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Articles   |    
Treatment Seeking and Unmet Need for Care Among Persons Reporting Psychosis-Like Experiences
Jordan E. DeVylder, M.S.; Hans Y. Oh, M.S.W.; Cheryl M. Corcoran, M.D.; Ellen P. Lukens, Ph.D., M.S.W.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300254
View Author and Article Information

Mr. DeVylder, Mr. Oh, and Dr. Lukens are with the School of Social Work and Dr. Corcoran is with the Department of Psychiatry, Columbia University, New York City (e-mail: jed2147@columbia.edu). Dr. Corcoran is also with the New York State Psychiatric Institute, New York City.

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  Psychosis-like experiences may be clinically significant given their demonstrated associations with concurrent psychological distress and the later development of diagnosable psychotic disorders. Prior studies of treatment for psychosis-like experiences have yielded conflicting results. The aims of this study were to investigate help seeking and need for care among individuals with psychosis-like experiences in a large general population sample.

Methods  Data from the Collaborative Psychiatric Epidemiology Surveys (N=10,541) were used to examine help-seeking behaviors among survey respondents who reported psychosis-like symptoms over a 12-month period. Adjusted odds ratios were calculated for a variety of help-seeking variables, with control for demographic factors and co-occurring psychiatric conditions.

Results  Among the 10,541 respondents, 3.4% reported a psychosis-like experience in the past 12 months. Respondents who reported psychosis-like experiences were more than twice as likely as those who did not to seek treatment. Those who reported such experiences but who did not seek treatment were more likely to have felt the need for or to have been encouraged by others to seek treatment and less likely to have felt that they had no psychiatric problem. Associations with unmet need for care were largely attributable to co-occurring psychiatric disorders.

Conclusions  Respondents with psychosis-like experiences had elevated rates of help seeking, as well as significant unmet clinical need among those not in treatment.

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Table 1Demographic characteristics and diagnoses of 10,541 general population survey respondents, by whether they reported psychosis-like experiencesa
Table Footer Note

a Weighted percentages and standard errors are adjusted for complex survey design to ensure that the sample was representative of the U.S. adult population (aged 18–64).

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Table 2Help seeking and need for care among 10,541 general population survey respondents, by whether they reported psychosis-like experiencesa
Table Footer Note

a Weighted percentages and standard errors are adjusted for complex survey design to ensure that the sample was representative of the U.S. adult population (aged 18–64).

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Table 3Logistic regression models of predictors of help seeking among 10,541 general population survey respondentsa
Table Footer Note

a Odds ratios were adjusted for age, sex, race-ethnicity, education, and marital status. All variables in all models were significant predictors (Wald χ2, Bonferroni correction, p<.007).

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Table 4Logistic regression models of predictors of need for care among 6,210 respondents who did not seek carea
Table Footer Note

a Odds ratios were adjusted for age, sex, race-ethnicity, education, and marital status. Reporting psychosis-like experiences was a significant predictor only in model 1 for encouraged by others; all other variables in all models were significant predictors (Wald χ2, Bonferroni correction, p<.007).

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Table 5Logistic regression models of predictors of reasons for not seeking treatment among 5,669 respondents who did not seek care and provided an explanationa
Table Footer Note

a Odds ratios were adjusted for age, sex, race-ethnicity, education, and marital status. Reporting psychosis-like experiences was not a significant predictor in any model. Having an affective or anxiety disorder was a significant predictor in all models that included these variables (Wald χ2, Bonferroni correction, p<.007).

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