在西欧医疗保健环境中,寻求治疗的有抑郁或焦虑障碍的成年人的障碍和促进因素:一项定性研究。

Barriers and facilitators for treatment-seeking in adults with a depressive or anxiety disorder in a Western-European health care setting: a qualitative study.

机构信息

Amsterdam UMC, Vrije Universiteit (VU) Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.

GGZ inGeest Specialised Mental Health Care, Amsterdam, The Netherlands.

出版信息

BMC Psychiatry. 2022 Mar 5;22(1):165. doi: 10.1186/s12888-022-03806-5.

Abstract

BACKGROUND

Previous research on barriers and facilitators regarding treatment-seeking of adults with depressive and anxiety disorders has been primarily conducted in the Anglosphere. This study aims to gain insight into treatment-seeking behaviour of adults with depressive and anxiety disorders in a European healthcare system.

METHODS

In-depth semi-structured interviews were conducted with 24 participants, aged ≥18 years and diagnosed with an anxiety disorder and/or depressive disorder according to DSM-IV. Participants were purposively sampled from an outpatient department for mental health care in the Netherlands. The seven steps of framework analysis were used to identify relevant themes emerging from the interviews.

RESULTS

Data analysis suggested an interplay between individual aspects, personal social system, healthcare system and sociocultural context influences. Amongst the most relevant themes were mental health illiteracy, stigma, a negative attitude toward professional help, the influence of significant others and general practitioner, and waiting time. Financial barriers were not of relevance.

CONCLUSIONS

Even in a country with a well-developed mental health care system and in absence of financial barriers, there are many barriers to treatment-seeking in adult patients with depressive and anxiety disorders. National campaigns to increase awareness and decrease stigma in the general population, and to empower the social environment might reduce the treatment gap.

摘要

背景

之前关于成年人寻求抑郁和焦虑障碍治疗的障碍和促进因素的研究主要在英语国家进行。本研究旨在深入了解欧洲医疗保健系统中成年人寻求抑郁和焦虑障碍治疗的行为。

方法

对 24 名年龄≥18 岁、根据 DSM-IV 诊断为焦虑障碍和/或抑郁障碍的参与者进行了深入的半结构化访谈。参与者是从荷兰精神卫生保健的门诊部门中按目的抽样的。使用框架分析的七个步骤来确定访谈中出现的相关主题。

结果

数据分析表明,个人方面、个人社会系统、医疗保健系统和社会文化背景影响之间存在相互作用。其中最重要的主题包括心理健康素养低、污名化、对专业帮助的消极态度、重要他人和全科医生的影响,以及等待时间。经济障碍并不重要。

结论

即使在一个心理健康保健系统发达且不存在经济障碍的国家,患有抑郁和焦虑障碍的成年患者寻求治疗也存在许多障碍。在普通人群中开展提高认识和减少污名化的全国性运动,并赋予社会环境权力,可能会缩小治疗差距。

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