Treatment-seeking behaviours for depression in the general population: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

Carragher, Natacha; Adamson, Gary; Bunting, Brendan; McCann, Siobhan

doi:10.1016/j.jad.2009.05.009

Cited by 26 publications

(40 citation statements)

References 71 publications

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“…The overall prevalence rates we observed (21% with a psychiatric disorder and 20% with a substance use disorder) were significantly elevated compared with rates of non–HIV-positive individuals in the general population (1). As in previous general population (29,30) and HIV (23) studies, in this study major depression was the most prevalent diagnosis. Overall rates and prevalence of specific psychiatric and substance use disorders were somewhat lower than those observed in other large HIV samples, perhaps because we used provider-assigned diagnosis in our sample selection rather than structured interviews (3,4,23).…”

Section: Discussionsupporting

confidence: 67%

Factors Associated With Treatment Initiation for Psychiatric and Substance Use Disorders Among Persons With HIV

Satre¹,

DeLorenze²,

Quesenberry³

et al. 2013

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Objective Prior studies of individuals with HIV infection have found that accessing psychiatric and substance abuse treatment when needed can improve health and prolong life, yet little is known about factors associated with treatment initiation. Methods In a retrospective cohort design including individuals with HIV infection (≥14 years old) in an integrated health care system in Northern California, this study included 822 patients with a major psychiatric diagnosis and 1,624 with a substance use disorder diagnosis. Data were extracted from a regional HIV registry and computerized databases. Results Twenty-four percent (N=198) of study patients with psychiatric diagnoses and 15% (N=245) with substance abuse or dependence received one or more specialty care visits within 12 months of diagnosis. Among patients with a psychiatric diagnosis, significant predictors of visiting a psychiatry clinic included not having an AIDS diagnosis at baseline or before the study (p=.049), having a diagnosis of major depression (p=.013), having a diagnosis of bipolar disorder (p<.001), and receiving a psychiatric diagnosis in 1996 versus later years of the study (p<.01). Among patients with a substance use disorder, significant predictors of initiating substance abuse treatment included age <30 (p=.015) and being in the HIV transmission risk group of injection drug use (p<.001). Conclusions Clinical, diagnostic, and demographic factors were associated with specialty care treatment initiation in this sample of individuals with HIV infection and substance use or psychiatric disorders. Developing strategies to enhance treatment initiation has the potential to improve outcomes for individuals with HIV infection.

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Section: Discussionsupporting

confidence: 67%

Factors Associated With Treatment Initiation for Psychiatric and Substance Use Disorders Among Persons With HIV

Satre¹,

DeLorenze²,

Quesenberry³

et al. 2013

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“…Poor targeting of treatments may result in attenuation of treatment effects. Disparities in access to mental health services have been repeatedly noted in past research (Alegria et al, 2002;Barksdale et al, 2010;Carragher et al, 2010;Hauenstein et al, 2006;Jorm et al, 2000;Kataoka et al, 2002;Mojtabai, 2009b;Parslow and Jorm, 2001).…”

Section: Discussionmentioning

confidence: 88%

Trends in psychological distress, depressive episodes and mental health treatment-seeking in the United States: 2001–2012

Mojtabai

Jorm

2015

Journal of Affective Disorders

121

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“…The paradoxical fi nding that women identify with more barriers to care seeking while simultaneously being more likely to seek treatment deserves future research attention. 35 This effect should be interpreted with caution, because it emerges only in the adjusted analysis. It may be that this ambivalence and doubt are motivating some women to seek and accept treatment.…”

Section: Discussionmentioning

confidence: 99%

Suffering in Silence: Reasons for Not Disclosing Depression in Primary Care

Bell

Franks

Duberstein

et al. 2011

The Annals of Family Medicine

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PURPOSE Depression symptoms are underreported by patients. We thus assessed individuals' reasons for not disclosing depression to their primary care physician. METHODSWe conducted a follow-up telephone survey of 1,054 adults who had participated in the California Behavioral Risk Factor Survey System. Respondents were asked about reasons for nondisclosure of depressive symptoms to their primary care physician, depression-related beliefs, and demographic characteristics. Descriptive and inferential statistical procedures were used to characterize perceived obstacles to disclosure. RESULTSOf the respondents, 43% reported 1 or more reasons for nondisclosure. The most frequent reason was the concern that the physician would recommend antidepressants (22.9%; 95% confi dence interval, 18.8%-27.5%). Reported reasons for nondisclosure of depression varied based on whether the respondent had a history of depression. For example, respondents with no depression history were more likely to believe that depression falls outside the purview of primary care (P = .040) and more likely to fret about being referred to a psychiatrist (P = .036). Respondents with clinically signifi cant depressive symptoms rated 10 of 11 barriers to disclosure as more personally applicable than did those without symptoms (all P values ≤.014). Number of reported disclosure barriers was predicted by demographic characteristics (being female, Hispanic, of low socioeconomic status), depression beliefs (depression is stigmatizing and should be under one's control), symptom severity, and absence of a family history of depression.CONCLUSIONS Many adults subscribe to beliefs likely to inhibit explicit requests for help from their primary care physician during a depressive episode. Interventions should be developed to encourage patients to disclose their depression symptoms and physicians to ask about depression. Ann Fam Med 2011;9:439-446. doi:10.1370/afm.1277. INTRODUCTIONL ifetime and 12-month prevalence of major depressive disorder (MDD) in the United States has been estimated to be 16.2% and 6.6%, respectively.1 In one-fourth of primary care patients with MDD, the condition is not diagnosed, 1 and a majority who seek help from a primary care physician do not receive appropriate treatment.2,3 Because patients are often treated in primary care, 3 efforts have been made to improve recognition, treatment, and follow-up for patients with depression in general practice. 4 Suboptimal levels of recognition and treatment are due to a variety of physician, health system, and patient factors. 4-7The present study is part of the formative research of a larger project that will develop and evaluate offi ce-based interventions to encourage seeking care for depression. This research is grounded in a model that assumes self-disclosure of depression is a key step on the road to appropriate diagnosis and therapy. Physicians are more likely to initiate treatment when the patient provides recognizable clues to depression, 8 discloses symptoms of depression, or dire...

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Treatment-seeking behaviours for depression in the general population: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

Cited by 26 publications

References 71 publications

Factors Associated With Treatment Initiation for Psychiatric and Substance Use Disorders Among Persons With HIV

Factors Associated With Treatment Initiation for Psychiatric and Substance Use Disorders Among Persons With HIV

Trends in psychological distress, depressive episodes and mental health treatment-seeking in the United States: 2001–2012

Suffering in Silence: Reasons for Not Disclosing Depression in Primary Care

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