Predictive factors of delay in contact with a psychiatrist in depressive disorders

Abstract

Background:The different duration of delay to first contact with a psychiatrist in depressive disordered patients has been observed in western and non western cultures. This study aimed to examine the duration and predictive factors of delay in contact with a psychiatrist in depressive patients in Isfahan city of Iran.
Methods:In This cross sectional study 156 depressive patients were recruited from various outpatient clinics in Isfahan city between January 2013 and February 2013. We used the Anderson Socio-Behavioral Model (ASBM) for examine the role of various factors influencing delay in help seeking. In this models there were three categories variables (predisposing, enabling and need factors). Quintile regression model was used to study the predictors. Potential predictors were entered in this model in four steps. Predisposing factors in the first step, Enabling factors in the second step, Need factors in the third step and in the last step, all the factors were entered.
Results:the median duration between symptom onset and
first contact with a psychiatrist was 1 year. In the first step
(predisposing model), age at onset of depressive symptoms and never married were negative predictors for delay, but widowed or divorced statues was positive predictors for delay. In the enabling model past contact with health provider was positively associated with duration of delay. In the need model, neither variable had a significant effect on duration of delay. In the full model, younger age at onset, widowed or divorced statues and past contact with health provider increased duration of delay.
Conclusions:More delay of help seeking by children and
adolescence and probability ofmaladaptive coping style such
as substance use and complicating of situation need to earlier diagnosis of depression in young group and earlier treatment for decrease DALLY for MDD, Therefore we suggest the mental health awareness programs for adolescent in school , and more ever for the influenced roles of parent and other family members and teachers on teen and young person’s life, the education for families and teachers on adolescent mental health problems canbe effective. First help seeking contact with nonpsychiatric medical professionals enhance the delay of contact with a psychiatrist. Appropriate training of non-psychiatric medical professionals and
developing a referral system would lead to better provision of mental health care.
Keywords:Delay, depression, predictive factors, psychiatrist