Brandstetter Susanne, Dodoo-Schittko Frank, Speerforck Sven, Apfelbacher Christian, Grabe Hans-Jörgen, Jacobi Frank, Hapke Ulfert, Schomerus Georg, Baumeister Sebastian E
Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany.
Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
Soc Psychiatry Psychiatr Epidemiol. 2017 Aug;52(8):1005-1013. doi: 10.1007/s00127-017-1384-y. Epub 2017 Apr 29.
This study sought to examine trends in non-help-seeking for mental disorders among persons with a prevalent mental disorder (12-month prevalence) in Germany between 1997-1999 and 2009-2012.
We examined data from 1909 persons aged 18-65 years who participated in two independent, repeated cross-sectional surveys (German National Interview and Examination Study 1997-1999, German Health Interview and Examination Survey for Adults 2009-2012) conducted 12 years apart. Prevalent mental disorders (12-month prevalence) were determined using the Composite International Diagnostic Interview, which included information on lifetime help-seeking for mental health problems. Correlates of self-reported help-seeking were analyzed according to Andersen's Behavioral Model. Multivariable Poisson regression models were used to assess time trends in the directly standardized and model-adjusted prevalence of non-help-seeking across strata of socio-economic and clinical variables.
The proportion of people with a prevalent mental disorder who have never sought help in their lifetime decreased significantly from 62% (95% CI 58.7-64.7) to 57% (95% CI 52.2-60.9) between 1997-1999 and 2009-2012 in adults aged 18-65 years in Germany. Downward trends in non-help-seeking occurred in all investigated strata and reached statistical significance in women, in people who were living alone, people with medium educational level, people living in middle-sized communities, people with non-statutory health insurance, smokers, and people with co-existing somatic conditions.
Despite a downward trend over the course of 12 years, a large proportion of people suffering from mental disorders are still not seeking treatment in Germany. Further efforts to increase uptake of help-seeking for mental disorders in hard-to-reach groups are warranted to continue this trend.
本研究旨在调查1997 - 1999年至2009 - 2012年间德国患有常见精神障碍（12个月患病率）的人群中不寻求精神障碍帮助的趋势。
我们研究了1909名年龄在18 - 65岁之间的参与者的数据，他们参加了两项独立的、重复的横断面调查（1997 - 1999年德国全国访谈与检查研究、2009 - 2012年德国成人健康访谈与检查调查），这两项调查相隔12年进行。使用综合国际诊断访谈确定常见精神障碍（12个月患病率），该访谈包括有关终生寻求心理健康问题帮助的信息。根据安德森行为模型分析自我报告寻求帮助的相关因素。多变量泊松回归模型用于评估社会经济和临床变量各阶层中不寻求帮助的直接标准化患病率和模型调整患病率的时间趋势。
在德国18 - 65岁的成年人中，1997 - 1999年至2009 - 2012年间，终生从未寻求过帮助的常见精神障碍患者比例从62%（95%可信区间58.7 - 64.7）显著降至57%（95%可信区间52.2 - 60.9）。在所有调查阶层中均出现了不寻求帮助的下降趋势，并且在女性、独居者、中等教育水平者、居住在中型社区者、拥有非法定医疗保险者、吸烟者以及患有并存躯体疾病者中达到统计学显著水平。
尽管在12年期间呈下降趋势，但在德国，仍有很大比例的精神障碍患者未寻求治疗。有必要进一步努力提高难以触及群体中精神障碍寻求帮助的比例，以延续这一趋势。
