Low Use of Mental Heat Services Among Older Americans With Mood and Anxiety Disorders
Low Use of Mental Heat Services Among Older Americans With Mood and Anxiety Disorders
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DOI：
10.1176/appi.ps.201100121
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发表时间：
2012-01-01
影响因子：
3.8
通讯作者：
Yaffe, Kristine
中科院分区：
文献类型：
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作者：
Byers, Amy L.;Arean, Patricia A.;Yaffe, Kristine
目的：目前尚不清楚为什么晚年情绪和焦虑障碍治疗严重不足，尽管在老年人中很常见。因此，本研究探讨了社区居住的老年人患有这些疾病的患病率和与不使用精神卫生服务相关的关键因素。研究方法：样本包括348名年龄在55岁或以上的参与者，他们符合DSM-IV情绪和焦虑障碍的12个月标准，并对国家科摩罗调查重复（NCS-R）做出了回应，NCS-R是一个基于人群的概率样本。分析包括频率测量和具有权重的逻辑回归以及复杂设计校正的统计检验。与不使用精神卫生服务相关的关键因素在最终的多变量模型中确定，该模型基于一种系统方法，该方法考虑了潜在预测因子的全面列表。结果：大约70%的情绪和焦虑障碍的老年人没有使用服务。那些来自少数民族群体的人，不喜欢讨论个人问题，已婚或同居，中等收入和高收入的人不使用心理健康服务的几率增加。此外，轻度与严重疾病，无慢性疼痛投诉，低与高感知认知障碍的受访者有更大的不使用几率。结论：结果表明，需要在以下方面进行改进，以打击美国老年人未经治疗的大量情绪和焦虑障碍：对需求的认识，与医疗保健专业人员讨论个人问题的舒适度，以及筛查和其他预防工作。（精神病学服务63：66-72，2012）
Objective: It is unclear why late-life mood and anxiety disorders are highly undertreated, despite being common among older adults. Thus this study examined prevalence of and key factors associated with nonuse of mental health services among older community-dwelling adults with these disorders. Methods: The sample included 348 participants aged 55 years or older who met 12-month criteria for DSM-IV mood and anxiety disorders and responded to the National Comorbidity Survey Replication (NCS-R), a population-based probability sample. Analyses included frequency measures and logistic regression with weights and complex design corrected statistical tests. Key factors associated with not using mental health services were determined in a final multivariable model based on a systematic approach that accounted for a comprehensive list of potential predictors. Results: Approximately 70% of older adults with mood and anxiety disorders did not use services. Those who were from racial-ethnic minority groups, were not comfortable with discussing personal problems, were married or cohabitating, and had middle- versus high-income status had increased odds of not using mental health services. In addition, respondents with mild versus serious disorders, no chronic pain complaints, and low versus high perceived cognitive impairment had greater odds of nonuse. Conclusions: Results indicate that improvements are needed in the following areas to combat the very high number of mood and anxiety disorders that go untreated in older Americans: awareness of need, comfort in discussing personal problems with a health care professional, and screening and other prevention efforts. (Psychiatric Services 63:66-72, 2012)