Vivane Kovess-Masfety1, Anders Boyd2, Sarah van de Velde3, Ron de Graaf4, Gemma Vilagut5, Josep Maria Haro6, Silvia Florescu7, Siobhan O'Neill8, Lauren Weinberg1, Jordi Alonso5. 1. Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France. 2. Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France Inserm UMR_S1136, Institut Pierre-Louis d'Epidemiologie et de Santé Publique, Paris, France. 3. Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France Ghent University, Ghent, Belgium. 4. Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands. 5. Institute of Municipal d'Investigacio Medica (IMIM), Barcelona, Spain. 6. Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain. 7. National School of Public Health, Management and Professional Development, Bucharest, Romania. 8. Bamford Centre for Mental Health and Well-Being, University of Ulster, Londonderry, Northern Ireland.
Abstract
BACKGROUND: Women are more likely than men to use mental healthcare (MHC) due to differences in the types of problems and help-seeking behaviours. The consistency of this relationship across European countries, whose MHC organisation differs substantially, is unknown. METHODS: Lifetime MHC-use and the type of MHC provider were assessed in 37 289 participants from the EU-World Mental Health (EU-WMH) survey, including 10 European countries (Northern Ireland, The Netherlands, Belgium, Germany, France, Spain, Italy, Portugal, Bulgaria and Romania). Lifetime mood/anxiety disorders (DSM-IV) and severity were evaluated using the CIDI V.3.0. RESULTS: MHC use was significantly higher for women than men in every country except for Romania (overall OR=1.80, 95% CI1.64 to 1.98), while remaining so after adjusting for socioeconomic characteristics (age, income level, employment status, education, marital status; adjusted OR=1.87, 95% CI 1.69 to 2.06) and country-level indicators (MHC provision, private household out-of-pocket expenditure, and Gender Gap Index; adjusted OR=1.89, 95% CI 1.71 to 2.08). Compared with men, women were also more likely to consult general practitioners (GP) versus specialised MHC (OR=1.32, 95% CI 1.12 to 1.56) with high between-country variability. In participants with mood disorder, the gender relationship in MHC use and type of MHC did not change. Conversely, in participants with anxiety disorder, no significant gender relationship in MHC use was observed (adjusted OR=1.21, 95% CI 0.99 to 1.47). Finally, men with severe mental health problems had a significantly higher odds of MHC use (OR=14.70) when compared with women with similar levels (OR=8.95, p for interaction=0.03) after adjusting for socioeconomic characteristics and country-level indicators. CONCLUSIONS: Women use MHC and GPs more frequently than men, yet this depends on the type and severity of mental health problems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND:Women are more likely than men to use mental healthcare (MHC) due to differences in the types of problems and help-seeking behaviours. The consistency of this relationship across European countries, whose MHC organisation differs substantially, is unknown. METHODS: Lifetime MHC-use and the type of MHC provider were assessed in 37 289 participants from the EU-World Mental Health (EU-WMH) survey, including 10 European countries (Northern Ireland, The Netherlands, Belgium, Germany, France, Spain, Italy, Portugal, Bulgaria and Romania). Lifetime mood/anxiety disorders (DSM-IV) and severity were evaluated using the CIDI V.3.0. RESULTS: MHC use was significantly higher for women than men in every country except for Romania (overall OR=1.80, 95% CI1.64 to 1.98), while remaining so after adjusting for socioeconomic characteristics (age, income level, employment status, education, marital status; adjusted OR=1.87, 95% CI 1.69 to 2.06) and country-level indicators (MHC provision, private household out-of-pocket expenditure, and Gender Gap Index; adjusted OR=1.89, 95% CI 1.71 to 2.08). Compared with men, women were also more likely to consult general practitioners (GP) versus specialised MHC (OR=1.32, 95% CI 1.12 to 1.56) with high between-country variability. In participants with mood disorder, the gender relationship in MHC use and type of MHC did not change. Conversely, in participants with anxiety disorder, no significant gender relationship in MHC use was observed (adjusted OR=1.21, 95% CI 0.99 to 1.47). Finally, men with severe mental health problems had a significantly higher odds of MHC use (OR=14.70) when compared with women with similar levels (OR=8.95, p for interaction=0.03) after adjusting for socioeconomic characteristics and country-level indicators. CONCLUSIONS:Women use MHC and GPs more frequently than men, yet this depends on the type and severity of mental health problems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
Gender; Health Behaviour; Health Services; Mental Health
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