Zhong Shaoling, Ma Chao, Huang Yueqin, Zhang Tingting, Hou Xiaofei, Tai Tak Ching, Yan Jie, Yu Yaqin, Xu Xiufeng, Wang Zhizhong, Xu Yifeng, Li Tao, Xu Guangming, Xu Xiangdong, Wang Limin, Yan Yongping, Xiao Shuiyuan, Li Lingjiang, Liu Zhaorui, Zhou Liang
The Affiliated Brain Hospital, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou 510370, China.
Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Peking University, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, China.
J Affect Disord. 2025 Mar 1;372:386-393. doi: 10.1016/j.jad.2024.12.010. Epub 2024 Dec 3.
Utilisation of health services is low and delayed among individuals with mood mental disorders and anxiety disorders, despite high disease burdens and available effective treatments. This study aims to examine patterns and delays in help-seeking and associated factors among individuals with lifetime disorder of mood disorders and/or anxiety disorders.
We used data from the China Mental Health Survey (CMHS), a nationally representative multistage clustered-area probability sample study across 31 provinces. We assessed lifetime mental disorders and help-seeking behaviour using the Composite International Diagnostic Interview (CIDI). Logistic regression analyses were used to examine sociodemographic and clinical correlates of delay to seek health care.
Among 32,552 participants, we identified 3075 patients with lifetime mood and/or anxiety disorders; 486 (15.5 % [95 % CI: 13.6-17.5 %]) have sought health care. Of these, 163 (4.8 % [95 % CI: 3.7-6.3]) ever sought specialized mental health services. The delays to initial health care were 1.0 (IQR: 0-7.1), 1.9 (0-10.0), and 10.0 (1.0-22.1) years for depressive, bipolar, and anxiety disorders. Patients with comorbidities, later age of onset, and living in urban areas showed a higher propensity for help-seeking (all p < 0.05). Older cohort was associated with longer delays in seeking health care, while a later age of onset was associated with shorter delays (all p < 0.05).
The cross-sectional retrospective design and self-assessment approach may add bias.
Failure and delays in help-seeking are common in China. National strategies are needed to promote health care utilisation.
尽管情绪性精神障碍和焦虑症患者疾病负担重且有有效的治疗方法，但他们对卫生服务的利用率较低且就诊延迟。本研究旨在调查患有终生情绪障碍和/或焦虑症的个体寻求帮助的模式、延迟情况及相关因素。
我们使用了中国精神卫生调查（CMHS）的数据，这是一项对全国31个省份具有代表性的多阶段整群区域概率抽样研究。我们使用复合国际诊断访谈（CIDI）评估终生精神障碍和寻求帮助行为。采用逻辑回归分析来研究寻求医疗保健延迟的社会人口学和临床相关因素。
在32552名参与者中，我们确定了3075名患有终生情绪和/或焦虑症的患者；486名（15.5%[95%CI：13.6 - 17.5%]）寻求过医疗保健。其中，163名（4.8%[95%CI：3.7 - 6.3]）曾寻求过专门的心理健康服务。抑郁症、双相情感障碍和焦虑症患者首次寻求医疗保健的延迟时间分别为1.0年（IQR：0 - 7.1）、1.9年（0 - 10.0）和10.0年（1.0 - 22.1）。患有合并症、发病年龄较大以及居住在城市地区的患者寻求帮助的倾向更高（所有p < 0.05）。年龄较大的队列寻求医疗保健的延迟时间更长，而发病年龄较晚则与较短的延迟时间相关（所有p < 0.05）。
横断面回顾性设计和自我评估方法可能会增加偏差。
在中国，未能寻求帮助和就诊延迟的情况很常见。需要制定国家战略来促进卫生服务的利用。
