RESUMO
BACKGROUND: The Internet is widely used by young people and could serve to improve insufficient access to mental health care. Previous information on this topic comes from selected samples (students or self-selected individuals) and is incomplete. OBJECTIVE: In a community sample of young adults, we aimed to describe frequency of e-mental health care study-associated factors and to determine if e-mental health care was associated with the use of conventional services for mental health care. METHODS: Using data from the 2011 wave of the TEMPO cohort study of French young adults (N=1214, aged 18-37 years), we examined e-mental health care and associated factors following Andersen's behavioral model: predisposing factors (age, sex, educational attainment, professional activity, living with a partner, children, childhood negative events, chronic somatic disease, parental history of depression), enabling factors (social support, financial difficulties, parents' income), and needs-related factors (lifetime major depression or anxiety disorders, suicidal ideation, ADHD, cannabis use). We compared traditional service use (seeking help from a general practitioner, a psychiatrist, a psychologist; antidepressant or anxiolytics/hypnotics use) between participants who used e-mental health care versus those who did not. RESULTS: Overall, 8.65% (105/1214) of participants reported seeking e-mental health care in case of psychological difficulties in the preceding 12 months and 15.7% (104/664) reported psychological difficulties. Controlling for all covariates, the likelihood of e-mental health care was positively associated with 2 needs-related factors, lifetime major depression or anxiety disorder (OR 2.36, 95% CI 1.36-4.09) and lifetime suicidal ideation (OR 1.91, 95% CI 1.40-2.60), and negatively associated with a predisposing factor: childhood life events (OR 0.60, 95% CI 0.38-0.93). E-mental health care did not hinder traditional care, but was associated with face-to-face psychotherapy (66.2%, 51/77 vs 52.4%, 186/355, P=.03). CONCLUSIONS: E-mental health care represents an important form of help-seeking behavior for young adults. Professionals and policy makers should take note of this and aim to improve the quality of online information on mental health care and to use this fact in clinical care.
Assuntos
Comportamento de Busca de Ajuda , Internet , Transtornos Mentais/terapia , Saúde Mental , Telemedicina/organização & administração , Adolescente , Adulto , Estudos de Coortes , Transtorno Depressivo Maior , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Serviços de Saúde Mental/organização & administração , Apoio Social , Adulto JovemRESUMO
The COVID-19 pandemic has had a substantial and lasting impact on care provision, particularly in the field of cancer care. National steering has helped monitor the health situation and adapt the provision and organisation of care. Based on data from the French administrative healthcare database (SNDS) on the entire French population (67 million people), screening, diagnostic and therapeutic activity was monitored and compared 2019 on a monthly basis. A noteworthy decline in all activities (with the exception of chemotherapy) was observed during the first lockdown in France. Over the months that followed, this activity returned to normal but did not make up for the shortfall from the first lockdown. Finally, during the lockdown in late 2020, cancer care activity was conserved. In brief, in 2020, the number of mammograms decreased by 10% (- 492,500 procedures), digestive endoscopies by 19% (- 648,500), and cancer-related excision by 6% (- 23,000 surgical procedures). Hospital radiotherapy activity was down 3.8% (- 4400 patients) and that in private practice was down 1.4% (- 1600 patients). Chemotherapy activity increased by 2.2% (7200 patients), however. To summarize, COVID-19 had a very substantial impact during the first lockdown. Safeguarding cancer care activity helped limit this impact over the months that followed, but the situation remains uncertain. Further studies on the medium- and long-term impact on individuals (survival, recurrence, after-effects) will be conducted.
Assuntos
COVID-19 , Atenção à Saúde/estatística & dados numéricos , Neoplasias/diagnóstico , Neoplasias/terapia , Serviço Hospitalar de Oncologia/estatística & dados numéricos , Quarentena/estatística & dados numéricos , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Atenção à Saúde/métodos , França/epidemiologia , HumanosRESUMO
BACKGROUND: Unlike other psychological correlates of weight status, emotional eating (EmE) has received relatively limited attention in the literature. OBJECTIVES: We aimed to examine the association between the EmE score and weight status and the influence of sex and dieting on this association. DESIGN: A total of 8580 men and 27,061 women aged ≥18 y who participated in the NutriNet-Santé cohort study were selected in this cross-sectional analysis. Self-reported weight and height, EmE scores of the revised 21-item version of the Three-Factor Eating Questionnaire, and dieting status data were collected. The relation between EmE and weight status was estimated by using multiple linear and logistic regression models adjusted for sociodemographic and lifestyle factors. Interactions of EmE with sex and dieting history were assessed. RESULTS: Median EmE scores were greater in women than in men and in former or current dieters than in subjects without a history of dieting. Strong associations appeared between the EmE score and weight status in most categories of sex × dieting status. The strongest associations between EmE and weight status were observed in women, particularly in never dieters [body mass index slope (95% CI): 2.61 (2.43, 2.78); overweight OR (95% CI): 5.06 (4.24, 6.05)]. CONCLUSIONS: These observations support the existence of an association between EmE and weight status. The effect modification of sex and dieting on the EmE score and on the association of the EmE score with weight status should be taken into account in obesity prevention.