Abstract
Objective
This study examines the extent to which gender differences in use of services in three subcultures in Israel can be accounted for by the psychosocial differences between women and men, and by differences in the prevalence of common psychiatric disorders and levels of distress.
Method
A representative sample extracted from the National Population Register of non-institutionalized residents aged 21 or older of Israel was used in this cross-sectional survey. Data on health, use of services and socio demographic background were collected using face-to-face computer-assisted interviews. DSM-IV disorders were assessed using the WMH-CIDI.
Results
Gender effects in the three different subcultures remained significant in predicting the use of services for mental health purposes after adjustment for educational level, family status, chronic illness, experience of violence, presence of mental disorder and psychological distress.
Conclusion
The higher rates of help seeking in women could not be explained by psychosocial differences and are likely related to women’s greater readiness to articulate and communicate distress.
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References
Bekker MH, van Mens-Verhulst J (2007) Anxiety disorders: sex differences in prevalence, degree, and background, but gender-neutral treatment. Gend Med 4 Suppl B:S178–S193 Review
Piccinelli M, Wilkinson G (2000) Gender differences in depression: critical review. Br J Psychiatry 177:486–492
Kuehner C (2000) Gender differences in unipolar depression: an update of epidemiological findings and possible explanations. Acta Psychiatr Scand 108:163–174
Hyde JS, Mezulis AH, Abramson LY (2008) The ABCs of depression: integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression. Psychol Rev 115(2):291–313
Marchesi C, Maggini C (2007) Socio-demographic and clinical features associated with demoralization in medically ill in-patients. Soc Psychiatry Psychiatr Epidemiol 42(10):824–829
Levav I, Gilboa S, Ruiz F (1991) Demoralization and gender differences in a kibbutz. Psychol Med 21:1019–1028
Weich S, Sloggett A, Lewis G (2001) Social roles and the gender difference in rates of the common mental disorders in Britain: a 7-year, population-based cohort study. Psychol Med 31(6):1055–1064 (GHQ)
Hintikka J, Koskela K, Kontula O, Viinamäki H (2000) Gender differences in associations between religious attendance and mental health in Finland. J Nerv Ment Dis 188(11):772–776 (GHQ)
Women’s Mental Health (2000) An evidence based review. Mental Health Determinants and Populations, Department of Mental Health and Substance Dependence. WHO, Geneva
Astbury J (2001) Gender disparities in mental health. Background report for World Health Assembly roundtables. WHO, Geneva
Biddle L, Gunnell D, Sharp D, Donovan JL (2004) Factors influencing help seeking in mentally distressed young adults: a cross-sectional survey. Br J Gen Pract 54(501):248–253
Vasiliadis HM, Lesage A, Adair C, Boyer R (2005) Service use for mental health reasons: cross-provincial differences in rates, determinants, and equity of access. Can J Psychiatry 50(10):614–619
Ladwig KH, Marten-Mittag B, Formanek B, Dammann G (2000) Gender differences of symptom reporting and medical health care utilization in the German population. Eur J Epidemiol 16(6):511–518
Oliver MI, Pearson N, Coe N, Gunnell D (2005) Help-seeking behaviour in men and women with common mental health problems: cross-sectional study. Br J Psychiatry 186:297–301
Kessler RC, Brown RL, Broman CL (1981) Sex differences in psychiatric help-seeking: evidence from four large-scale surveys. J Health Soc Behav 22:49–64
Vasiliadis HM, Lesage A, Adair C, Wang PS, Kessler RC (2007) Do Canada and the United States differ in prevalence of depression and utilization of services? Psychiatr Serv 58(1):63–71
Shemesh AA, Kohn R, Blumstein T, Geraisy N, Novikov I, Levav IA (2006) Community study on emotional distress among Arab and Jewish Israelis over the age of 60. Int J Geriatr Psychiatry 21(1):64–76
Levinson D, Zilber N, Lerner Y, Grinshpoon A, Levav I (2007) Prevalence of mood and anxiety disorders in the community: results from the Israel National Health Survey. Isr J Psychiatry Relat Sci 44(2):94–103
Abu-Baker K (2005) The impact of social values on the psychology of gender among Arab couples: a view from psychotherapy. Isr J Psychiatry Relat Sci 42(2):106–114
Ritsner M, Ponizovsky A, Nechamkin Y, Modai I (2001) Gender differences in psychosocial risk factors for psychological distress among immigrants. Compr Psychiatry 42(2):151–160
Davidson KW, Trudeau KJ, Roosmalen EV, Stewart M, Kirkland S (2006) Perspective: gender as a health determinant and implications for health education. Health Educ Behav 33:731–744
Kendler KS, Thornton LM, Prescott CA (2001) Gender differences in the rates of exposure to stressful life events and sensitivity to their depressogenic effects. Am J Psychiatry 158(4):587–593
Clarke DM, Smith GC, Dowe DL, McKenzie DP (2003) An empirically derived taxonomy of common distress syndromes in the medically ill. J Psychosom Res 54(4):323–330
Agid O, Kohn Y, Lerer B (2000) Environmental stress and psychiatric illness. Biomed Pharmacother 54(3):135–141 Review
Strickland PL, Deakin JF, Percival C, Dixon J, Gater RA, Goldberg DP (2002) Bio-social origins of depression in the community: interactions between social adversity, cortisol and serotonin neurotransmission. Br J Psychiatry 180:168–173
Kessler RC, Ustun TB (2004) The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 13:93–121
Levinson D, Paltiel A, Nir M, Makovki T (2007) The Israel-World Mental Health Survey: issues and methods. Isr J Psychiatry Relat Sci 44:85–93
Haro JM, Arbabzadeh-Bouchez S, Brugha TS, de Girolamo G, Guyer ME, Jin R et al (2006) Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health Surveys. Int J Methods Psychiatr Res 15(4):167–180
Shemesh AA, Levav I, Blumstein T (2004) Nobikov I: a community study on emotional distress among the elderly in Israel. Isr J Psychiatry 41:174–183
Knight M, Stewart-Brown S, Fletcher L (2001) Estimating health needs: the impact of a checklist of conditions and quality of life measurements on health information derived from community surveys. J Public Health Med 23:179–186
Fan VS, Au D, Heagerty P, Deyo RA, McDonell MB, Fihn SD (2002) Validation of case-mix measures derived from self-reports of diagnoses and health. J Clin Epidemiol 55:371–380
National Center for Health Statistics (1994) Evaluation of National Health Interview Survey diagnostic reporting. Vital Health Stat 120:1–116
Research Triangle Institute (2003) SUDAAN Version 8.0.2. Research Triangle Park, Research Triangle Institute
Madden D (2008) Gender differences in mental well-being: a decomposition analysis. HEDG Working Paper (2008) http://www.york.ac.uk/res/herc/documents/wp/08_08.pdf
Patel V, Araya R, de Lima M, Ludermir A, Todd C (1999) Women, poverty and common mental disorders in four restructuring societies. Soc Sci Med 49(11):1461–1471
Koopmans GT, Lamers LM (2007) Gender and health care utilization: the role of mental distress and help-seeking propensity. Soc Sci Med 64(6):1216–1230 Epub 2006 Dec 27
Elnekave E, Gross R (2004) The healthcare experiences of Arab Israeli women in a reformed healthcare system. Health Policy 69:101–116
Schomerus G, Matschinger H, Angermeyer MC (2009) The stigma of psychiatric treatment and help-seeking intentions for depression. Eur Arch Psychiatry Clin Neurosci 259(5):298–306 Epub 2009 Feb 17
Galdas PM, Cheater F, Marshall P (2005) Men and health help-seeking behaviour: literature review. J Adv Nurs 49(6):616–623 Review
Mahalik JR, Burns SM, Syzdek M (2007) Masculinity and perceived normative health behaviors as predictors of men’s health behaviors. Soc Sci Med 64(11):2201–2209 Epub 2007 Mar 26
Danielsson U, Johansson EE (2005) Beyond weeping and crying: a gender analysis of expressions of depression. Scand J Prim Health Care 23(3):171–177
Acknowledgments
The National Health Survey was funded by the Ministry of Health with an additional support from the Israel National Institute for Health Policy and Health Services Research and the National Insurance Institute of Israel. The views and opinions expressed in this chapter are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, or of the Government. The Israel Health Survey was carried out in conjunction with the World Health Organization/World Mental Health (WMH) Survey Initiative. We thank the staff of the WMH Data Collection and Data Analysis Coordination Centers for assistance with instrumentation, fieldwork, and consultation on data analysis. These activities were supported by the National Institute of Mental Health (R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the U.S. Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Co., Ortho-McNeil Pharmaceutical, Inc., GlaxoSmithKline, and Bristol-Myers Squibb. A complete list of WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/.
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Levinson, D., Ifrah, A. The robustness of the gender effect on help seeking for mental health needs in three subcultures in Israel. Soc Psychiat Epidemiol 45, 337–344 (2010). https://doi.org/10.1007/s00127-009-0079-4
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DOI: https://doi.org/10.1007/s00127-009-0079-4