Yakushi Takashi, Kuba Teizo, Nakamoto Yuzuru, Fukuhara Hiroshi, Koda Munenaga, Tanaka Osamu, Kondo Tsuyoshi
Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.
Aomori Prefectural Center for Mental Health and Welfare, 353-92 Sannai Sawabe, Aomori, 038-0031, Japan.
BMC Health Serv Res. 2017 Feb 10;17(1):126. doi: 10.1186/s12913-017-2071-0.
There is an urgent need to establish effective strategies for suicide prevention. Stigma against depression may be a potential anti-protective factor for suicide. Thus, we investigated baseline levels of awareness and attitudes toward depression and its treatment among the general population by our original 18-item questionnaire, which we aimed to validate in the present study. Next, we conducted two types of educational interventions and examined the results to clarify the difference in the quality of these lectures.
Subjects were 834 citizens (245 males and 589 females) who received an anti-stigma-targeted (n = 467) or non-targeted lecture (n = 367). An 18-item questionnaire assessing levels of awareness and attitudes toward depression and its treatments was administered to each participant before and after the lecture. A chi-square test was used to investigate categorical variables for background data on the participants. Factor analysis of baseline scores was conducted on the 18 questionnaire items. Student's t-test was used for analysis of the gender effect. A two-way analysis of variance (ANOVA) was used for comparison among the 5 age groups and comparison of the effect of the two lectures. Multiple regression analysis was applied to examine the determinants of improved attitudes after intervention.
Public attitudes toward depression consisted of 4 distinct elements, which were disease-model attitudes, help-seeking behavior, negative affect toward depression, and non-medication solutions. Older participants had poorer disease-model attitudes and more negative affect toward depression, whereas younger participants showed poorer help-seeking behavior (p < 0.05). The anti-stigma-targeted lecture was superior to the non-targeted lecture in improving disease-model attitudes and non-medication solutions (p < 0.05). Multiple regression analyses revealed that each subscale score at post-lecture was strongly dependent on its own baseline subscale score (p < 0.01), and that baseline disease-model attitudes also affected post-lecture scores on negative affect toward depression and non-medication solutions (p < 0.01).
The educational intervention appears useful for acquiring accurate attitudes toward depression in a medical model. However, other strategies should be considered to enhance help-seeking behavior, especially in younger people.
迫切需要制定有效的自杀预防策略。对抑郁症的污名化可能是自杀的一个潜在反保护因素。因此，我们通过我们最初的18项问卷调查了普通人群对抑郁症及其治疗的认知和态度基线水平，我们旨在在本研究中对该问卷进行验证。接下来，我们进行了两种类型的教育干预并检查结果，以阐明这些讲座质量的差异。
研究对象为834名公民（245名男性和589名女性），他们参加了以消除污名为目标的讲座（n = 467）或非针对性讲座（n = 367）。在讲座前后，对每位参与者进行一份18项问卷，评估对抑郁症及其治疗的认知和态度水平。使用卡方检验调查参与者背景数据的分类变量。对18项问卷项目进行基线分数的因子分析。使用学生t检验分析性别效应。使用双向方差分析（ANOVA）对5个年龄组进行比较以及比较两种讲座的效果。应用多元回归分析来检查干预后态度改善的决定因素。
公众对抑郁症的态度由4个不同的要素组成，即疾病模式态度、寻求帮助行为、对抑郁症的负面影响和非药物解决方案。年龄较大的参与者疾病模式态度较差，对抑郁症的负面影响较大，而年轻参与者的寻求帮助行为较差（p < 0.05）。以消除污名为目标的讲座在改善疾病模式态度和非药物解决方案方面优于非针对性讲座（p < 0.05）。多元回归分析显示，讲座后的每个子量表分数强烈依赖于其自身的基线子量表分数（p < 0.01），并且基线疾病模式态度也影响讲座后对抑郁症的负面影响和非药物解决方案的分数（p < 0.01）。
教育干预似乎有助于在医学模式下获得对抑郁症的准确态度。然而，应该考虑其他策略来增强寻求帮助行为，特别是在年轻人中。
