寻求精神疾病治疗

Help-seeking for psychiatric disorders.

作者信息

Bland R C, Newman S C, Orn H

机构信息

Department of Psychiatry, University of Alberta, Edmonton.

出版信息

Can J Psychiatry. 1997 Nov;42(9):935-42. doi: 10.1177/070674379704200904.

DOI:10.1177/070674379704200904

PMID:9429063

Abstract

OBJECTIVE

To examine demographic and clinical determinants of seeking help for mental or emotional problems. To determine the proportion of those people with a disorder who sought help. To determine what categories of professionals are sought by those who get care.

METHOD

A 2-stage random sample of 3956 adult residents of Edmonton, Alberta, Canada was interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS) (73% completion rate). An average of 2.8 years later, a systematic random sample of 1964 subjects was reinterviewed (an 86% completion rate) using the DIS and a health care utilization questionnaire. After adjusting for age and sex, the reinterview sample was representative of those with and without a diagnosis at the first interview.

RESULTS

Of the 1964 subjects, 570 (31%) met criteria for a DIS/DSM-III diagnosis in the year preceding the interview (one-year prevalence rate). These diagnoses included generalized anxiety disorder (GAD) and posttraumatic stress disorder (PTSD). For those with a diagnosis, sex, age, marital status, education, employment, and income were examined as determinants of help-seeking. Only sex (female) and age (under 45) were significant predictors. Comorbidity was highly significant: the help-seeking rate for those with one diagnosis was 20.3%; for those with more than one diagnosis, the rate was 42.8% (OR = 2.94, chi 2 = 31.4, df = 1, P < 0.001). Just over 28% of those with a diagnosis saw any health care professional, and 7.7% of those without a diagnosis sought help for a mental or emotional problem. A specific diagnosis made a difference: 46.7% of those with a major depressive episode sought help, but only 16.0% of those with alcohol abuse or dependence sought care.

CONCLUSION

Major determinants of help-seeking are sex (female), age (under 45), severity of the illness, and comorbidity. A surprisingly high proportion of those with a disorder (72%) do not seek help, and over one-third of those seeking help do not have a current DIS/DSM-III disorder.

摘要

目的

研究寻求心理或情绪问题帮助的人口统计学和临床决定因素。确定患有疾病的人群中寻求帮助的比例。确定接受治疗的人群寻求何种专业人士的帮助。

方法

对加拿大艾伯塔省埃德蒙顿市3956名成年居民进行两阶段随机抽样，由经过培训的非专业访谈员使用诊断访谈表（DIS）进行访谈（完成率73%）。平均2.8年后，对1964名受试者进行系统随机抽样重新访谈（完成率86%），使用DIS和一份医疗保健利用调查问卷。在对年龄和性别进行调整后，重新访谈样本代表了首次访谈时有诊断和无诊断的人群。

结果

在1964名受试者中，570人（31%）在访谈前一年符合DIS/DSM - III诊断标准（一年患病率）。这些诊断包括广泛性焦虑症（GAD）和创伤后应激障碍（PTSD）。对于那些有诊断的人，研究了性别、年龄、婚姻状况、教育程度、就业情况和收入作为寻求帮助的决定因素。只有性别（女性）和年龄（低于45岁）是显著的预测因素。共病情况非常显著：患有一种诊断的人的求助率为20.3%；患有不止一种诊断的人的求助率为42.8%（比值比 = 2.94，卡方 = 31.4，自由度 = 1，P < 0.001）。略多于28%的有诊断的人咨询过任何医疗保健专业人士，7.7%的无诊断的人因心理或情绪问题寻求过帮助。具体诊断有影响：患有重度抑郁发作的人中有46.7%寻求帮助，但患有酒精滥用或依赖的人中只有16.0%寻求治疗。