Department of Psychiatry and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Virchowstraße 174, 45147 Essen, Germany.
University of Applied Labour Studies, Seckenheimer Landstraße 16, 68163 Mannheim, Germany.
Int J Environ Res Public Health. 2023 Mar 13;20(6):5066. doi: 10.3390/ijerph20065066.
Research has shown complex interactions between unemployment and mental health. However, the prevalence of specific mental disorders, utilization of mental health care services and influences on help-seeking behavior have been investigated surprisingly little in the past. In this study, we investigated a sample of long-term unemployed people in a cooperation program of the local unemployment agency and a psychiatric university hospital in a larger city in Germany. Mental disorders, treatment history, accordance of treatment to national treatment guidelines and factors influencing previous treatment were assessed. Participants ( = 879; male 56%, female 44%, mean age 43.9 years) showed a high psychiatric morbidity, mostly with diagnoses from the ICD-10 categories F1 (22%), F3 (61%) and F4 (68%). Currently, 18% were in psychiatric treatment, 6% were in psychotherapeutic treatment, and 28% received psychopharmacological treatment. Mostly young men underutilized the psychiatric-psychotherapeutic system, with middle-aged men and women being most frequently in psychopharmacological treatment. Of those treated, only about 10% of the subjects currently received a treatment according to national guidelines. The utilization of psychotherapeutic treatment was strikingly poor. This study identified high psychiatric morbidity and severe treatment gaps in unemployed people. These results can help to target subjects with specific needs for interventions and to modify counseling programs.
研究表明，失业和心理健康之间存在复杂的相互作用。然而，过去对特定精神障碍的流行程度、精神卫生保健服务的利用以及对寻求帮助行为的影响的研究却少之又少。在这项研究中，我们调查了德国一个较大城市的当地失业机构和一家精神病大学医院合作项目中的一个长期失业者样本。评估了精神障碍、治疗史、治疗是否符合国家治疗指南以及影响以前治疗的因素。参与者（=879；男性 56%，女性 44%，平均年龄 43.9 岁）表现出很高的精神发病率，主要是 ICD-10 类别 F1（22%）、F3（61%）和 F4（68%）的诊断。目前，18%的人正在接受精神病治疗，6%的人正在接受心理治疗，28%的人正在接受精神药物治疗。大多数年轻男性对精神病-心理治疗系统的利用率较低，而中年男性和女性则最常接受精神药物治疗。在接受治疗的人中，只有约 10%的人目前接受的治疗符合国家指南。心理治疗的利用率极低。这项研究确定了失业人群中存在较高的精神发病率和严重的治疗差距。这些结果可以帮助针对具有特定干预需求的对象，并修改咨询计划。
