LIFE PREVALENCE OF DEPRESSIVE EPISODES AND THE USE OF SPECIALIZED SERVICES

The present report is based on data obtained in a comprehensive epidem iological psychiatric survey carried out on a representative sample of the adult population of Mexico City during 1995. The objectives of th is study included the estimation of lifetime prevalence of specific ps ychiatric disorders and exploration of the help-seeking patterns. This paper is focused on: what characteristics or circumstances facilitate or act as barriers in the help-seeking process as related to mental h ealth professionals on the population with lifetime prevalence oi depr essive disorders defined in terms of the ICD-10 research diagnostic cr iteria. The design of the study was a household survey restricted to M exico City, excluding the rest of the metropolitan area. The target po pulation were adults aged 18 to 64 years old living permanently or tem porary in private dwelings in the 16 political division areas of the c ity. The sampling design was polietapic and stratified by sex; the sel ection probability in the third stage resulted in a self-weighted segm ent sample within each domain. As an accessibility measure for this re port the response to the question about being affiliated to some kind of medical service was considered. The interviews were carried out by using the CIDI-Fresno, which is a modified version of the CIDI 1.1, as well as variables included in the National Comorbidity Survey in the United States. The dependent variable was the access to mental health professionals during the reported lifetime depressive episode. Descrip tive results are presented as related to the number of impairments res ulting from the disorder and the help-seeking behaviour. Association w ith variables exploring accesibility, opinions, attitudes, beliefs, in tentions and experiences with other persons, and obstacles was carried out by means of the odds ratio. Complete interviews were obtained for 1937 subjects; only eight percent of the eligible subjects openly ref used to be interviewed. Lifetime prevalence of depressive episodes rep resented 8.3 % of the adult inhabitants. Only 13.9 % depressed subject s sought help from mental health professionals. The help-seeking patte rn showed differences by sex and number of reported impairments mediat ed by affiliation status. Accesibility in terms of the affiliation sta tus and as an indirect gross indicator of socioeconomic conditions, wa s clearly associated with help sought from mental health professionals . Differences by sex were elicited about intentions and attitudes; men were more likely to disscuss their emotional problems with a professi onal and hence their association was stronger than in women who sought more help from mental health professionals. Interestingly both, women and men, didn't sought help when they considered that their problems were personal. Also, opinions on sex differences were elicited showing that women were more likely to consider that they have to solve their problems by themselves, thus they didn't seek professional help. Both , women and men, didn't seek mental health aid when they considered th at general physicians could help them. Experiences of third persons fa cilitated the access to mental health professionals for both, men and women, although the association was stronger for women. Social obstacl es were more likely to be responsable for not seeking professional men tal help. In men, interference with working hours and the opinion of t heir boss prevented them from seeking professional help, while in wome n it was the opinion of family members and friends.