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针对精神疾病早期症状的求助意向及其相关因素:四种健康问题的比较

Help-seeking intentions for early signs of mental illness and their associated factors: comparison across four kinds of health problems.

作者信息

Suka Machi, Yamauchi Takashi, Sugimori Hiroki

机构信息

Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.

Center for Suicide Prevention, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

出版信息

BMC Public Health. 2016 Apr 7;16:301. doi: 10.1186/s12889-016-2998-9.

Abstract

BACKGROUND

Failure and delay in initial treatment contact for mental disorders has been recognized as an important public health problem. According to the concept of mental health literacy, recognition of symptoms is crucial to making decisions to seek or not seek professional help. The aims of this study were to investigate the types of health problems for which Japanese adults intend to seek help, their preferred sources of help, and the factors associated with help-seeking intentions.

METHODS

A cross-sectional web-based survey was conducted in June 2014 among Japanese adults aged 20-59 years. A total of 3308 eligible respondents were included in this study. Help-seeking intentions were measured by listing potential sources of help (including 'would not receive help') and asking which ones would be chosen in four health conditions indicated by irritability, dizziness, insomnia, and depressed mood, respectively.

RESULTS

In the case of dizziness, 85.9% of the participants reported a positive help-seeking intention and 42.7% gave first priority to seeking help from formal sources. These percentages were smaller in the cases of insomnia (75.4 and 25.0%), depressed mood (74.9 and 18.7%), and irritability (72.9 and 0.9%). Multiple logistic regression analysis revealed that the factors significantly associated with help-seeking intentions were almost identical across the four health problems. In particular, perception of family and friends regarding help-seeking, psychiatric history, contact with people with mental illness, better health literacy, and neighborhood communicativeness were significantly associated with the overall help-seeking intention and also the help-seeking intention from formal sources for all the problems of dizziness, insomnia, and depressed mood.

CONCLUSIONS

The majority of participants indicated their intentions to seek help, but psychological problems (insomnia and depressed mood) were less likely to induce help-seeking intentions than a physical problem (dizziness). Besides developing health literacy skills, community-based interventions for creating a friendly approachable atmosphere and facilitating daily interactions with family, friends, and neighbors may be worth considering as a possible public health strategy for encouraging help-seeking whether for psychological or physical problems.

摘要

背景

精神障碍初次治疗接触的失败与延迟已被视为一个重要的公共卫生问题。根据心理健康素养的概念,症状识别对于决定是否寻求专业帮助至关重要。本研究的目的是调查日本成年人打算寻求帮助的健康问题类型、他们偏爱的求助来源以及与求助意愿相关的因素。

方法

2014年6月对20至59岁的日本成年人进行了一项基于网络的横断面调查。本研究共纳入3308名符合条件的受访者。通过列出潜在的求助来源(包括“不会寻求帮助”)并询问在分别由易怒、头晕、失眠和情绪低落所表明的四种健康状况下会选择哪些来源来衡量求助意愿。

结果

在头晕的情况下,85.9%的参与者表示有积极的求助意愿,42.7%的人将向正规来源寻求帮助列为首要选择。在失眠(75.4%和25.0%)、情绪低落(74.9%和18.7%)和易怒(72.9%和0.9%)的情况下,这些百分比更低。多因素逻辑回归分析显示,与求助意愿显著相关的因素在这四种健康问题中几乎相同。特别是,家人和朋友对求助的看法、精神病史、与精神疾病患者的接触、更好的健康素养以及邻里沟通性与总体求助意愿以及在头晕、失眠和情绪低落所有问题上向正规来源求助的意愿显著相关。

结论

大多数参与者表示有寻求帮助的意愿,但心理问题(失眠和情绪低落)比身体问题(头晕)更不容易引发求助意愿。除了培养健康素养技能外,基于社区的干预措施,营造友好、平易近人的氛围并促进与家人、朋友和邻居的日常互动,可能值得作为一种鼓励针对心理或身体问题寻求帮助的公共卫生策略加以考虑。

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