Use of mental health services in a developing country
Use of mental health services in a developing country
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在发展中国家使用心理健康服务
DOI：
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发表时间：
2005
影响因子：
4.4
通讯作者：
V. Lasebikan
中科院分区：
文献类型：
--
作者：
O. Gureje;V. Lasebikan
来自发达工业化国家的证据表明，人们对心理健康服务的接受程度很低。在资源有限的发展中国家，没有关于社区精神卫生服务需求得到满足和未得到满足的数据。方法对尼日利亚约鲁巴语地区（人口约2500万人，占尼日利亚全国人口的22%）的家庭进行四阶段分层概率抽样研究。对18岁及以上的人（n=4,984）进行面对面访谈，使用世界精神卫生版的综合国际诊断访谈。我们确定了患有12个月精神疾病诊断和统计手册第四版（DSM-IV）焦虑、情绪或物质使用障碍的受访者的比例，他们接受过任何精神健康治疗以及治疗接受的相关因素。结果12个月DSM-IV障碍患者中只有9.0%接受了治疗。虽然有11%的情绪障碍患者接受了一些治疗，但没有一个物质使用障碍患者接受过心理健康服务。大多数治疗都是在普通医疗机构接受的，只有大约1%的DSM-IV障碍患者接受了专门的精神卫生服务。令人惊讶的是，只有约4%的精神障碍患者咨询了补充或替代医疗服务提供者，尽管在没有DSM-IV障碍但接受精神健康治疗的患者中，有57%的比例要高得多，他们向这些医疗服务提供者咨询过。无论疾病或接受治疗的部门如何，几乎没有任何治疗被认为是最低限度的适当治疗。结论在这个发展中国家，社区精神卫生服务需求未得到满足的程度令人震惊。虽然正式公共卫生部门的不足可能是造成这一现象的部分原因，但公众对精神疾病的性质了解不足和耻辱也可能阻碍对精神健康问题的治疗。
BackgroundEvidence from developed industrialized countries suggests poor uptake of mental health services. No data exist in developing resource-constrained countries about met and unmet need for mental health service in the community.MethodA four-stage stratified probability sample of households was studied in the Yoruba-speaking part of Nigeria (population, approximately 25 million people or 22% of the Nigerian national population). Face-to-face interviews were conducted with persons 18 years old and above (n=4,984) using the World Mental Health version of the Composite International Diagnostic Interview. We determined the proportions of respondents with 12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) anxiety, mood, or substance use disorder who had received any mental health treatment and the correlates of treatment receipt.ResultsOnly 9.0% of those with any 12-month DSM-IV disorder had received treatment. While 11% of those with a mood disorder had received some treatment, none of those with substance use disorders had used a mental health service. Most treatments were received from general medical settings, with only about 1% of those with DSM-IV disorders receiving specialist mental health service. Surprisingly, complementary or alternative health providers were also consulted by only about 4% of those with mental disorders, although a much higher proportion of 57% of those with no DSM-IV disorders but who nevertheless received mental health treatment did so from such providers. Irrespective of the disorders or the sector where treatment was received, virtually no treatment was adjudged minimally adequate.ConclusionThere is a striking level of unmet need for mental health service in the community in this developing country setting. While inadequacy of the formal public health sector may be partly responsible for this observation, there is the likelihood that receipt of treatment for mental health problems may also be hampered by the public's poor knowledge of the nature of the disorders and by stigma.
影响因子：
17.7
作者：
Kessler, RC;Zhao, SY;Leaf, P
通讯作者：
Leaf, P