University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Eur Psychiatry. 2018 Oct;54:1-9. doi: 10.1016/j.eurpsy.2018.06.009. Epub 2018 Jul 19.
Absent or delayed help-seeking is considered to aggravate the immense personal and societal burden caused by mental disorders. Therefore, we cross-sectionally examined rates and clinical and sociodemographic moderators of early help-seeking for current clinician-assessed non-psychotic mental problems/disorders in the community.
Altogether, 2683 individuals of the Swiss Canton Bern (16-40 years old, response rate 63.4%) were interviewed by telephone for current axis-I problems/disorders using the Mini-International Neuropsychiatric Interview, for psychosocial functioning using the Social and Occupational Functioning Assessment Scale, and for help-seeking for mental problems.
In total, 1122 (41.8%) reported mental problems. Of these, 769 (68.5%) affirmed any one screening question and 353 (31.5%) fulfilled criteria for any current axis-I disorder, and 396 (35.3%) reported any lifetime help-seeking (28.3% sought help in the past and 7.0% were in current treatment). In path analyses, current help-seeking was associated mainly by type and number of mental problems/disorders mediated by functional impairment, in addition to older age, no current partner, and past treatment.
Our cross-sectional data indicate a gap in help-seeking for mental problems/disorders. The relationship between number of mental problems/disorders and help-seeking mediated by functional impairment confirm that individuals commonly do not seek help until problems are severe enough to cause problems in occupational and psychosocial functioning, driving the already immense costs of mental disorders. Thus, campaigns promoting early help-seeking, including early diagnostic clarification of and support for subthreshold mental problems in terms of an indicated prevention, should focus on psychosocial functioning, aside from signs of mental illness.
寻求帮助的缺失或延迟被认为会加剧精神障碍给个人和社会带来的巨大负担。因此，我们在横断面研究中调查了社区中当前临床评估的非精神病性精神问题/障碍的早期寻求帮助的比例以及临床和社会人口统计学的调节因素。
共对瑞士伯尔尼州的 2683 名个体（16-40 岁，应答率 63.4%）进行了电话访谈，使用 Mini-International Neuropsychiatric Interview 评估当前的轴 I 问题/障碍，使用社会和职业功能评估量表评估心理社会功能，并评估寻求精神问题帮助的情况。
共有 1122 人（41.8%）报告有精神问题。其中，769 人（68.5%）肯定了任何一个筛查问题，353 人（31.5%）符合任何当前轴 I 障碍的标准，396 人（35.3%）报告有任何既往寻求帮助的情况（28.3%的人过去寻求过帮助，7.0%的人正在接受治疗）。在路径分析中，当前的寻求帮助主要与通过功能障碍中介的精神问题/障碍的类型和数量有关，此外还与年龄较大、没有当前伴侣和过去的治疗有关。
我们的横断面数据表明，寻求精神问题/障碍的帮助存在差距。精神问题/障碍的数量与通过功能障碍中介的寻求帮助之间的关系证实，个体通常不会在问题严重到导致职业和心理社会功能出现问题之前寻求帮助，这加剧了精神障碍已经带来的巨大负担。因此，提倡早期寻求帮助的运动，包括在早期诊断方面推广，以及为亚阈值精神问题提供支持，除了关注精神疾病的迹象外，还应侧重于心理社会功能。
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