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与寻求帮助和接受抗抑郁药物治疗常见精神障碍症状相关的态度和人口统计学因素。

Attitudinal and demographic factors associated with seeking help and receiving antidepressant medication for symptoms of common mental disorder.

机构信息

Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.

Psychiatry Department, University of Medicine, Pharmacy, Science and Technology, Tirgu-Mures, Romania.

出版信息

BMC Psychiatry. 2020 Dec 3;20(1):579. doi: 10.1186/s12888-020-02971-9.

Abstract

BACKGROUND

Despite the increased attention given to improvement of mental health-related knowledge and attitudes, rates of help-seeking for mental illness remain low even in countries with well-developed mental health services. This study examines the relationships between attitudes to mental illness, symptoms of common mental disorder and seeking-help and receiving medication for a mental health problem.

METHODS

We used data from the nationally representative Health Survey for England 2014 to design three logistic regression models to test for the effects of attitudes to mental illness (measured by a shortened version of the Community Attitudes toward the Mentally Ill, CAMI scale) on: recent contact with a doctor for a mental health problem; use of any type of mental health service in the last 12 months; and having antidepressants currently prescribed, while controlling for symptoms of common mental disorder (measured by the General Health Questionnaire, GHQ). We also tested for an interaction between attitudes to mental illness and symptoms of common mental disorder on the outcomes.

RESULTS

A significant but very small effect of CAMI score was found on 'antidepressants currently prescribed' model (OR = 1.01(1.00, 1.02) but not on the two indicators of help-seeking. We also found a significant but very small interaction between CAMI and GHQ scores on recent contact with a doctor (OR = 0.99, 95% CI (0.990, 0.998); adjusted Wald test P = 0.01)). Knowing someone with a mental illness had a significant positive effect on help-seeking indicated by: (a) recent contact with a doctor (2.65 (1.01, 6.98)) and (b) currently prescribed antidepressant (2.67 (1.9, 3.75)) after controlling for attitudes to mental illness.

CONCLUSIONS

Our results suggest that knowing someone with a mental health problem seems to have a further positive effect on help-seeking, beyond improving attitudes to mental illness. Furthermore, multiple different types and aspects of stigma may contribute to help-seeking behaviours, consequently multi-faceted approaches are likely to be most efficient.

摘要

背景

尽管人们越来越关注提高与心理健康相关的知识和态度,但即使在心理健康服务发达的国家,寻求精神疾病治疗的比例仍然很低。本研究考察了对精神疾病的态度、常见精神障碍症状与寻求帮助和接受精神健康问题药物治疗之间的关系。

方法

我们使用了来自英国全国代表性的 2014 年健康调查的数据,设计了三个逻辑回归模型,以检验对精神疾病的态度(通过社区对精神病态态度量表的简短版本测量)对以下方面的影响:最近因精神健康问题就诊;在过去 12 个月内使用任何类型的精神健康服务;目前正在服用抗抑郁药,同时控制常见精神障碍症状(通过一般健康问卷测量)。我们还测试了对精神疾病态度和常见精神障碍症状在结果上的相互作用。

结果

CAMI 评分对“目前正在服用抗抑郁药”模型有显著但很小的影响(OR=1.01(1.00,1.02),但对寻求帮助的两个指标没有影响。我们还发现 CAMI 和 GHQ 分数之间存在显著但很小的相互作用,对最近看医生有影响(OR=0.99,95%CI(0.990,0.998);调整后的 Wald 检验 P=0.01))。了解患有精神疾病的人对寻求帮助有显著的积极影响,表现为:(a)最近看医生(2.65(1.01,6.98))和(b)目前正在服用抗抑郁药(2.67(1.9,3.75)),在控制对精神疾病的态度后。

结论

我们的研究结果表明,了解患有精神健康问题的人似乎对寻求帮助有进一步的积极影响,而不仅仅是改善对精神疾病的态度。此外,多种不同类型和方面的污名可能会对寻求帮助的行为产生影响,因此多方面的方法可能是最有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed5b/7713160/62755d3b6869/12888_2020_2971_Fig1_HTML.jpg

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