideation (OR 1.91, 95% CI 1.40-2.60), and negatively associated with a predisposing factor: childhood life events (OR 0.60, 95% CI 0.38-0.93). E-mental health care did not hinder traditional care, but was associated with face-to-face psychotherapy (66.2%, 51/77 vs 52.4%, 186/355, P=.03).
E-mental health care represents an important form of help-seeking behavior for young adults. Professionals and policy makers should take note of this and aim to improve the quality of online information on mental health care and to use this fact in clinical care.
互联网在年轻人中广泛使用，可用于改善心理健康护理可及性不足的问题。此前关于该主题的信息来自特定样本（学生或自我选择的个体），并不完整。
在一个年轻成年人社区样本中，我们旨在描述电子心理健康护理研究相关因素的频率，并确定电子心理健康护理是否与使用传统心理健康护理服务相关。
利用2011年法国年轻成年人TEMPO队列研究的数据（N = 1214，年龄18 - 37岁），我们按照安德森行为模型研究了电子心理健康护理及相关因素： predisposing因素（年龄、性别、教育程度、职业活动、与伴侣同住、子女、童年负面事件、慢性躯体疾病、父母抑郁病史）、促成因素（社会支持、经济困难、父母收入）以及需求相关因素（终生重度抑郁或焦虑症、自杀意念、注意力缺陷多动障碍、大麻使用）。我们比较了使用电子心理健康护理的参与者与未使用电子心理健康护理的参与者之间传统服务的使用情况（向全科医生、精神科医生、心理学家寻求帮助；使用抗抑郁药或抗焦虑药/催眠药）。
总体而言，8.65%（105/1214）的参与者报告在过去12个月出现心理困难时寻求过电子心理健康护理，15.7%（104/664）报告有心理困难。在控制所有协变量后，电子心理健康护理的可能性与两个需求相关因素呈正相关，即终生重度抑郁或焦虑症（OR 2.36，95%CI 1.36 - 4.09）和终生自杀意念（OR 1.91，95%CI 1.40 - 2.60），与一个predisposing因素呈负相关：童年生活事件（OR 0.60，95%CI 0.38 - 0.93）。电子心理健康护理并未阻碍传统护理，但与面对面心理治疗相关（66.2%，51/77对52.4%，186/355，P = 0.03）。
电子心理健康护理是年轻成年人寻求帮助行为的一种重要形式。专业人员和政策制定者应注意到这一点，并致力于提高在线心理健康护理信息的质量，并在临床护理中利用这一事实。
