Factors associated with help‐seeking behaviors in Mexican older individuals with depressive symptoms: a cross‐sectional study

Abstract

Objective Depression in the elderly is associated with multiple adverse outcomes, such as high health service utilization rates, low pharmacological compliance, and synergistic interactions with other comorbidities. Moreover, the help seeking process, which usually starts with the feeling “that something is wrong” and ends with appropriate medical care, is influenced by several factors. The aim of this study was to explore factors associated with the pathway of help seeking among older adults with depressive symptoms. Methods A cross-sectional study of 60-year or older of community dwelling elderly belonging to the largest health and social security system in Mexico was done. A standardized interview explored the process of seeking health care in four dimensions: depressive symptoms, help seeking, help acquisition and specialized mental health. Results A total of 2,322 individuals were studied; from these, 67.14% (n=1,559) were women, and the mean age was 73.18 years (SD=7.02) 57.9% had symptoms of depression, 337 (25.1%) participants sought help, and 271 (80.4%) received help and 103 (38%) received specialized mental health care. In the stepwise model for not seeking help (χ2=81.66, p<0.0001), significant variables were female gender (OR=0.07 95% CI 0.511–0.958 p=0.026), health care use (OR 3.26 CI 95% 1.64–6.488, p=0.001). Number of years in school, difficulty in activities, SAST score and depression as a disease belief were also significant. Conclusions Appropriate mental health care is rather complex and is influenced by several factors. The main factors associated with help seeking were gender, education level, recent health service use, and the belief that depression is not a disease. Detection of subjects with these characteristics could improve care of elderly with depressive symptoms.

Risk factors for depression in the elderly inflammatory bowel disease population

“…Education level, in a complex model also including gender, health care utilization and the belief that depression is not a disease, has been associated with help-seeking behavior for depressive symptoms in community-dwelling older individuals. 28 Regan et al also demonstrated a significant inverse association between education level and depressive symptoms in older adults. 19 …”

Risk Factors for Depression in the Elderly Inflammatory Bowel Disease Population

“…Education level, in a complex model also including gender, health care utilization and the belief that depression is not a disease, has been associated with help-seeking behavior for depressive symptoms in community-dwelling older individuals. 28 Regan et al also demonstrated a significant inverse association between education level and depressive symptoms in older adults. 19 There have been several proposed mechanisms for the associations between depression and IBD.…”

Determinantes asociados a depresión crónica e incidente en adultos mayores mexicanos

“…No obstante, es una realidad que, en los países de bajo y mediano ingreso, la posibilidad de recibir tratamiento oportuno y adecuado es limitada 32 . En México, en una encuesta realizada a 2322 AM derechohabientes del Instituto Mexicano del Seguro Social, se encontró que solo el 7.6% de los sujetos con síntomas depresivos contaba con atención adecuada, lo cual se traduce en que más del 90% no la recibe, ya sea porque no la solicitan o porque no se les otorga 34 . Por todo lo hasta aquí señalado, debe considerarse que es necesario identificar las diversas condiciones asociadas a cada tipo particular de depresión e identificar grupos en riesgo para planear intervenciones, para contribuir a abatir la depresión en el AM y sus consecuencias.…”