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成年人有无精神障碍的精神卫生服务利用:发展阶段是否重要?

Mental health services use among adults with or without mental disorders: Do development stages matter?

机构信息

Centre de réadaptation en dépendance de Montréal - Institut universitaire, Montréal, QC, Canada Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montréal, QC, Canada

Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montréal, QC, Canada.

出版信息

Int J Soc Psychiatry. 2016 Aug;62(5):434-51. doi: 10.1177/0020764016641906. Epub 2016 Apr 13.

Abstract

BACKGROUND

Mental health services (MHS) use is a complex behaviour that does not only concern individuals with current mental disorder. To date, few studies have examined age-related contextualisation of MHS use. Reasons for seeking help may vary according to development stages in adulthood.

AIMS

This study aimed to determine which predisposing, enabling and need factors, using Andersen's model, were associated with MHS use according to adult development stages among individuals with or without current psychiatric diagnosis.

METHODS

Three age groups were examined: 18- to 29-year-olds (n = 775), 30- to 49-year-olds (n = 1,560) and 50- to 64-year-olds (n = 960). Data were obtained from the Montreal Longitudinal Catchment Area Study. Bivariate and multivariate logistic regression analyses were conducted for each age group separately to determine which predisposing, enabling and need factors were associated with MHS use in the past 12 months.

RESULTS

For 18- to 29-year-olds, one enabling factor (Internet search) and two need factors (presence of major depressive disorder and number of stressful events) were positively associated with MHS use. For 30- to 49-year-olds, one predisposing factor (family history of mental disorder), four enabling factors (not currently working or in school, perceiving neighbourhood disorder, social cohesion and Internet searching) and one need factor (major depressive disorder) correlated with help seeking. For 50- to 64-year-olds, two predisposing factors (family history of mental disorder and higher self-perceived stigma), two enabling factors (low satisfaction in personal relationship and Internet searching) and one need factor (alcohol dependence) were associated with MHS use.

CONCLUSIONS

Factors associated with MHS use differ according to adult development stages. Programmes and policies should be based on age-related contextualisation to increase MHS use.

摘要

背景

精神卫生服务(MHS)的使用是一种复杂的行为,不仅涉及当前有精神障碍的个体。迄今为止,很少有研究探讨与年龄相关的 MHS 使用的背景。寻求帮助的原因可能因成年期的发展阶段而异。

目的

本研究旨在根据有无当前精神科诊断,使用安德森模型确定与 MHS 使用相关的倾向因素、促成因素和需求因素,这些因素与成年发展阶段有关。

方法

研究考察了三个年龄组:18 至 29 岁(n=775)、30 至 49 岁(n=1560)和 50 至 64 岁(n=960)。数据来自蒙特利尔纵向捕获区研究。对每个年龄组分别进行了双变量和多变量逻辑回归分析,以确定哪些倾向因素、促成因素和需求因素与过去 12 个月的 MHS 使用相关。

结果

对于 18 至 29 岁的人,一个促成因素(互联网搜索)和两个需求因素(存在重度抑郁障碍和压力事件数量)与 MHS 使用呈正相关。对于 30 至 49 岁的人,一个倾向因素(精神障碍家族史)、四个促成因素(未就业或上学、感知邻里混乱、社会凝聚力和互联网搜索)和一个需求因素(重度抑郁障碍)与寻求帮助相关。对于 50 至 64 岁的人,两个倾向因素(精神障碍家族史和更高的自我感知耻辱感)、两个促成因素(人际关系满意度低和互联网搜索)和一个需求因素(酒精依赖)与 MHS 使用相关。

结论

与 MHS 使用相关的因素因成年发展阶段而异。方案和政策应基于与年龄相关的背景,以增加 MHS 的使用。

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