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寻求精神疾病和物质滥用治疗:一项关于有和没有精神疾病的军人的态度、信念和需求的横断面研究。

Seeking treatment for mental illness and substance abuse: A cross-sectional study on attitudes, beliefs, and needs of military personnel with and without mental illness.

机构信息

Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Warandelaan 2, 5037, AB Tilburg, the Netherlands; Brain Research and Innovation Centre, Ministry of Defence, Lundlaan 1, 3584 CX, Utrecht, the Netherlands.

Brain Research and Innovation Centre, Ministry of Defence, Lundlaan 1, 3584 CX, Utrecht, the Netherlands; Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands.

出版信息

J Psychiatr Res. 2022 Mar;147:221-231. doi: 10.1016/j.jpsychires.2022.01.028. Epub 2022 Jan 13.

Abstract

BACKGROUND

Often, military personnel do not seek treatment for mental illness or wait until they reach a crisis point. Effective, selective, and indicated prevention is best achieved by seeking treatment early.

AIMS

We aimed to examine military personnel's attitudes, beliefs, and needs around seeking treatment for mental illness. We compared those who sought treatment to those who did not and those with and without the intention to seek treatment. Finally, we examined factors associated with intentions of not seeking treatment.

METHOD

We conducted a cross-sectional questionnaire study of military personnel with (N = 324) and without (N = 554) mental illness. Descriptive and regression analyses (logistic and ordinal) were performed.

RESULTS

The majority of the personnel believed treatment was effective (91.6%); however, most preferred to solve their own problems (66.0%). For personnel with mental illness, compared to those who sought treatment, those who did not had a higher preference for self-management and found advice from others less important. For those without mental illness, those with no intention to seek treatment indicated a higher preference for self-management, stigma-related concerns, denial of symptoms, lower belief in treatment effectiveness and found it less important to be an example, compared to those with treatment-seeking intentions. A clear indication of where to seek help was the most reported need (95.7%). Regression analyses indicated that not seeking treatment was most strongly related to preference for self-management (OR(95%CI) = 4.36(2.02-9.39); no intention to seek treatment was most strongly related to a lower belief that treatment is effective (OR(95%CI) = .41(0.28-0.59) and with not having had positive earlier experiences with treatment seeking (OR(95%CI) = .34(0.22-0.52).

CONCLUSIONS

To facilitate (early) treatment seeking, interventions should align with a high preference for self-management, mental illness stigma should be targeted, and a clear indication of where to seek treatment is needed.

摘要

背景

军人往往不会寻求治疗精神疾病,或者等到他们达到危机点才寻求治疗。通过早期治疗,能够最好地实现有效、有选择性和有针对性的预防。

目的

我们旨在研究军人在寻求精神疾病治疗方面的态度、信念和需求。我们比较了那些寻求治疗的人和那些没有寻求治疗的人,以及那些有和没有寻求治疗意向的人。最后,我们研究了与不寻求治疗意向相关的因素。

方法

我们对有(N=324)和没有(N=554)精神疾病的军人进行了横断面问卷调查研究。进行了描述性和回归分析(逻辑和有序)。

结果

大多数军人认为治疗是有效的(91.6%);然而,大多数人更愿意自己解决问题(66.0%)。对于有精神疾病的人员,与寻求治疗的人员相比,那些没有寻求治疗的人员更倾向于自我管理,并且认为他人的建议不那么重要。对于没有精神疾病的人员,那些没有寻求治疗意向的人员表示更倾向于自我管理,对耻辱感相关问题的担忧,对症状的否认,对治疗效果的信念较低,并且认为成为榜样的重要性较低,与有治疗寻求意向的人员相比。明确指出在哪里寻求帮助是最常报告的需求(95.7%)。回归分析表明,不寻求治疗与自我管理偏好(OR(95%CI)=4.36(2.02-9.39))关系最强;没有寻求治疗意向与认为治疗效果不佳(OR(95%CI)=0.41(0.28-0.59))的信念关系最强,并且与早期寻求治疗的积极经历较少(OR(95%CI)=0.34(0.22-0.52))有关。

结论

为了促进(早期)治疗寻求,干预措施应与高度的自我管理偏好保持一致,应针对精神疾病耻辱感,并明确指出在哪里寻求治疗。

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