Skip to main content
Erschienen in: Psychiatric Quarterly 2/2010

01.06.2010 | Original Paper

Determinants of Barriers to Treatment for Anxiety Disorders

verfasst von: Mariko Chartier-Otis, Michel Perreault, Claude Bélanger

Erschienen in: Psychiatric Quarterly | Ausgabe 2/2010

Einloggen, um Zugang zu erhalten

Abstract

The objectives of this study were to evaluate perceived unmet need for mental healthcare, determinants of unmet need, and barriers to care in individuals with social anxiety (SA) or panic disorder with agoraphobia (PDA) in Quebec. Data from 206 participants diagnosed with SA or PDA were collected using an online questionnaire. Correlational analyses and binary stepwise logistic regressions were conducted to explore determinants of perceived unmet need. Of the 206 participants, 144 (69.9%) reported instances of unmet need for treatment. Perceived unmet need was correlated with variables related to the severity of the disorder, such as comorbid depression, avoidance, duration of worry, interference with functioning, and time lapsed between the appearance of first symptoms and first consultation. Depression and avoidance emerged as predictors for perceived unmet need in the regression analysis. The most common barriers to treatment reported were concern about the cost of services (63.9%), not knowing where to go to get help (63.2%), lack of health insurance coverage (52.4%), and appointment wait times (52.1%). The results of this study demonstrate the need to overcome barriers to treatment engendered by avoidance behaviors associated with anxiety. Potential methods for achieving this objective include Internet outreach, support groups, and increased accessibility to public services.
Literatur
1.
Zurück zum Zitat Kessler RC, McGonagle KA, Zhao S, et al.: Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry 51:8–19, 1994PubMed Kessler RC, McGonagle KA, Zhao S, et al.: Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry 51:8–19, 1994PubMed
2.
Zurück zum Zitat Wittchen HU, Essau CA: Epidemiology of panic disorder: progress and unresolved issues. Journal of Psychiatric Research 27:47–68, 1993CrossRefPubMed Wittchen HU, Essau CA: Epidemiology of panic disorder: progress and unresolved issues. Journal of Psychiatric Research 27:47–68, 1993CrossRefPubMed
3.
Zurück zum Zitat Katerndahl DA: Predictors of the development of phobic avoidance. Journal of Clinical Psychiatry 61:618–625, 2000PubMed Katerndahl DA: Predictors of the development of phobic avoidance. Journal of Clinical Psychiatry 61:618–625, 2000PubMed
4.
Zurück zum Zitat Turk CL, Heimberg RG, Magee L: Social Anxiety Disorders. In: Barlow DH (Eds) Clinical Handbook of Psychological Disorders: A step-by-step Treatment Manual, 4th edn. New York, The Guilford Press, 2008 Turk CL, Heimberg RG, Magee L: Social Anxiety Disorders. In: Barlow DH (Eds) Clinical Handbook of Psychological Disorders: A step-by-step Treatment Manual, 4th edn. New York, The Guilford Press, 2008
5.
Zurück zum Zitat Kasper A: Social phobia: the nature of the disorder. Journal of Affective Disorders 50:S3–S9, 1998CrossRefPubMed Kasper A: Social phobia: the nature of the disorder. Journal of Affective Disorders 50:S3–S9, 1998CrossRefPubMed
6.
Zurück zum Zitat Heimberg RG: Current status of psychotherapeutic interventions for social phobia. Journal of Clinical Psychiatry 62:36–42, 2001PubMed Heimberg RG: Current status of psychotherapeutic interventions for social phobia. Journal of Clinical Psychiatry 62:36–42, 2001PubMed
7.
Zurück zum Zitat Heimberg RG: Cognitive-behavioral therapy for social anxiety disorder: current status and future directions. Society of Biological Psychiatry 51:101–108, 2002CrossRef Heimberg RG: Cognitive-behavioral therapy for social anxiety disorder: current status and future directions. Society of Biological Psychiatry 51:101–108, 2002CrossRef
8.
Zurück zum Zitat Telch NJ, Schmidt NB, Jaimez TL, et al.: Impact of cognitive-behavioral treatment on quality of life in panic disorder patients. Journal of Consulting and Clinical Psychology 63:823–830, 1995CrossRefPubMed Telch NJ, Schmidt NB, Jaimez TL, et al.: Impact of cognitive-behavioral treatment on quality of life in panic disorder patients. Journal of Consulting and Clinical Psychology 63:823–830, 1995CrossRefPubMed
9.
Zurück zum Zitat Marchand A, Germain V, Reinharz D, et al.: Analyse des coûts et de l’efficacité d’une psychothérapie pour le Trouble panique avec agoraphobie versus un traitement combinant la pharmacothérapie et la psychothérapie. Santé mentale au Québec 29:201–220, 2004PubMed Marchand A, Germain V, Reinharz D, et al.: Analyse des coûts et de l’efficacité d’une psychothérapie pour le Trouble panique avec agoraphobie versus un traitement combinant la pharmacothérapie et la psychothérapie. Santé mentale au Québec 29:201–220, 2004PubMed
10.
Zurück zum Zitat Olfson M, Kessler RC, Berglund PA, et al.: Psychiatric disorder onset and first treatment contact in the United States and Ontario. American Journal of Psychiatry 155:1415–1422, 1998PubMed Olfson M, Kessler RC, Berglund PA, et al.: Psychiatric disorder onset and first treatment contact in the United States and Ontario. American Journal of Psychiatry 155:1415–1422, 1998PubMed
11.
Zurück zum Zitat Perreault M, Bélanger C, Marchand A, et al.: Client Perspectives on How to Improve the Therapeutic Procedures of a Cognitive-Behavioural Treatment (CBT) for Panic Disorder with Agoraphobia (PDA). In: 6th Annual International Conference of the European Network for Mental Health Service Evaluation, London, 2004 Perreault M, Bélanger C, Marchand A, et al.: Client Perspectives on How to Improve the Therapeutic Procedures of a Cognitive-Behavioural Treatment (CBT) for Panic Disorder with Agoraphobia (PDA). In: 6th Annual International Conference of the European Network for Mental Health Service Evaluation, London, 2004
12.
Zurück zum Zitat Lépine JP: The epidemiology of anxiety disorders: prevalence and societal costs. Journal of Clinical Psychiatry 63:4–8, 2002PubMed Lépine JP: The epidemiology of anxiety disorders: prevalence and societal costs. Journal of Clinical Psychiatry 63:4–8, 2002PubMed
13.
Zurück zum Zitat Katerndahl DA: Factors influencing care seeking for a self-defined worst panic attack. Psychiatric Services 53:464–470, 2002CrossRefPubMed Katerndahl DA: Factors influencing care seeking for a self-defined worst panic attack. Psychiatric Services 53:464–470, 2002CrossRefPubMed
14.
Zurück zum Zitat Magee WJ, Eaton WW, Wittchen HU, et al.: Agoraphobia, simple phobia, and social phobia in the national comorbidity survey. Archives of General Psychiatry, 53:159–168, 1996PubMed Magee WJ, Eaton WW, Wittchen HU, et al.: Agoraphobia, simple phobia, and social phobia in the national comorbidity survey. Archives of General Psychiatry, 53:159–168, 1996PubMed
15.
Zurück zum Zitat Kessler RC, Zhao S, Katz SJ, et al.: Past-year use of outpatient services for psychiatric problems in the national comorbidity survey. American Journal of Psychiatry 156:115–123, 1999PubMed Kessler RC, Zhao S, Katz SJ, et al.: Past-year use of outpatient services for psychiatric problems in the national comorbidity survey. American Journal of Psychiatry 156:115–123, 1999PubMed
16.
Zurück zum Zitat Wang PS, Lane M, Olfson M et al.: Twelve-month use of mental health services in the United States: results from the national comorbidity survey replication. Archives of General Psychiatry 62:629–640, 2005CrossRefPubMed Wang PS, Lane M, Olfson M et al.: Twelve-month use of mental health services in the United States: results from the national comorbidity survey replication. Archives of General Psychiatry 62:629–640, 2005CrossRefPubMed
17.
Zurück zum Zitat Mojtabai R, Olfson M, Mechanic D: Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Archives of General Psychiatry 59:77–84, 2002CrossRefPubMed Mojtabai R, Olfson M, Mechanic D: Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Archives of General Psychiatry 59:77–84, 2002CrossRefPubMed
18.
Zurück zum Zitat Andersen RM: Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior 36:1–10, 1995CrossRefPubMed Andersen RM: Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior 36:1–10, 1995CrossRefPubMed
19.
Zurück zum Zitat Craske MG, Edlund MJ, Sullivan G, et al.: Perceived unmet need for mental health treatment and barriers to care among patients with panic disorder. Psychiatric Services 56:988–994, 2005CrossRefPubMed Craske MG, Edlund MJ, Sullivan G, et al.: Perceived unmet need for mental health treatment and barriers to care among patients with panic disorder. Psychiatric Services 56:988–994, 2005CrossRefPubMed
20.
Zurück zum Zitat Christiana JM, Gilman SE, Guardino M, et al.: Duration between onset and tie of obtaining initial treatment among people with anxiety and mood disorders: an international survey of members of mental health patient advocate groups. Psychological Medicine 30:693–703, 2000CrossRefPubMed Christiana JM, Gilman SE, Guardino M, et al.: Duration between onset and tie of obtaining initial treatment among people with anxiety and mood disorders: an international survey of members of mental health patient advocate groups. Psychological Medicine 30:693–703, 2000CrossRefPubMed
21.
Zurück zum Zitat Olfson M, Guardino M, Struening E, et al.: Barriers to the treatment of social anxiety. American Journal of Psychiatry 157:521–527, 2000CrossRefPubMed Olfson M, Guardino M, Struening E, et al.: Barriers to the treatment of social anxiety. American Journal of Psychiatry 157:521–527, 2000CrossRefPubMed
22.
Zurück zum Zitat Granello DH, Wheaton JE: Online data collection: strategies for research. Journal of Counseling and Development 82:387–393, 2004 Granello DH, Wheaton JE: Online data collection: strategies for research. Journal of Counseling and Development 82:387–393, 2004
23.
Zurück zum Zitat Erwin BA, Turk CL, Heimberg RG, et al.: The internet: home to a severe population of individuals with social anxiety disorder? Journal of anxiety disorders 18:629–646, 2004CrossRefPubMed Erwin BA, Turk CL, Heimberg RG, et al.: The internet: home to a severe population of individuals with social anxiety disorder? Journal of anxiety disorders 18:629–646, 2004CrossRefPubMed
24.
Zurück zum Zitat Schmidt WC 1997 World-wide web survey research: benefits, potential problems, and solutions. Behavior Research Methods, Instruments & Computers 29:274–279 Schmidt WC 1997 World-wide web survey research: benefits, potential problems, and solutions. Behavior Research Methods, Instruments & Computers 29:274–279
25.
Zurück zum Zitat Dillman DA, Tortora RD, Contradt J, et al.: Influence of plain vs fancy design on response rates for web surveys, 1998 Dillman DA, Tortora RD, Contradt J, et al.: Influence of plain vs fancy design on response rates for web surveys, 1998
26.
Zurück zum Zitat First MB, Spitzer RL, Gibbon M, et al.: Structured Clinical Interview for DSM-IV Axis I Disorders Clinician Version (SCID-CV). Washington, DC, American Psychiatric Press, 1996 First MB, Spitzer RL, Gibbon M, et al.: Structured Clinical Interview for DSM-IV Axis I Disorders Clinician Version (SCID-CV). Washington, DC, American Psychiatric Press, 1996
27.
Zurück zum Zitat Kjernisted KD: Fear: the impact and treatment of social phobia. Journal of Psychopharmacology 14:13–23, 2000 Kjernisted KD: Fear: the impact and treatment of social phobia. Journal of Psychopharmacology 14:13–23, 2000
28.
Zurück zum Zitat Roy-Byrne PP, Stein MB, Russo J, et al.: Panic disorder in the primary care setting: comorbidity, disability, service utilization, and treatment. Journal of Clinical Psychiatry 60:492–499, 1999PubMed Roy-Byrne PP, Stein MB, Russo J, et al.: Panic disorder in the primary care setting: comorbidity, disability, service utilization, and treatment. Journal of Clinical Psychiatry 60:492–499, 1999PubMed
29.
Zurück zum Zitat Fournier L, Aubé D, Roberge P, et al.: Vers une première ligne forte en santé mentale: messages clés de la littérature scientifique. Institut national de santé publique du Québec: 1–39, 2007 Fournier L, Aubé D, Roberge P, et al.: Vers une première ligne forte en santé mentale: messages clés de la littérature scientifique. Institut national de santé publique du Québec: 1–39, 2007
30.
Zurück zum Zitat Vasiliadis HM, Lesage A, Adair C, et al.: Service use for mental health reasons: cross-provincial differences in rates, determinants, and equity of access. Canadian Journal of Psychiatry 50:614–619, 2005 Vasiliadis HM, Lesage A, Adair C, et al.: Service use for mental health reasons: cross-provincial differences in rates, determinants, and equity of access. Canadian Journal of Psychiatry 50:614–619, 2005
31.
Zurück zum Zitat Alegria M, Canino G, Rios R, et al.: IInequalities in use of specialty mental health services among Latinos, African Americans, and non-Latino whites. Mental Health Care for Latinos 53:1547–1555, 2002 Alegria M, Canino G, Rios R, et al.: IInequalities in use of specialty mental health services among Latinos, African Americans, and non-Latino whites. Mental Health Care for Latinos 53:1547–1555, 2002
32.
Zurück zum Zitat Diala CC, Muntaner C: Mood and anxiety disorders among rural, urban, and metropolitan residents in the United States. Community Mental Health Journal 39:239-252, 2003CrossRefPubMed Diala CC, Muntaner C: Mood and anxiety disorders among rural, urban, and metropolitan residents in the United States. Community Mental Health Journal 39:239-252, 2003CrossRefPubMed
33.
Zurück zum Zitat Lyons AC, Cude B, Lawrence FC, et al.: Conducting research online: challenges facing researchers in family and consumer sciences. Family and Consumer Sciences Research Journal 33: 341–356, 2005CrossRef Lyons AC, Cude B, Lawrence FC, et al.: Conducting research online: challenges facing researchers in family and consumer sciences. Family and Consumer Sciences Research Journal 33: 341–356, 2005CrossRef
34.
Zurück zum Zitat Perreault M, Pawliuk N, Veilleux R, et al.: Qualitative assessment of mental health service satisfaction: strengths and limitations of a self-administered procedure. Community Mental Health Journal 42:233–241, 2006CrossRefPubMed Perreault M, Pawliuk N, Veilleux R, et al.: Qualitative assessment of mental health service satisfaction: strengths and limitations of a self-administered procedure. Community Mental Health Journal 42:233–241, 2006CrossRefPubMed
35.
Zurück zum Zitat Botella C, Villa H, Garcia-Palacios A, et al.: The use of VR in the treatment of panic disorders and agoraphobia. Studies In Health Technology and Informatics 99:73–90, 2004PubMed Botella C, Villa H, Garcia-Palacios A, et al.: The use of VR in the treatment of panic disorders and agoraphobia. Studies In Health Technology and Informatics 99:73–90, 2004PubMed
36.
Zurück zum Zitat Marcus HP, Runge CM: Community-based services for agoraphobics families in society. The Journal of Contemporary Human Services 71:602–606, 1990 Marcus HP, Runge CM: Community-based services for agoraphobics families in society. The Journal of Contemporary Human Services 71:602–606, 1990
Metadaten
Titel
Determinants of Barriers to Treatment for Anxiety Disorders
verfasst von
Mariko Chartier-Otis
Michel Perreault
Claude Bélanger
Publikationsdatum
01.06.2010
Verlag
Springer US
Erschienen in
Psychiatric Quarterly / Ausgabe 2/2010
Print ISSN: 0033-2720
Elektronische ISSN: 1573-6709
DOI
https://doi.org/10.1007/s11126-010-9123-5

Weitere Artikel der Ausgabe 2/2010

Psychiatric Quarterly 2/2010 Zur Ausgabe

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.