Trends in levels of self-reported psychological distress among individuals who seek psychiatric services over eight years: a comparison between age groups in three population surveys in Stockholm County

Abstract

BackgroundPsychiatric service use has increased in Sweden and in other developed countries, particularly among young people. Possible explanations include lower threshold for help-seeking among young people, but evidence is scarce.MethodsWe analysed the 2002, 2006 and 2010 Stockholm public health surveys for changes in the mean level of psychological distress among adult users of psychiatric in- and outpatient services in four age groups: 18–24, 25–44, 45–64 and ≥65 years. Psychological distress was measured via the 12-item General Health Questionnaire (GHQ-12), using the Likert scoring method 0–1–2-3. In- and out-patient psychiatric service use within 6 months from the surveys was obtained from registers.ResultsThe mean level of distress among young adults 18–24 years who utilize psychiatric services decreased between 2002 (mean GHQ-12 score, 95% confidence interval 20.5, 18.1–23.0) and 2010 (16.2, 14.6–17.7), while it remained fairly stable in older age groups. Results were similar in sex-stratified analyses, although the decrease was statistically significant only among young women 18–24 years. At the end of the follow-up, the level of distress among patients was similar for all age-groups.ConclusionsThere were no differences between age groups in the level of distress when seeking care at the end of the follow-up period, supporting that there is no age-specific over- or under-consumption of psychiatric care in later years. However, the lowered threshold for help-seeking among young adults over time might have contributed to increases in psychiatric service use in the young age group. Public health policy and service delivery planning should consider the needs of the widening group of young users of psychiatric services.

Trends in the utilization of youth primary healthcare services and psychological distress

“…According to the Norwegian Institute of Public Health [43], underuse of primary healthcare services appears to be more likely in the general population. On the other hand, the Norwegian Institute of Public Health points out that if help-seeking behavior were to increase among those with low levels of psychological symptoms as opposed to those with high levels of symptoms, as seen in our study and in a study by Kosidou et al [13], this might instead indicate overuse of health services.…”

“…However, this development was not found among adults. The authors therefore argued that a lower threshold of help-seeking behavior among young people may explain the recent increase in psychiatric service use in Sweden and perhaps in other developed countries [13]. Another study involving patient data from 34 countries investigated the propensity to seek healthcare and found that it was weakly associated with greater use of a family doctor [45].…”

“…Our nding of increased primary healthcare service utilization among the less distressed are rather unexpected, based on the healthcare utilization theory, and it is a topic that has seldomly been explored in research. Subsequently, it is unknown to what extent this may represent a general phenomenon, re ecting greater societal awareness-or reduced stigma of mental health problems [13,44]. Other researchers, however, suggest a more speci c cause of increased primary healthcare utilization, speci c to Norwegian youth.…”

Automated screening for distress: A perspective for the future

“…The Symptom Checklist‐90) and Brief Symptom Inventory have been widely used for screening of psychological distress in medical patients and demonstrated high levels of specificity and sensitivity (Carlson & Bultz, ; Zabora, Smith‐Wilson, Fetting, & Enterline, ). The 12‐item General Health Questionnaire (GHQ‐12) is designed to study psychological disorders in general clinical setting and has been used in various studies for distress screening (Cuellar‐Flores, Sánchez‐López, Limiñana‐Gras, & Colodro‐Conde, ; Kosidou et al, ). A popular scale for distress assessment is the K10 (Kessler et al, ).…”

“…The 12-item General Health Questionnaire (GHQ-12) is designed to study psychological disorders in general clinical setting and has been used in various studies for distress screening (Cuellar-Flores, Sánchez-López, Limiñana-Gras, & Colodro-Conde, 2014;Kosidou et al, 2017). A popular scale for distress assessment is the K10(Kessler et al, 2002).…”