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.
Significant others of individuals with posttraumatic stress disorder (PTSD) may experience both intrapersonal and interpersonal distress as caregivers. The aim of the present study is 3-fold: (1) to examine symptoms of psychological and relationship distress (anxiety, depression, and dyadic adjustment) among partners of civilian patients with PTSD, (2) to investigate the links between partners' distress and PTSD patients' symptoms (severity; intrusion, avoidance, and arousal subscales), and (3) to explore the perception of mental and physical health, types of trauma and compare partners and PTSD patients' measures. Fifty-seven PTSD patients and their partners filled out 4 questionnaires: Marital Adjustment Test, Beck Anxiety Inventory, Beck Depression Inventory-II, and Medical Outcome Survey-Short Form-12. Results showed that only a minority of partners presented clinical levels of depression (16.7%), anxiety (14.8%), and relationship distress (37%). Pearson correlations analyses revealed an absence of statistically significant relationship between partners' distress and PTSD patients' symptoms. In conclusion, although our study is not a direct validation of the secondary traumatic stress model, our findings fail to provide strong support to the secondary traumatic stress hypothesis among partners of civilian PTSD patients.
Objectifs: La présente étude traite des obstacles au traitement auxquels se butent des personnes qui sont aux prises avec un trouble anxieux (TA) et qui n'ont pas obtenu de services pour leur problème. Les recommandations que formulent ces personnes pour améliorer l'accès au traitement sont rapportées. Méthode: Un questionnaire diffusé sur le Web traitant de l'accessibilité du traitement pour les troubles anxieux a été rempli par 610 personnes domiciliées au Québec et ayant rapporté souffrir d'anxiété. Des chi-carrés ont été effectués pour comparer les réponses des personnes qui ont reçu des services ( n = 151) avec les réponses de celles qui n'en ont pas reçu ( n = 434). Résultats: Les délais d'attente trop importants pour obtenir un traitement (X2 = 29,66; dl = 1; P < 0,001), les difficultés éprouvées pour joindre un professionnel par téléphone (X2 = 13,75; dl = 1; P < 0,001) ainsi que la distance géographique des lieux de services (X2 = 4,34; dl = 1; P = 0,04) sont les obstacles qui ont nui aux participants qui n'ont pas reçu les services désirés davantage qu'à ceux qui les ont obtenus. Conclusions: Les obstacles et les recommandations des participants mettent en lumière le besoin d'accroître l'accès aux professionnels de la santé en ce qui concerne les délais d'attente, de former et informer davantage les professionnels de première ligne en matière de dépistage et de traitement des TA, ainsi que de développer l'offre de services psychothérapeutiques dans le réseau de santé public.
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