Delay in initial treatment contact after first onset of mental disorders in metropolitan China

Lee, S.; Fung, S. C.; Tsang, Adley; Zhang, M. Y.; Huang, Yueqin; He, Yan; Liu, Zhaorui; Shen, Yucun; Kessler, Ronald C.

doi:10.1111/j.1600-0447.2006.00933.x

Cited by 19 publications

(16 citation statements)

References 22 publications

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“…According to the National Comorbidity Survey – Replication, the cumulative lifetime probability of treatment of MDD approaches 90%, but median time from disorder onset to first treatment is 8 years (3). Long lags in first contact for depression treatment have also been reported in Italy (10), Mexico (11) and China (12). …”

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confidence: 89%

Influence of Comorbid Mental Disorders on Time to Seeking Treatment for Major Depressive Disorder

et al. 2012

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Background Although treatment of depression has increased in recent years, long delays commonly separate disorder onset from first treatment contact. Objectives This study evaluates the effects of psychiatric comorbidities and socio-demographic characteristics on lifetime treatment seeking and speed to first treatment contact for major depressive disorder (MDD). Measures A cross-sectional epidemiological survey including retrospective structured assessments of DSM-IV MDD and other psychiatric disorders, respondent age at disorder onset, and age at first treatment contact. Subjects A nationally representative sample of 5,958 adults aged ≥18 years residing in households and group quarters who met lifetime criteria for MDD. Data Analysis The percentage of respondents with lifetime MDD who reported ever seeking treatment is reported overall and stratified by sociodemographic characteristics. Unadjusted and adjusted hazard ratios are presented of time to first depression treatment seeking by sociodemographic characteristics and comorbid psychiatric disorders. Results A majority (61.3%) of respondents with MDD reported having sought treatment for depression at some point in their lives. Time to first depression treatment contact was significantly related to the occurrence of comorbid panic disorder (AHR=2.01, 95%CI=1.69–2.39), generalized anxiety disorder (AHR=1.55, 95%CI=1.33–1.81), drug dependence (AHR=1.54, 95%CI=1.06–2.26), dysthymic disorder (AHR=1.54, 95%CI=1.35–1.76), and PTSD (AHR=1.34, 95%CI=1.13–1.59) and inversely related to male sex (AHR=0.74, 95%CI=0.66–0.82) and black race/ethnicity (AHR=0.69, 95%CI=0.59–0.81). Conclusion Comorbid psychiatric disorders, especially panic, generalized anxiety, substance use, and dysthymic disorders, appear to play an important role in accelerating treatment seeking for MDD. Outreach efforts should include a focus on depressed individuals without complicating psychiatric comorbidities.

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confidence: 89%

Influence of Comorbid Mental Disorders on Time to Seeking Treatment for Major Depressive Disorder

et al. 2012

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“…While the public health aspects of psychiatry are largely neglected in medical education worldwide [7], we have previously reported that the public health impact of depression is more widely known among Australian than Chinese medical students [8]. Other issues related to under-treatment of mental disorders in China include immense population size, inadequacies of the health system including poor mental health expenditure, lack of mental health specialists especially in rural areas, as well as stigma in both the community and among health professionals [9,10]. A lack of medical or personal knowledge of common mental health problems like depression may contribute to negative attitudes and reinforce health services neglect and other discriminatory behaviour [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…Thus the vast majority of medical presentations of depression will be to doctors without specific mental health expertise. However, only approximately 8% of people suffering from a mood disorder will make contact with a treatment provider for their condition in China [9]. Thus there will be a growing reliance in China upon non-specialist doctors to achieve early recognition and treatment.…”

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confidence: 99%

Improving Knowledge and Attitudes towards Depression: a controlled trial among Chinese medical students

et al. 2011

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BackgroundEstablishing an evidence-based method of improving knowledge and attitudes concerning depression has been identified as a priority in Chinese medical education. The purpose of this study was to determine whether a self-directed learning strategy as a part of student-centred education improved knowledge of and attitudes towards depression among Chinese medical students.MethodsA controlled trial in which 205 medical students were allocated to one of two groups: didactic teaching (DT) group or a combined didactic teaching and self-directed learning (DT/SDL) group. The DT/SDL group continued having a series of learning activities after both groups had a lecture on depression together. Student's knowledge and attitudes were assessed immediately after the activities, one month and six months later.ResultsThe intervention (DT/SDL) group showed substantially greater improvements in recognition of depression as a major health issue and identifying helpful treatments than the DT group. Only the DT/SDL group demonstrated any improvement in attitudes. This improvement was sustained over six months.ConclusionsSelf-directed learning is an effective education strategy in improving medical students' knowledge of and attitudes towards depression.

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“…En Estados Unidos se observó que en los pacientes con abuso de alguna droga demoran en promedio 6 años y los que hacían abuso del alcohol 9 años 17 . En China, la demora en hacer contacto con los servicios de salud es de 17 años 32 . Estos lapsos de demora pueden ser mayores o menores en comparación a otros trastornos (Depresión y Ansiedad) y según el lugar de la evaluación 17,26,32 .…”

Section: Discussionunclassified

“…En China, la demora en hacer contacto con los servicios de salud es de 17 años 32 . Estos lapsos de demora pueden ser mayores o menores en comparación a otros trastornos (Depresión y Ansiedad) y según el lugar de la evaluación 17,26,32 . El promedio de demora en la población estudiada es mayor al observado en otros países desarrollados y en vías de desarrollo, sin embargo no llega a ser tan alto como en China.…”

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Demora en la búsqueda de atención médica en pacientes adictos a sustancias psicoactivas

Rivadeneyra

Cabrera

2010

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Introduction: Clinical practice shows that addict patients tend to seek Introduction: Clinical practice shows that addict patients tend to seek Introduction: attention from health services after a long period of time, and that their relatives do not seek early medical care, despite knowledge of the addiction. Objectives: To determine the time elapsed between the . Objectives: To determine the time elapsed between the . Objectives: beginning of patients' substance use and when they first seek specialized medical care (TC) and the time elapsed between relatives perceiving the substance use and when they first seek specialized medical care (TSAM); also, to identify the factors associated with seeking medical care earlier.Design: Observational, descriptive study. A structured survey, validated by experts in the field of addiction, was applied to 113 family members responsible for patients addicted to psychoactive substances in 5 hospitals in the city of Lima. Results: Patients seek specialist medical care for the first time 11.22 years after commencement of substance use, and family members take to 4.69 years to seek medical care from when they perceive of the substance use. Female gender, the concept of addiction as a disease and not waiting for the patient's decision before seeking medical care reduce TC and TSAM in the case of most substances. Conclusions: Patients addicted to psychoactive substances turn to health services only after long TC and TSAM; moreover, the delay in seeking medical care on the part of relatives means that patients continue to use substances. RESUMEN ABSTRACTIntroducción: En la práctica clínica se observa que los pacientes adictos Introducción: En la práctica clínica se observa que los pacientes adictos Introducción: a sustancias psicoactivas acuden a los servicios de salud después de un largo periodo de tiempo y que los familiares conociendo del consumo no realizan una búsqueda temprana de la atención médica. Objetivos: Determinar el tiempo transcurrido desde que los pacientes empiezan el consumo hasta que buscan por primera vez atención médica especializada (TC) y el tiempo transcurrido desde que los familiares perciben el consumo hasta que buscan por primera vez atención médica especializada (TSAM). Determinar los factores que se asocian a una búsqueda temprana de la atención médica. Diseño: Estudio observacional, descriptivo de corte transversal. Se aplicó una encuesta estructurada validada por juicio de expertos en el área de adicciones a 113 familiares responsables de pacientes adictos a sustancias psicoactivas de 5 hospitales de la ciudad de Lima. Resultados: Los pacientes acuden Resultados: Los pacientes acuden Resultados: a la atención médica especializada por primera vez después de 11.22 años de iniciado el consumo y los familiares tardan en buscar atención médica 4.69 años desde que perciben el consumo. El género femenino, la concepción de la adicción como enfermedad y no esperar la decisión del paciente para acudir a la atención médica, reducen el TC y TSAM en la mayoría de s...

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Delay in initial treatment contact after first onset of mental disorders in metropolitan China

Abstract: Failure to receive treatment is a pervasive phenomenon among people with mental disorders in metropolitan China.

Cited by 19 publications

References 22 publications

Influence of Comorbid Mental Disorders on Time to Seeking Treatment for Major Depressive Disorder

Influence of Comorbid Mental Disorders on Time to Seeking Treatment for Major Depressive Disorder

Improving Knowledge and Attitudes towards Depression: a controlled trial among Chinese medical students

Demora en la búsqueda de atención médica en pacientes adictos a sustancias psicoactivas

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