Brunault P, Bray A, Rerolle C, Cognet S, Gaillard P, El-Hage W
Pôle de psychiatrie et d'addictologie, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Département de psychologie, EA 2114 « psychologie des âges de la vie », université François-Rabelais de Tours, 3, rue des Tanneurs, 37041 Tours, France.
Pôle de psychiatrie et d'addictologie, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
Rev Epidemiol Sante Publique. 2017 Apr;65(2):125-136. doi: 10.1016/j.respe.2016.11.001. Epub 2017 Jan 30.
Internet has become a major tool for patients to search for health-related information and to communicate on health. We currently lack data on how patients with psychiatric disorders access and use Internet to search for information on their mental health. This study aimed to assess, in patients followed for a psychiatric disorder (schizophrenia, bipolar disorder, mood and anxiety disorder, substance-related and addictive disorders and eating disorders), prevalence of Internet access and use, and patient expectations and needs regarding the use of Internet to search for mental-health information depending on the psychiatric disorder.
We conducted this cross-sectional study between May 2013 and July 2013 in 648 patients receiving psychiatric care in 8 hospitals from the Region Centre, France. We used multivariate logistic regression adjusted for age, gender, socio-educational level and professional status to compare use, expectations and needs regarding Internet-based information about the patient's psychiatric disorder (65-items self-administered questionnaires) as a function of the psychiatric disorders. We identified patients clusters with multiple correspondence analysis and ascending hierarchical classification.
Although 65.6% of our population accessed Internet at home, prevalence for Internet access varied depending on the type of psychiatric disorder and was much more related to limited access to a computer and low income than to a lack of interest in the Internet. Most of the patients who used Internet were interested in having access to reliable Internet-based information on their health (76.8%), and most used Internet to search for Internet based health-information about their psychiatric disorder (58.8%). We found important differences in terms of expectations and needs depending on the patient's psychiatric disorder (e.g., higher interest in Internet-based information among patients with bipolar disorder, substance-related and addictive disorders and eating disorders). We identified three clusters: younger patients with depressive or anxiety disorders and higher Internet access and Internet use; older patients with low socio-economical status and low Internet access and Internet use; patients receiving long-term care for schizophrenia, with low Internet access and Internet use.
Patients with psychiatric disorders reported average use, needs and expectations for Internet-based health information comparable to the overall population. However, Internet use, needs and expectations for Internet-based mental health information differed between patients depending on their psychiatric disorder. Internet-based information and communication for mental health should be designed specifically for each psychiatric disorder.
互联网已成为患者搜索健康相关信息及交流健康问题的主要工具。目前，我们缺乏关于精神疾病患者如何访问和使用互联网来搜索其心理健康信息的数据。本研究旨在评估患有精神疾病（精神分裂症、双相情感障碍、情绪和焦虑障碍、物质相关及成瘾性障碍和进食障碍）的患者中互联网接入和使用的患病率，以及患者对于使用互联网搜索心理健康信息的期望和需求（取决于精神疾病类型）。
2013年5月至2013年7月期间，我们在法国中部地区8家医院接受精神科护理的648名患者中开展了这项横断面研究。我们使用经年龄、性别、社会教育水平和职业状况调整的多变量逻辑回归，以比较作为精神疾病函数的、关于患者精神疾病的基于互联网信息的使用、期望和需求（65项自填式问卷）。我们通过多重对应分析和升序层次分类确定患者群组。
尽管我们研究人群中有65.6%的人在家中接入互联网，但互联网接入的患病率因精神疾病类型而异，更多地与计算机使用受限和低收入有关，而非对互联网缺乏兴趣。大多数使用互联网的患者有兴趣获取基于互联网的可靠健康信息（76.8%），并且大多数人使用互联网搜索关于其精神疾病的基于互联网的健康信息（58.8%）。我们发现，根据患者的精神疾病不同，期望和需求存在重要差异（例如，双相情感障碍、物质相关及成瘾性障碍和进食障碍患者对基于互联网的信息兴趣更高）。我们确定了三个群组：患有抑郁或焦虑障碍、互联网接入和使用较高的年轻患者；社会经济地位低、互联网接入和使用较低的老年患者；因精神分裂症接受长期护理、互联网接入和使用较低的患者。
患有精神疾病的患者报告的基于互联网健康信息的平均使用、需求和期望与总体人群相当。然而，根据精神疾病不同，患者对基于互联网的心理健康信息的使用、需求和期望存在差异。基于互联网的心理健康信息和交流应针对每种精神疾病进行专门设计。
