Emotional Problems And Service Needs Of Community Residents

[Objectives] The aims of the study were to assess depression, anxiety, and qualityof life of community residents, to assess knowledge about mental disorders amongresidents, to assess the utility of and willingness to use community mental healthservices. The results will be used to guide resource allocation of and future mentalhealth education, training and intervention, to prepare for the future construction ofcommunity mental health services, and ultimately improve mental health literacy,identification and intervention levels on the common mental disorders of communityresidents.[Methods](1) In Xinzhuang Town, Zhuanqiao Town of Minhang District andXinhua Jiedao, Huayang Jiedao of Changning District in Shanghai,8918residentscompleted Patient Health Questionnaire (PHQ-9),12-item short-form (SF-12)TM,Mental Health and Psychological Care Knowledge Questionnaire, and8917residentscompleted the7-Item Generalized Anxiety Disorders Scale (GAD-7). PHQ-9has nineitems. Subjects were asked how ofen,over the last2weeks, they have been botheredby the nine depressive symptoms, including lack of interest, mood swings and others.GAD-7has seven items, subjects were asked how often, over the last2weeks, theyhave been bothered by the seven anxiety symptoms, including anxiety and can notstop worrying plagued by problems. SF-12has12items, including eight dimensions,yielding the summary scales physical health (Physical component summary, PCS) andmental health (Mental component summary, MCS). Full score of the knowledgequestionnaire is20and higher scores indicate more advanced understanding aboutmental health.8023residents completed Case Vignettes.2case vignettes describeddepression and anxiety disorder.7related questions were asked about recognition,causes, helpful interventions, attitudes and so on.2486residents completed MentalHealth Service Utilization Questionnaire, which has6questions. The subjects of thequestions were asked to understand whether residents are willing to seek help formental health services and objects, whether in the last six months received mentalhealth services and the institutions, whether received in the community mental health education and services and the education forms.[Results](1) There were1195respondents having depressive syndrome (PHQ-9score≥5), accounting for13.4%of the total. The score was higher in women thanmen (P=0.045),65years and older had higher score than35-64years old, and both ofthe two age groups had higher score than age group of35or less (P<0.001). Primaryeducational group had higher mean score than secondary educational group, and themean score of secondary educational group was higher than that of universityeducational group (P<0.001). Mean score of divorced or widowed group was higherthan that of married or unmarried (P<0.001).Unemployed or retired score was higherthan incumbents (P<0.001). There were698respondents having anxiety syndrome(GAD-7score≥5), accounting for7.8%of the total. The score was higher in womenthan men (P=0.002),65years and older had higher score than65years under group(P<0.001). Primary group score had higher mean score than secondary educationalgroup, and the mean score of secondary educational group than that of universityeducational group (P<0.001). Mean score of divorced or widowed group was higherthan that of married or unmarried (P<0.001). Unemployed or retired score was higherthan incumbents (P<0.001).(2) The PCS score was higher in women than men(t=6.726, P<0.001), and there was no significant difference between men and womenin MCS score (P=0.124). Age group of35or lesshad higher PCS and MCS score than35-64years old group, which was higher than the65years and older (P<0.001).University educational group had higher PCS and MCS score than secondaryeducational group, and the score of secondary educational group than that ofprimary educational group (P<0.001). PCS and MCS score of unmarried was higherthan that of married, which was higher than that of divorced or widowed (P<0.001).Incumbents PCS and MCS score higher than unemployed, which was higher thanretired (P<0.001). The PCS and MCS score in no depressive symptoms group washigher than the group with mild symptoms of depression, which was higher than thegroup with moderate symptoms of depression, and moderate depressive symptomsgroup higher than severe depressive symptoms group (P<0.001). The PCS and MCSscore in no anxiety symptoms group was higher than the group with mild symptoms of anxiety, which was higher than the group with moderate symptoms of anxiety, andmoderate anxiety symptoms group higher than severe anxiety symptoms group(P<0.001).(3) The proportion of correct reponses of the knowledge questionnaire wasbetween32.2%and98.8%with mean proportion of77.0%and mean score of15.4(SD2.9). There was no significant differences between men and women (P=0.794).The score of35years under group was above35years old to64years old group,which was higher than the65years and above group (F=53.578, P<0.001). Universitygroup score was higher than secondary group, and secondary group beyond primarygroup (F=219.979, P<0.001). Unmarried score was higher than married, which washigher than divorced or widowed(F=37.700, P<0.001). Incumbents score was higherthan unemployed, which was higher than retired (F=46.959, P<0.001). The pressurefrom work (Depression Case:61.3%, Anxiety Disorder Case:79.9%), Personalityproblems (Depression Case:14.2%, Anxiety Disorder Case:12.4%) and beingstimulated (Depression Case:17.0%, Anxiety Disorder Case:5.2%) were reported tobe the3main causes of mental disorders. Rates of identification of depresion andanxiety disorder were56.5%and36.0%. Counsellors (Depression Case:65.0%,Anxiety Disorder Case:59.4%) was reported to be the major helpful interventions.(4)85.4%of respondents believed that community mental health services was essentialfor everyone. If there was a problem of emotional or mental problems,80.8%ofrespondents were willing to accept mental health services. The mental healthknowledge scores of respondents who were willing to seek help for mental healthwere higher than the reluctant ones’(t=41.280, P<0.001). There was no significantdifference between depressive symptoms group and no depressive symptoms group inproportion of willing to make use of mental health services. None was AnxietyDisorder. The proportion of depressive symptom respondents using mental healthservices was higher than the proportion of the group without depressive symptomsones (χ2=16.743, P<0.001). So was Anxiety Disorder (χ2=18.151, P<0.001).[Conclusions](1) The positive rate of screening depressive symptoms and anxietysymptoms group among respondents was lower than other regions. Gender, age,marital status and work status were impact factors of PHQ-9, GAD-7score.(2) The literacy of mental health knowledge was high, but the correct recognition rate ofdepression and anxiety disorder could still be improved, and the attribution ofdepression and anxiety disorder was not fully understood.(3) Depression, anxietysymptoms affected quality of life of residents.(4) The respondents who had moreknowledge of mental health prefered to seek help for menal health services.(5) Therespondents who had emotional problems used mental health services more than thosewho had no emotional problems, but the actual utilization of both were low.