RESUMO
BACKGROUND: Although 40% of people with panic attacks never seek care for their attacks, those who do may use medical settings or mental health settings, or both. The purpose of this study was to examine where people seek care for their panic attacks within and outside the health care system, and to determine what variables predict the choice of a given site. METHODS: The Panic Attack Care-Seeking Threshold (PACT) study is a community-based survey of 97 subjects meeting the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) criteria for panic attacks. A structured interview was used to collect information about panic attacks, family characteristics, psychiatric comorbidity, health care access and utilization, illness attitudes and behaviors, quality of life, and symptom perceptions. RESULTS: Forty-nine percent of the subjects seeking care for panic attacks presented to medical settings, whereas 26% of subjects used mental health settings. The family physician's office was the most frequent site of presentation (35%), followed by a hospital emergency department (32%). Only 13% of subjects sought care from a site outside the health care system. Variables predicting presentation to specific health care sites varied. Subject demographics, panic characteristics, and symptom perceptions were generally significant factors in care-seeking. Illness behaviors, readiness for sick role, health locus of control, and family measures failed to predict the seeking of care specific to any particular site. CONCLUSIONS: When subjects with panic attacks seek care, they most commonly present to a general or family physician's office or a hospital emergency department.
Assuntos
Serviços de Saúde/estatística & dados numéricos , Transtorno de Pânico/terapia , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Atenção à Saúde/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Medicina de Família e Comunidade/estatística & dados numéricos , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Medicina Tradicional , Serviços de Saúde Mental/estatística & dados numéricos , México/etnologia , Pessoa de Meia-Idade , TexasRESUMO
A standardized interview including parts of the NIMH-Diagnostic Interview Schedule was used to determine the prevalence of depression (major depression or dysthymia) and generalized anxiety in a random sample of predominantly low-income Mexican American patients attending an inner-city family health center. Overall rates of current DSM-III-diagnosable depression and anxiety were similar to rates reported for other primary care patient populations in the United States. There were racial/ethnic and sex differences in the rates of these disorders, with Anglo females having disproportionately high rates. Among women, the rate of mental disorders was higher for those with many somatic symptoms, three or more children, low scores on a scale of family integration, and numerous missed appointments in the last year.