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1.
BMC Psychiatry ; 21(1): 570, 2021 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-34781933

RESUMEN

BACKGROUND: It has been hypothesized that mental illness stigma differs according to what matters most to people, and that this results in value-based differences in stigma within societies. However, there is a lack of stigma measures that account for a broad range of values, including modern and liberal values. METHODS: For the development of the Value-based Stigma Inventory (VASI) a preliminary item-pool of 68 VASI-items was assembled by mental health and stigma experts. For psychometric evaluation, we tested the VASI in an online sample of the general population (n = 4983). RESULTS: Based on item-characteristics as well as explorative and confirmatory factor analyses, a final version of the VASI was developed, comprising 15 items and 5 subscales. The VASI shows good psychometric properties (item difficulty = 0.34 to 0.67; mean inter-item correlation r = 0.326; Cronbach's α = 0.879). Medium to high correlations with established stigma scales (SDS, SSMI), medium associations with instruments assessing personal values (PVQ, KSA-3) and small to no associations with a social desirability scale (KSE-G) attest to good convergent and discriminatory validity of the new instrument. Normative values for the VASI subscales are presented. CONCLUSIONS: The developed VASI can be used to assess public stigma of mental illness including personal stigma-relevant value orientations.

2.
Int J Behav Med ; 2021 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-34642890

RESUMEN

BACKGROUND: Anticipated and experienced stigma constitute important issues for patients with multiple sclerosis receiving adequate healthcare. Stigma is likely to be associated with lower quality of life in patients with multiple sclerosis, but the underlying mechanisms and contributing factors are unclear. METHODS: We conducted a cross-sectional survey among N = 101 patients with a diagnosis of multiple sclerosis in a German outpatient department. Patients completed questionnaires on enacted and self-stigma (SSCI-8), sense of coherence (SOC-L9) and quality of life (MusiQol). Age, sex, disease duration, disability or extent of limitations (EDSS), cognition (SDMT), depression (BDI-II) and fatigue (FSMC) were used as covariates in linear regression and mediation models. RESULTS: 57.3% of patients with MS reported having experienced stigmatization due to MS at least once. Fatigue (b = -0.199, p < 0.001), enacted stigmatization experience (b = -0.627, p = 0.010) and sense of coherence (b = 0.654, p < 0.001) were significant predictors for quality of life. The mediation analysis showed a partial mediation of the association between enacted stigma and quality of life by patients' sense of coherence (direct effect: b = -1.042, t = -4.021, p < 0.001; indirect effect: b = -0.773, CI = -1.351--0.339. The association of self-stigma with quality of life was fully mediated by sense of coherence (b = -1.579, CI = -2.954--0.669). CONCLUSION: Patients with multiple sclerosis are affected by stigma, which is associated with lower quality of life. Sense of coherence is a potentially important mediator of stigma and represents a promising target to refine existing stigma interventions and improve the quality of life in these patients.

3.
PLoS One ; 16(10): e0258782, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34662349

RESUMEN

Victims of childhood trauma report shame and anticipation of stigma, leading to non-disclosure and avoidance of help. Stigma is potentially aggravating the mental health consequences of childhood trauma. So far there is no comprehensive study examining stigma toward adult survivors of various forms of childhood trauma, and it is unclear whether stigma interferes with reaching out to affected individuals. In a vignette study based on a representative sample of the German general population (N = 1320; 47.7% male) we randomly allocated participants to brief case vignettes pertaining to past childhood sexual/physical abuse or accidents, and adult physical abuse. Stigma was elicited by applying the Social Distance Scale, assessing respondents' attitudes/stereotypes toward the persons in the vignette and their reluctance to address the specific trauma in conversation. While one aim was to establish the prevalence of stigma toward persons with CT, we hypothesized that attitudes differ according to type of trauma. Of the respondents, 45% indicated they were unlikely to reach out to a victim of childhood sexual abuse, 38% to a victim of childhood physical abuse, 31% to someone reporting a childhood accident and 25% to someone reporting adult physical abuse. Contrary to our expectations, childhood sexual abuse did not consistently elicit more stigma than childhood physical abuse in Krukall-Wallis tests. Equally, childhood interpersonal trauma did not consistently elicit more stigma than childhood accidental trauma. Structural equation modeling revealed social distance as mediator of the relationship between negative stereotypes and reluctance to address childhood trauma in conversation. Our analyses further revealed an ambiguous role of negative stereotypes in addressing childhood trauma in conversation with trauma victims, which has yet to be examined. There is evidence for stigma associated with having survived childhood trauma, which is interfering with offering help.

4.
Sci Rep ; 11(1): 14068, 2021 07 07.
Artículo en Inglés | MEDLINE | ID: mdl-34234182

RESUMEN

Childhood maltreatment has been shown to relate to adult obesity. In this epidemiological study, we investigate the association between childhood maltreatment and waist-to-height-ratio (WHtR) in a sample of the German adult population, comprising of N = 2936 participants. WHtR, an indicator for risk of obesity, was the primary outcome. Childhood maltreatment was assessed by the Childhood Trauma Screener (CTS), which assesses emotional and physical neglect, abuse as well as sexual abuse. Cohort-data were harmonized and analyzed within DataSHIELD. We used multivariable regression models to estimate the association of childhood maltreatment and WHtR at different levels of adjustments for potential confounders. Overall childhood maltreatment was associated with a higher WHtR in both sexes (women: p = 0.004, men: p < 0.001); associations were no longer significant in women after adding socioeconomic variables, but remained significant in men (p = 0.013). Additionally, we were able to identify sex specific patterns for childhood maltreatment predicting the WHtR. Emotional neglect and abuse had stronger impacts on the WHtR in women than in men, whereas physical neglect and abuse had stronger impacts in men. To our knowledge, this is the first comprehensive population-based study testing various types of childhood maltreatment with WHtR in sex-, region- and weight-stratified analyses. Future studies in clinical populations are warranted to examine U-shaped correlations between increased WHtR and childhood maltreatment.


Asunto(s)
Experiencias Adversas de la Infancia/estadística & datos numéricos , Obesidad/epidemiología , Obesidad/etiología , Adulto , Niño , Maltrato a los Niños/estadística & datos numéricos , Susceptibilidad a Enfermedades , Femenino , Humanos , Masculino , Análisis Multivariante , Vigilancia de la Población , Medición de Riesgo , Factores de Riesgo
5.
Curr Opin Psychiatry ; 34(4): 400-404, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33993170

RESUMEN

PURPOSE OF REVIEW: To summarize the most recent literature on risk factors of homelessness, mental, and somatic health needs, healthcare use, stigma as well as intervention strategies for people experiencing homelessness. RECENT FINDINGS: Studies identified adverse life events as well as mental health problems like drug use or suicidality as significant predictors of becoming homeless. Prevalence rates of mental disorders, especially substance use disorders, psychotic disorders, and depression are high. Barriers of healthcare use are financial resources and insurance status as well as experiences of discrimination. Aspects of trust and safety as well as age and gender were identified of high importance in the design of interventions. Strategies of permanent supportive housing like Housing First have shown a stable positive effect on housing stability, but not mental health outcomes. Peer support, forms of intensive case management, and harm reduction strategies are the most promising approaches to address these further needs. SUMMARY: Exploration into the relationship of homelessness and mental health as well as adequate intervention strategies is far from being conclusive. Especially, the development of effective interventions addressing issues of trauma, stigma and discrimination, community integration, and mental health needs is still in its infancy.


Asunto(s)
Necesidades y Demandas de Servicios de Salud , Personas sin Hogar , Servicios de Salud Mental , Estigma Social , Vivienda , Humanos , Factores de Riesgo
6.
Psychiatr Prax ; 48(8): 404-411, 2021 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-34015855

RESUMEN

OBJECTIVE: Study of sociodemographic and disorder-specific determinants of professional help-seeking in lifetime depression. METHODS: In the population-based SHIP-Trend-1 study (2016-2019), we assessed N = 490 adults with lifetime depression and their help-seeking behaviour. Gender, socioeconomic status and disorder-specific variables were implemented in age-stratified logistic regression models. RESULTS: Men and older adults at the time of the survey sought less help than women and younger people. In the younger and middle age group severity level was associated with professional help-seeking, in the older age group professional help-seeking was more prevalent in case of physical causes for the depression. CONCLUSION: We found age-specific differences in the determinants for professional help-seeking. Latent variables like age-specific experiences, values, and life styles may explain those differences.


Asunto(s)
Depresión , Aceptación de la Atención de Salud , Anciano , Femenino , Alemania , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
7.
Fortschr Neurol Psychiatr ; 89(11): 573-577, 2021 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-33946123

RESUMEN

AIM: In specialties that heavily rely on communication skills such as psychiatry, psychotherapy and psychosomatic medicine, teaching in times of the COVID-19 pandemic is especially challenging. In this overview, educators and course directors report their experiences in eteaching and share their innovative solutions. METHODS: We present a collection of methods that relate to teaching and assessment as well as student activation. RESULTS: A range of helpful tools for teaching were compiled. This includes instructional videos with simulated patients, structured homework to document a mental status examination, structured hand-offs, and practical examinations in video format. Motivational techniques include podcasts with interviews with clinicians and patients and teaching with the use of cinematic material. DISCUSSION: Switching to online formats creates opportunities and advantages for the advancement of time- and location-independent learning. A fast conversion in this direction might also pose some disadvantages. A direct patient-student interaction is critical for engaging with transference, countertransference and situational aspects for teaching in psychosocial disciplines. Empirical studies of the effectiveness of these newly developed formats and faculty development for digital teaching are necessary.


Asunto(s)
COVID-19 , Educación Médica , Humanos , Aprendizaje , Pandemias , SARS-CoV-2
9.
Psychiatr Prax ; 2021 May 20.
Artículo en Alemán | MEDLINE | ID: mdl-34015852

RESUMEN

OBJECTIVE: We present a German version of the Prejudice towards People with Mental Illness Scale in long (PPMI-DL) and short form (PPMI-DK) and provide a psychometric evaluation in a German population sample. METHODS: After German translation (including back-translation), an online survey (N = 1004) was conducted. RESULTS: Item difficulty and selectivity are in the desirable medium range. Internal consistencies are high to excellent (PPMI-DL: α = 0.919; PPMI-DK: α = 0.872) in the overall scale. Confirmatory factor analyses confirm the 4 subscales of the original scale. Medium correlations are found with authoritarian attitudes (KSA-3) and low negative correlations with social desirability (KSE-G). Norm values for the PPMI subscales are reported. CONCLUSION: The PPMI-D can be used in German-speaking countries to survey prejudice towards people with mental illness.

10.
Alcohol Clin Exp Res ; 45(5): 899-911, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33970504

RESUMEN

BACKGROUND: We summarize research on the public stigmatization of persons with alcohol use disorder (AUD) in comparison with other mental health conditions and embed the results into a conceptual framework of the stigma process. METHODS: We conducted a systematic search using Embase, MEDLINE, PubMed and PsycINFO (via Ovid), and Web of Science for population-based studies on the public stigma in AUD and at least 1 other mental health condition, published between October 1, 2010 and December 20, 2020, thus including all studies published since the last systematic review on this topic. The study is registered with PROSPERO (registration number: CRD42020173054). RESULTS: We identified 20,561 records, of which 24 met the inclusion criteria, reporting results from 16 unique studies conducted in 9 different countries. Compared to substance-unrelated mental disorders, persons with AUD were generally less likely to be considered mentally ill, while they were perceived as being more dangerous and responsible for their condition. Further, the public desire for social distance was consistently higher for people with AUD. We found no consistent differences in the public stigma toward persons with AUD in comparison with other substance use disorders. CONCLUSION: The stigmatization of persons with AUD remains comparatively high and is distinct from that of other substance-unrelated disorders.

11.
Psychol Med ; 51(5): 716-726, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33827725

RESUMEN

BACKGROUND: Promulgating a continuum model of mental health and mental illness has been proposed as a way to reduce stigma by decreasing notions of differentness. This systematic review and meta-analysis examines whether continuum beliefs are associated with lower stigma, and whether continuum interventions reduce stigma. METHODS: Following a pre-defined protocol (PROSPERO: CRD42019123606), we searched three electronic databases (PubMed, Web of Science, and PsycINFO) yielding 6726 studies. After screening, we included 33 studies covering continuum beliefs, mental illness, and stigma. Of these, 13 studies were included in meta-analysis. RESULTS: Continuum beliefs are consistently associated with lower stigma. Interventions were effective at manipulating continuum beliefs but differ in their effects on stigmatising attitudes. CONCLUSIONS: We discuss whether and to what extent attitudes towards people with mental illness can be improved by providing information on a mental health-mental illness continuum. It appeared to be relevant whether interventions promoted a feeling of 'us' and a process of identification with the person with mental illness. We discuss implications for the design of future interventions.

12.
BMC Public Health ; 21(1): 290, 2021 02 04.
Artículo en Inglés | MEDLINE | ID: mdl-33541318

RESUMEN

BACKGROUND: While a strong negative impact of unemployment on health has been established, the present research examined the lesser studied interplay of gender, social context and job loss on health trajectories. METHODS: Data from the German Socio-Economic Panel was used, which provided a representative sample of 6838 participants. Using latent growth modelling the effects of gender, social context (East vs. West Germans), unemployment (none, short-term or long-term), and their interactions were examined on health (single item measures of self-rated health and life satisfaction respectively). RESULTS: Social context in general significantly predicted the trajectories of self-rated health and life satisfaction. Most notably, data analysis revealed that West German women reported significantly lower baseline values of self-rated health following unemployment and did not recover to the levels of their East German counterparts. Only long-term, not short-term unemployment was related to lower baseline values of self-rated health, whereas, in relation to baseline values of life satisfaction, both types of unemployment had a similar negative effect. CONCLUSIONS: In an economic crisis, individuals who already carry a higher burden, and not only those most directly affected economically, may show the greatest health effects.


Asunto(s)
Autoevaluación Diagnóstica , Desempleo , Femenino , Estado de Salud , Humanos , Medio Social
13.
J Atten Disord ; 25(6): 783-793, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-31271090

RESUMEN

Objective: To investigate beliefs and attitudes of the public toward attention deficit hyperactivity disorder (ADHD) in children and adults. Method: In a representative population survey in Germany (N = 1,008) using computer-assisted telephone interviews, we asked participants about causal beliefs, illness recognition, treatment recommendations, and beliefs about ADHD, presenting an unlabelled vignette of a child or an adult with ADHD. Results: The most frequently endorsed causal beliefs for the depicted child with ADHD were "TV or Internet," "lack of parental affection," and "broken home." In comparison with the child vignette, biological causal beliefs were endorsed more often after the adult vignette. In the child vignette, 66% advised against a treatment with stimulant medication. About 90% of respondents had heard of ADHD. Of those, 20% said they believed ADHD to be not a real disease. Conclusion: Beliefs of the German public partly contradict evidence and should be considered in therapeutical and public contexts.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Conocimientos, Actitudes y Práctica en Salud , Opinión Pública , Adulto , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Trastorno por Déficit de Atención con Hiperactividad/etiología , Estimulantes del Sistema Nervioso Central/uso terapéutico , Niño , Alemania , Humanos , Padres
14.
Psychiatr Prax ; 47(4): 218-220, 2020 May.
Artículo en Alemán | MEDLINE | ID: mdl-32340051

RESUMEN

The SARS-CoV-2 pandemic triggered increasing symptoms of an undiagnosed delusional disorder at a mid-60-year-old woman resulting in an attempted suicide. Because of a pandemic with noticeable and visible social changes, it seems likely that people with previously subclinical psychotic illnesses are more often admitted to psychiatric care for the first time. Building a therapeutic relationship and integrating her into an outpatient clinic was possible despite her lack of insight into the illness and her rejection of medical treatment.


Asunto(s)
Infecciones por Coronavirus/psicología , Neumonía Viral/psicología , Virus del SRAS , Esquizofrenia Paranoide , Intento de Suicidio , Betacoronavirus , COVID-19 , Femenino , Alemania , Humanos , Persona de Mediana Edad , Pandemias , SARS-CoV-2
15.
Psychiatr Prax ; 47(3): 142-147, 2020 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-31952086

RESUMEN

OBJECTIVE: Shame may constitute a barrier for seeking help for mental health problems. We aimed at investigating potential differences in anticipated shame with regard to gender, education, and income. METHOD: In a sample comprised of 1647 persons from a locally representative community study, ordinal regression analyses were conducted with gender, education, income, and their interaction as predictors, while controlling for age and depressive symptoms. RESULTS: Men and persons with high income generally expressed higher levels of shame. Gender differences in shame increased with higher levels of education: Whereas men with high education expressed more shame, the opposite was true for women. CONCLUSION: Shame needs to be viewed in context of gender roles, status, and their interaction. Future studies should investigate the influence of mental health literacy.


Asunto(s)
Escolaridad , Renta , Trastornos Mentales , Vergüenza , Depresión , Femenino , Alemania , Humanos , Masculino , Trastornos Mentales/psicología , Salud Mental , Factores Sexuales
16.
Psychiatry Res ; 282: 112570, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31558401

RESUMEN

ADHD is a mental illness of high epidemiological and clinical importance, embedded in a complex socio-cultural context. We estimated the prevalence of attitudes related to ADHD in a representative population survey in Germany (n = 1008) after presenting an unlabelled vignette of a child or an adult with ADHD. Relations of personal experience, interpersonal contact and continuum beliefs with emotions and social distance were calculated using path models. About two-thirds of the German public indicated they believe in a continuum of ADHD symptoms, and half stated that they know somebody among family or close friends with a comparable problem. About one-quarter of respondents felt annoyed by the depicted person. While an adult with ADHD was most frequently accepted as a work colleague or neighbor, about one-quarter of the German general population rejected renting a room or giving a job recommendation. Personal Experience (both vignettes) and contact (adult vignette) were related to a higher belief in a continuum of symptoms, while explanation of variance was low. A belief in a continuum of symptoms was related to more pro-social reactions and less social distance. This study indicates that emphasizing aspects of a continuum of symptoms should be considered within the disorder model of ADHD.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/psicología , Opinión Pública , Estigma Social , Adolescente , Adulto , Actitud , Niño , Preescolar , Familia/psicología , Femenino , Amigos/psicología , Alemania , Humanos , Masculino , Encuestas y Cuestionarios
17.
Eur Arch Psychiatry Clin Neurosci ; 269(5): 565-576, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30014442

RESUMEN

BACKGROUND: Major depressive disorder (MDD) and bipolar disorder are associated with certain cardiovascular risk factors (CVRFs), but it is unclear whether they are associated with unfavourable changes of clinically manifest CVRFs over time. METHODS: We used baseline and 12-year follow-up (n = 1887) data from the German Health Interview and Examination Survey 1998. Multivariable linear regression models assessed associations between lifetime CIDI-diagnosed mood disorders at baseline and continuous risk factor-related outcomes (blood pressure, HbA1c, LDL-C, HDL-C, triglycerides, BMI) at follow-up. RESULTS: We did not find consistent deterioration of CVRFs in persons with compared to persons without MDD. Analyses pointed to severity of mood disorder as an important correlate of long-term changes of comorbid hypertension: while a history of mild MDD was not associated with changes in CVRFs, moderate MDD was associated with lower blood pressure [systolic: ß = - 7.5 (CI - 13.2; - 1.9); diastolic: ß = - 4.5 (CI - 7.8; - 1.3)] and a history of bipolar disorder was associated with higher systolic blood pressure at follow-up (ß = 14.6; CI 4.9-24.4). Further, severe MDD was weakly associated with a higher BMI at follow-up [ß = 1.2 (CI 0.0; 2.4)]. These outcomes were not mediated by use of psychotropic medication and remained statistically significant after adjusting for the use of antihypertensive medication. CONCLUSION: Since most investigated parameters showed no associations, participants with a lifetime history of MDD in this cohort did not carry a specific risk for a worsening of pre-existing clinically manifest CVRFs. Our findings extend evidence of MDD severity and bipolar disorder as important correlates of long-term changes of arterial hypertension and obesity.


Asunto(s)
Trastorno Bipolar/complicaciones , Enfermedades Cardiovasculares/epidemiología , Trastorno Depresivo Mayor/complicaciones , Adulto , Enfermedades Cardiovasculares/etiología , Femenino , Alemania/epidemiología , Humanos , Incidencia , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Índice de Severidad de la Enfermedad
18.
Eur Arch Psychiatry Clin Neurosci ; 269(4): 469-479, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29679153

RESUMEN

It is unclear to what extent failure to recognize symptoms as potential sign of a mental illness is impeding service use, and how stigmatizing attitudes interfere with this process. In a prospective study, we followed a community sample of 188 currently untreated persons with mental illness (predominantly depression) over 6 months. We examined how lack of knowledge, prejudice and discrimination impacted on self-identification as having a mental illness, perceived need, intention to seek help, and help-seeking, both with respect to primary care (visiting a general practitioner, GP) and specialist care (seeing a mental health professional, MHP). 67% sought professional help within 6 months. Fully saturated path models accounting for baseline depressive symptoms, previous treatment experience, age and gender showed that self-identification predicted need (beta 0.32, p < 0.001), and need predicted intention (GP: beta 0.45, p < 0.001; MHP: beta 0.38, p < 0.001). Intention predicted service use with a MHP after 6 months (beta 0.31, p < 0.01; GP: beta 0.17, p = 0.093). More knowledge was associated with more self-identification (beta 0.21, p < 0.01), while support for discrimination was associated with lower self-identification (beta - 0.14, p < 0.05). Blaming persons with mental illness for their problem was associated with lower perceived need (beta - 0.16, p < 0.05). Our models explained 37% of the variance of seeking help with a MHP, and 33% of help-seeking with a GP. Recognizing one's own mental illness and perceiving a need for help are impaired by lack of knowledge, prejudice, and discrimination. Self-identification is a relevant first step when seeking help for mental disorders.


Asunto(s)
Trastorno Depresivo/psicología , Autoevaluación Diagnóstica , Conocimientos, Actitudes y Práctica en Salud , Aceptación de la Atención de Salud/psicología , Estigma Social , Adulto , Trastorno Depresivo/terapia , Femenino , Estudios de Seguimiento , Medicina General/estadística & datos numéricos , Humanos , Masculino , Servicios de Salud Mental/estadística & datos numéricos , Persona de Mediana Edad , Aceptación de la Atención de Salud/estadística & datos numéricos
19.
Psychiatr Prax ; 44(8): 473-475, 2017 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-28724162
20.
Soc Psychiatry Psychiatr Epidemiol ; 52(8): 1005-1013, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28456871

RESUMEN

PURPOSE: This study sought to examine trends in non-help-seeking for mental disorders among persons with a prevalent mental disorder (12-month prevalence) in Germany between 1997-1999 and 2009-2012. METHODS: We examined data from 1909 persons aged 18-65 years who participated in two independent, repeated cross-sectional surveys (German National Interview and Examination Study 1997-1999, German Health Interview and Examination Survey for Adults 2009-2012) conducted 12 years apart. Prevalent mental disorders (12-month prevalence) were determined using the Composite International Diagnostic Interview, which included information on lifetime help-seeking for mental health problems. Correlates of self-reported help-seeking were analyzed according to Andersen's Behavioral Model. Multivariable Poisson regression models were used to assess time trends in the directly standardized and model-adjusted prevalence of non-help-seeking across strata of socio-economic and clinical variables. RESULTS: The proportion of people with a prevalent mental disorder who have never sought help in their lifetime decreased significantly from 62% (95% CI 58.7-64.7) to 57% (95% CI 52.2-60.9) between 1997-1999 and 2009-2012 in adults aged 18-65 years in Germany. Downward trends in non-help-seeking occurred in all investigated strata and reached statistical significance in women, in people who were living alone, people with medium educational level, people living in middle-sized communities, people with non-statutory health insurance, smokers, and people with co-existing somatic conditions. CONCLUSION: Despite a downward trend over the course of 12 years, a large proportion of people suffering from mental disorders are still not seeking treatment in Germany. Further efforts to increase uptake of help-seeking for mental disorders in hard-to-reach groups are warranted to continue this trend.


Asunto(s)
Conducta de Búsqueda de Ayuda , Trastornos Mentales/psicología , Trastornos Mentales/terapia , Aceptación de la Atención de Salud/estadística & datos numéricos , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Alemania/epidemiología , Encuestas de Atención de la Salud , Humanos , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Adulto Joven
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