Socio-economic problems of underdiagnosis of anxiety disorders and models of seeking mental health care

Full Text:
Read (RU)

Suggested citation:

Marachev MP, Arkusha IA, Zakharova KV, et al. [Socio-economic problems of underdiagnosis of anxiety disorders and models of seeking mental health care]. Rossiiskii psikhiatricheskii zhurnal [Russian Journal of Psychiatry]. 2022;(2):4-14. Russian

Abstract

In a scientific review to study the pathway of patients with anxiety disorders an analysis has been carried out of organizational and psychological models of seeking specialized medical care for patients with anxiety disorders, as well as delays in obtaining it. Current socio-epidemiological data, information on the dynamics of economic costs (direct medical and non-medical costs, as well as indirect costs) associated with such patients are provided. The study of the pathways of patients with anxiety disorders with an assessment of the behavioral mechanisms of seeking specialized psychiatric care can be a starting point in the development of preventive programs aimed at both reducing the burden on the general medical network and reducing the socioeconomic burden by reducing the period of delay in seeking specialized medical care.

Keywords anxiety disorders; pathways to seek mental help; help seeking; illness behavior; pathways to professional help; disease-related beliefs; attitude towards illness

References

1. GBD 2019 Mental Disorders Collaborators et al. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Psychiatry. 2022;9(2):137–50. DOI: https://doi.org/10.1016/S2215-0366(21)00395-3 2. Comprehensive mental health action plan 2013–2030. Geneva: World Health Organization, 2021. 36 p. 3. Andlin-Sobocki P, Jönsson B, Wittchen HU, Olesen J. Cost of disorders of the brain in Europe. Eur J Neurol. 2005;12(Suppl 1):1–27. DOI: https://doi.org/10.1111/j.1468-1331.2005.01202.x; PMID: 15877774 4. Olesen J, Gustavsson A, Svensson M, et al. The economic cost of brain disorders in Europe. Eur J Neurol. 2012;19(1):155–62. DOI: https://doi.org/10.1111/j.1468-1331.2011.03590.x 5. Wilking N, Jönsson B, Svedman C. Do Norwegian cancer patients receive the care they deserve? Tidsskr Nor Laegeforen. 2006;126(21):2828–9. (In Norweg.) PMID: 17086228 6. Wittchen HU, Jacobi F, Rehm J, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011;21(9):655–79. DOI: https://doi.org/10.1016/j.euroneuro.2011.07.018 7. Sagayadevan V, Lee SP, Ong C, et al. Quality of life across mental disorders in psychiatric outpatients. Ann Acad Med Singapore. 2018;47(7):243–52. PMID: 30120432 8. Baxter AJ, Scott KM, Vos T, Whiteford HA. Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychol Med. 2013;43(5):897–910. DOI: https://doi.org/10.1017/S003329171200147X 9. Alonso J, Liu Z, Evans-Lacko S, et al. Treatment gap for anxiety disorders is global: Results of the World Mental Health Surveys in 21 countries. Depress Anxiety. 2018;35(3):195–208. DOI: https://doi.org/10.1002/da.22711 10. Kessler RC, Aguilar-Gaxiola S, Alonso J, et al. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol Psychiatr Sci. 2009;18(1):23–33. DOI: https://doi.org/10.1017/s1121189x00001421 11. Wittchen HU, Jacobi F, Rehm J, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011;21(9):655–79. DOI: https://doi.org/10.1016/j.euroneuro.2011.07.018 12. Gustavsson A, Svensson M, Jacobi F, et al. Cost of disorders of the brain in Europe 2010. European neuropsychopharmacology. 2011;21(10):718–79. DOI: https://doi.org/10.1016/j.euroneuro.2011.08.008 13. Konnopka A, König H. Economic burden of anxiety disorders: a systematic review and meta-analysis. Pharmacoeconomics. 2020;38(1):25–37. DOI: https://doi.org/10.1007/s40273-019-00849-7 14. Olatunji BO, Cisler JM, Tolin DF. Quality of life in the anxiety disorders: a meta-analytic review. Clin Psychol Rev. 2007;27(5):572–81. DOI: https://doi.org/10.1016/j.cpr.2007.01.015 15. Mendlowicz MV, Stein MB. Quality of life in individuals with anxiety disorders. Am J Psychiatry. 2000;157(5):669–82. DOI: https://doi.org/10.1176/appi.ajp.157.5.669 16. Kalra H, Kamath P, Trivedi JK, Janca A. Caregiver burden in anxiety disorders. Curr Opin Psychiatry. 2008;21(1):70–3. DOI: https://doi.org/10.1097/YCO.0b013e3282f2dfca 17. Detzel T, Wesner AC, Fritz A, et al. Family burden and family environment: Comparison between patients with panic disorder and with clinical diseases. Psychiatry Clin Neurosci. 2015;69(2):100–8. DOI: https://doi.org/10.1111/pcn.12211 18. Senaratne R, Van Ameringen M, Mancini C, Patterson B. The burden of anxiety disorders on the family. J Nerv Mental Dis. 2010;198(12):876–80. DOI: https://doi.org/10.1097/NMD.0b013e3181fe7450 19. Burgess PM, Pirkis JE, Slade TN, et al. Service use for mental health problems: findings from the 2007 National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry. 2009;43(7):615–23. DOI: https://doi.org/10.1080/00048670902970858 20. Oakley Browne MA, Wells JE, McGee MA; New Zealand Mental Health Survey Research Team. Twelve-month and lifetime health service use in Te Rau Hinengaro: the New Zealand mental health survey. Aust N Z J Psychiatry. 2006;40(10):855–64. DOI: https://doi.org/10.1080/j.1440-1614.2006.01904.x 21. Alonso J, Codony M, Kovess V, et al. Population level of unmet need for mental healthcare in Europe. Br J Psychiatry. 2007;190(4):299–306. DOI: https://doi.org/10.1192/bjp.bp.106.022004 22. Wang PS, Berglund P, Olfson M, et al. Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):603–13. DOI: https://doi.org/10.1001/archpsyc.62.6.603 23. Kessler RC, Olfson M, Berglund PA. Patterns and predictors of treatment contact after first onset of psychiatric disorders. Am J Psychiatry. 1998;155(1):62–9. DOI: https://doi.org/10.1176/ajp.155.1.62 24. Christiana JM, Gilman SE, Guardino M, et al. Duration between onset and time of obtaining initial treatment among people with anxiety and mood disorders: an international survey of members of mental health patient advocate groups. Psychol Med. 2000;30(3):693–703. DOI: https://doi.org/10.1017/s0033291799002093 25. Thompson A, Issakidis C, Hunt C. Delay to seek treatment for anxiety and mood disorders in an Australian clinical sample. Behaviour Change. 2008;25(2):71–84. 26. Wang PS, Angermeyer M, Borges G, et al. Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry. 2007;6(3):177–85. PMID: 18188443 27. Wagner R, Silove D, Marnane C, Rouen D. Delays in referral of patients with social phobia, panic disorder and generalized anxiety disorder attending a specialist anxiety clinic. J Anxiety Disord. 2006;20(3):363–71. DOI: https://doi.org/10.1016/j.janxdis.2005.02.003 28. Altamura AC, Camuri G, Dell'Osso B. Understanding the role of the duration of untreated illness in psychiatric disorders: a narrative review. Riv Psichiatr. 2010;45(4):197–208. (In Ital.) PMID: 20942365 29. Altamura AC, Buoli M, Albano A, Dell'Osso B. Age at onset and latency to treatment (duration of untreated illness) in patients with mood and anxiety disorders: a naturalistic study. Int Clin Psychopharmacol. 2010;25(3):172–9. DOI: https://doi.org/10.1097/YIC.0b013e3283384c74 30. Albert U, Barbaro F, Bramante S, et al. Duration of untreated illness and response to SRI treatment in obsessive-compulsive disorder. Eur Psychiatry. 2019;58:19–26. DOI: https://doi.org/10.1016/j.eurpsy.2019.01.017 31. Dell’Osso B, Glick ID, Baldwin DS, Altamura AC. Can long-term outcomes be improved by shortening the duration of untreated illness in psychiatric disorders? A conceptual framework. Psychopathology. 2013;46(1):14–21. DOI: https://doi.org/10.1159/000338608 32. Altamura AC, Dell’Osso B, D’Urso N, et al. Duration of untreated illness as a predictor of treatment response and clinical course in generalized anxiety disorder. CNS Spectr. 2008;13(5):415–22. DOI: https://doi.org/10.1017/s1092852900016588 33. Petelin DS. Nozogennye reaktsii s yavleniyami autoagressii (fenomen otkladyvaniya) pri zlokachestvennykh novoobrazovaniyakh [PhD thesis]. [Moscow (Russia)]: Pervyj Moskovskij gosudarstvennyj medicinskij universitet im. I.M. Sechenova [First Moscow State Medical University im. I.M. Sechenov]; 2018. 163 p. (In Russ.) 34. Malygin YaV, Tsygankov BD, Lindenbraten AL. Vybor meditsinskoi organizatsii i modeli povedencheskikh strategii sovladaniya s bolezn'yu patsientov s psikhicheskimi rasstroistvami nevroticheskogo urovnya. Moscow; 2016. 227 p. (In Russ.) 35. Mechanic D, Volkart EH. Illness behavior and medical diagnoses. J Health Hum Behav. 1960;1(2):86–94. 36. Rickwood D, Thomas K. Conceptual measurement framework for help-seeking for mental health problems. Psychol Res Behav Manag. 2012;5:173–83. DOI: https://doi.org/10.2147/PRBM.S38707 37. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36(1):1–10. PMID: 7738325 38. Kadushin C. Why people go to psychiatrists. N.Y.: Routledge; 2017. 381 p. 39. Rosenstock IM. Historical origins of the health belief model. Health Education Monographs. 1974;2(4):328–35. 40. Lynch JG, Cohen JL. The use of subjective expected utility theory as an aid to understanding variables that influence helping behavior. J Pers Soc Psychol. 1978;36(10):1138. 41. Safer MA, Tharps QJ, Jackson TC, Leventhal H. Determinants of three stages of delay in seeking care at a medical clinic. Med. Care. 1979;17(1):11–29. DOI: https://doi.org/10.1097/00005650-197901000-00002 42. Fishbein M, Middlestadt SE. Using the theory of reasoned action to develop educational interventions: Applications to illicit drug use. Health Educ Res. 1987;2(4):361–71. 43. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211. 44. Maddux JE, Rogers RW. Protection motivation and self-efficacy: A revised theory of fear appeals and attitude change. J Exp Soc Psychol. 1983;19(5):469–79. 45. Bandura A. The explanatory and predictive scope of self-efficacy theory. J Soc Clin Psychol. 1986;4(3):359–73. 46. Pescosolido BA. Beyond rational choice: The social dynamics of how people seek help. Am J Sociol. 1992;97(4):1096–138. 47. Fisher JD, Fisher WA, Amico KR, Harman JJ. An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychol. 2006;25(4):462–73. DOI: https://doi.org/10.1037/0278-6133.25.4.462 48. Andersen BL, Cacioppo JT. Delay in seeking a cancer diagnosis: delay stages and psychophysiological comparison processes. Br J Soc Psychol. 1995;34(1):33–52. DOI: https://doi.org/10.1111/j.2044-8309.1995.tb01047.x 49. Scott SE, Walter FM, Webster A, et al. The model of pathways to treatment: conceptualization and integration with existing theory. Br J Health Psychol. 2013;18(1):45–65. DOI: https://doi.org/10.1111/j.2044-8287.2012.02077.x 50. ten Have M, de Graaf R, Ormel J, et al. Are attitudes towards mental health help-seeking associated with service use? Results from the European Study of Epidemiology of Mental Disorders. Soc Psychiatry Psychiatr Epidemiol. 2010;45(2):153–63. DOI: https://doi.org/10.1007/s00127-009-0050-4 51. Babitsch B, Gohl D, Von Lengerke T. Re-revisiting Andersen’s Behavioral Model of Health Services Use: a systematic review of studies from 1998–2011. PsychoSoc Med. 2012;9:11. DOI: https://doi.org/10.3205/psm000089 52. Roberts T, Miguel Esponda G, Krupchanka D, et al. Factors associated with health service utilisation for common mental disorders: a systematic review. BMC psychiatry. 2018;18(1):1–19. DOI: https://doi.org/10.1186/s12888-018-1837-1 53. Goodwin R, Andersen RM. Use of the behavioral model of health care use to identify correlates of use of treatment for panic attacks in the community. Soc Psychiatry Psychiatr Epidemiol. 2002;37(5):212–9. DOI: https://doi.org/10.1007/s00127-002-0543-x 54. Mo PKH, Mak WWS. Help-seeking for mental health problems among Chinese. Soc Psychiatry Psychiatr Epidemiol. 2009;44(8):675–84. DOI: https://doi.org/10.1007/s00127-008-0484-0 55. Schomerus G, Matschinger H, Angermeyer MC. Attitudes that determine willingness to seek psychiatric help for depression: a representative population survey applying the Theory of Planned Behaviour. Psychol Med. 2009;39(11):1855–65. DOI: https://doi.org/10.1017/S0033291709005832 56. Bohon LM, Cotter KA, Kravitz RL, et al. The theory of planned behavior as it predicts potential intention to seek mental health services for depression among college students. J Am Coll Health. 2016;64(8):593–603. DOI: https://doi.org/10.1080/07448481.2016.1207646 57. Hagger MS, Chatzisarantis NLD. Integrating the theory of planned behaviour and self-determination theory in health behaviour: A meta-analysis. Br J Health Psychol. 2009;14(2):275–302. DOI: https://doi.org/10.1348/135910708X373959 58. Henshaw EJ, Freedman-Doan CR. Conceptualizing mental health care utilization using the health belief model. Clin Psychol (New York). 2009;16(4):420. 59. Rosenstock IM. The past, present, and future of health education. Health Behavior and Health Education: Theory, research and practice. K Glanz, BK Rimer, K Viswanath (Eds). Jossey-Bass; 1990. p. 405–20. 60. Langley EL, Wootton BM, Grieve R. The utility of the health belief model variables in predicting help‐seeking intention for anxiety disorders. Australian Psychologist. 2018;53(4):291–301.



DOI: http://dx.doi.org/10.47877/1560-957Х-2022-10201

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM