Constant Aymery, Sherlaw William, Kovess-Masfety Viviane
EHESP School of Public Health, Rennes, F-35043, France.
EHESP School of Public Health, Rennes, F-35043, France; Paris Descartes University, Paris, F-75006, France.
Alcohol. 2017 Mar;59:1-6. doi: 10.1016/j.alcohol.2016.09.028. Epub 2016 Sep 24.
Better knowledge of the factors that have an impact on pathways to mental health care may contribute greatly to organizing optimum health-care delivery. However, surveillance systems concerning alcohol problems in the French general population are suboptimal. The objectives of this study were to investigate: 1) the prevalence of mental health-care seeking in individuals with alcohol abuse/dependence in France, 2) which category of medical practitioner was consulted, and 3) psychological and socio-environmental factors associated with mental health-care seeking.
A total sample of 22,138 individuals was interviewed in a telephone survey. Individual data on alcohol dependence/abuse and other mental health disorders were collected using the Composite International Diagnosis Interview - short form. Mental health-care seeking was assessed, together with data on living conditions, deprivation, and self-reported drinking problems. Only respondents meeting criteria for alcohol dependence/abuse were included in analyses.
Less than half of the 722 respondents with alcohol abuse/dependence had sought mental health care in the preceding 12 months, of whom 90.5% consulted their general practitioner (GP) (56.1%), or both a general practitioner and a psychiatrist (34.4%). Mental health-care seeking was associated with female sex, previous alcohol discussion with a doctor, and the presence of psychiatric comorbidities arising in the preceding 12 months. Living environment, socio-economic status, or self-reported drinking problems had no influence.
A minority of people with alcohol abuse/dependence sought mental health care, mainly in relation to psychiatric comorbidities. In addition, most people consulting a GP were not referred to a psychiatrist. However, social deprivation and living in rural areas did not hinder mental health-care seeking among respondents. Adequate protocols to treat alcohol disorders could be implemented among private health-care providers to improve management of alcohol problems in France.
深入了解影响心理健康护理途径的因素，对于优化医疗服务的提供可能具有极大的推动作用。然而，法国普通人群中酒精问题的监测系统尚不完善。本研究的目的是调查：1）法国酒精滥用/依赖个体寻求心理健康护理的患病率；2）咨询的医生类别；3）与寻求心理健康护理相关的心理和社会环境因素。
通过电话调查对总共22138名个体进行了访谈。使用综合国际诊断访谈简表收集了关于酒精依赖/滥用及其他心理健康障碍的个体数据。评估了寻求心理健康护理的情况，以及生活条件、贫困状况和自我报告的饮酒问题等数据。分析仅纳入符合酒精依赖/滥用标准的受访者。
在722名酒精滥用/依赖的受访者中，不到一半的人在过去12个月内寻求过心理健康护理，其中90.5%咨询了他们的全科医生（56.1%），或同时咨询了全科医生和精神科医生（34.4%）。寻求心理健康护理与女性性别、之前与医生讨论过酒精问题以及过去12个月内出现的精神科合并症有关。生活环境、社会经济地位或自我报告的饮酒问题没有影响。
少数酒精滥用/依赖者寻求心理健康护理，主要是因为精神科合并症。此外，大多数咨询全科医生的人没有被转诊到精神科医生处。然而，社会贫困和生活在农村地区并没有阻碍受访者寻求心理健康护理。可以在私立医疗服务提供者中实施适当的酒精障碍治疗方案，以改善法国酒精问题的管理。
