Treatment seeking for depression in Canada and the United States
Treatment seeking for depression in Canada and the United States
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DOI：
10.1176/appi.ps.57.5.631
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发表时间：
2006-05-01
影响因子：
3.8
通讯作者：
Olfson, Mark
中科院分区：
文献类型：
--
作者：
Mojtabai, Ramin;Olfson, Mark
目的：对心理健康治疗寻求模式进行跨国比较，深入了解背景因素对心理健康服务使用的影响。本研究旨在比较加拿大和美国患有重度抑郁症的成年人寻求心理健康治疗的患病率和预测因素。方法：过去 12 个月内可能患有重度抑郁发作的 751 名参与者的数据来自 2002 - 2003 年加拿大/美国联合健康调查：304 名来自加拿大，447 名来自美国。通过综合国际诊断访谈 - 简短形式确定了可能的重度抑郁发作。比较了因心理健康原因与心理健康和一般健康提供者的接触模式。结果：在加拿大和美国，可能患有重度抑郁症的参与者中，因心理健康问题而与任何提供者接触的比例相似（181 名加拿大人，即 56%，而美国有 245 名美国人，即 52%）。加拿大的参与者比美国的参与者更有可能向家庭医生和全科医生寻求心理健康问题的治疗，而在寻求此类治疗的参与者中，加拿大人也更有可能向心理健康专业人士寻求治疗。在这两个国家，少数种族或族裔寻求治疗的可能性低于白人。在加拿大，抑郁症的严重程度与寻求治疗的关系比在美国更为密切。结论：尽管 20 世纪 90 年代初的研究表明，加拿大寻求抑郁症治疗的比例高于美国，但此处提供的最新数据并未显示出这样的差距。然而，不同提供商的使用仍然存在差异。与美国相比，加拿大的抑郁症严重程度和治疗之间的匹配度更接近，这表明加拿大可以更有效地分配精神卫生保健资源来治疗抑郁症。
Objective: Cross-country comparisons of patterns of mental health treatment seeking provide insights into the impact of contextual factors on mental health service use. This study aimed to compare prevalence and predictors of mental health treatment seeking among adults with major depression in Canada and the United States. Methods: Data for 751 participants with a probable major depressive episode in the past 12 months were drawn from the 2002 - 2003 Joint Canada/United States Survey of Health: 304 were from Canada and 447 were from the United States. Probable major depressive episodes were ascertained by the Composite International Diagnostic Interview - Short-Form. Patterns of contacts with mental health and general health providers for mental health reasons were compared. Results: Prevalence of contacts with any provider for mental health problems was similar among participants with a probable major depressive episode in Canada and the United States ( 181 Canadians, or 56 percent, compared with 245 Americans, or 52 percent). Canadian participants were more likely than those in the United States to seek treatment for mental health problems from family doctors and general practitioners, and among participants who sought such treatment, Canadians were more likely to also seek treatment from mental health professionals. In both countries, racial or ethnic minorities were less likely than Caucasians to seek treatment. Depression severity was more closely associated with treatment seeking in Canada than in the United States. Conclusions: Although studies from the early 1990s showed higher rates of treatment seeking for depression in Canada than in the United States, the more recent data presented here do not show such a gap. However, differences persist in the use of various providers. Compared with the United States, Canada had a closer match between depression severity and treatment, which suggests more efficient allocation of mental health care resources for treatment of depression in Canada.