Professional Help For Depression Research Articles

Abstract P463: E-cigarette Use and Seeking Professional Help for Depression Among Young Adults: Evidence From the VapeScan Study

Introduction: E-cigarettes (e-cigs) are the most commonly used tobacco product among youth. While cigarette use has been associated with a history of depression, research on the associations of e-cig use and depressive symptoms remains limited. While other studies have looked at the incidence of depression among e-cig users, the VapeScan study also factors in dual users who both smoke cigarettes and e-cigarettes. Hypothesis: We hypothesized that e-cig use is associated with seeking professional help for depression among young adult participants in the VapeScan Study. Methods: Participants aged 18 to 50 years were recruited from the greater New York area to participate in the VapeScan Study from May 2021 to October 2022. Participants were classified as exclusive current e-cig users (e-cig users), current e-cig and former cigarette users, current e-cig and cigarette users (dual users), or non-users of both e-cigs and cigarettes (controls); former vapers and exclusive cigarette users were excluded from the study. Participants self-reported if they had ever “seen a doctor or other health professional for depression.” Rates of professional care for depression were compared by logistic regression test. Logistic regression was used to test the association between e-cig use status and seeking professional help for depression, adjusted for age, sex, and race/ethnicity. Results: Among 147 participants, mean (SD) age was 28 (8) years, 54.42% (80 of 147) of participants were assigned female at birth, 36.73% (54 of 147) were Non-Hispanic White (ETC). There were 29 e-cig users, 42 dual users, and 76 controls. Forty-one percent of e-cig users (12 of 29) had seen a health professional for depression versus 64% (27 of 42) of dual users and 29% (22 of 76) of controls (p-value=0.0014). After adjustment, compared to controls, e-cig users were 1.66 times more likely to have sought professional care for depression (95%CI: 0.59-4.71) and dual users were 7.90 times more likely (95%CI: 2.99-20.88). Conclusions: E-cig use, and particularly dual use of e-cigs and cigarettes, was associated with having sought professional help for depression among young adults. Persons presenting with depressive symptoms should be screened for tobacco product use, and vice versa, to ensure provision of evidence-based mental health and tobacco cessation programs.

The effects of sociodemographic factors on help-seeking for depression: Based on the 2017-2020 Korean Community Health Survey.

When individuals face psychological difficulties that exceed their resources, consulting professionals for mental health treatment can be an effective way to overcome these difficulties. However, in general, only a few patients receive treatment for depression. The goal of the present study was to explore the help-seeking behaviors of currently employed individuals with depression and the factors influencing their help-seeking behaviors. This study used raw data from the Korean Community Health Survey (KCHS) obtained from 2017 to 2020. A total of 6,505 employed individuals, who responded as having experiences of sadness or hopelessness that caused problems in their lives for more than two weeks and who scored more than nine points on the Patient Health Questionnaire-9, were included in our analysis. Help-seeking behavior was measured as receiving expert advice due to feelings of sadness or hopelessness. Of the 6,505 people with depression, only 1,781 (27.38%) received professional counseling for it. Male participants (adjusted odds ratio [aOR] = 1.31, 95% confidence interval [CI] = 1.157-1.487), those aged 45-64 years (aOR = 1.192, 95% CI = 1.022-1.389) and more than 75 years (aOR = 1.446, 95% CI = 1.059-1.973), those not having a Medical Aid program (aOR = 1.750, 95% CI = 1.375-2.226), and those having low educational levels (aOR = .896, 95% CI = .830-.968) were less likely to seek professional help for depression. Our study found that help-seeking behaviors for depression in the Korean population were low. Furthermore, we identified the characteristics associated with individuals with depressive symptoms who chose not to receive help from mental health professionals. The results of this study provide insights to guide national interventions to increase help-seeking behaviors for depression.

Depression, Disability, and Cognitive Impairment Among Elders With Medical Illnesses Attending Follow-Up Clinics at a Tertiary Care Hospital in Northern Sri Lanka.

The rising proportion of the elderlyis increasingly affected by non-communicable diseases. Despite an abundance of literature suggesting that elders with medical conditions are more vulnerable to depression, disability, and cognitive impairment, these tend to go unnoticed and unaddressed. This study describes the prevalence and correlates of depression, disability, and cognitive impairment among elders with medical illnesses attending follow-up clinics in a tertiary care hospital in northern Sri Lanka. This descriptive cross-sectional study was carried out among 122 elders (≥60 years) attending medical clinics at Teaching HospitalJaffna. Depression, disability, and cognitive impairment were assessed by the 15-item Geriatric Depression Scale, 12-item World Health Organization Disability Assessment Schedule 2.0, and Montreal Cognitive Assessment, respectively. Student's T-Test, ANOVA, and correlation coefficient were used in analyzing data using Statistical Package for Social Sciences 25 (SPSS-v25) (IBM, New York, United States). The mean age of the participants was 68.3 years (SD=5.70); 58 (47.5%) were males and 64 (52.5%) were females. Prevalence of depression was 44.3% (95% CI=35.5-53.1), while disability was 95.9% (95% CI=92.4-99.4) and cognitive impairment was 80.3% (95% CI=73.2-87.4). Depression was significantly associated with gender (p=0.013), marital status (p=0.019), and living arrangement (p<0.001). Cognitive impairment was significantly associated with education level (p=0.045), and disability was associated with education level (p=0.008) and marital status (p=0.027). Among the study participants, only 12 (9.8%) had previously sought professional help for depression, disability, or cognitive impairment. Depression, disability, and cognitive impairment are common among the elderly attending medical clinics in Teaching HospitalJaffna, and are, in most cases, unaddressed.

COVID-19 Concerns, Depression and Loneliness in Middle-Age and Older Adults

The coronavirus pandemic forced many people to restrict their activities and social interactions out of fear and due to local health regulations. This study examined whether one’s self-reported level of concern related to COVID-19 was associated with loneliness and depressive symptoms. Using early release 2020 data from the Health and Retirement Study (N=2,759 adults over age 50), we conducted ordinary least-squares and logistic regressions, controlling for age, gender, education, marital status, self-rated health, and exercise. Higher levels of self-reported concern about the coronavirus pandemic were associated with more depressive symptoms (B=.05, p<.01) and increased odds of being lonely (OR=1.05, p<.01). Female sex, lower education, not being married, worse self-rated health, and lack of exercise were associated with more depressive symptoms and higher odds of being lonely, while older age was associated with lower depression but higher odds of loneliness. These results suggest that mental health assessments should include measures specifically asking about COVID-19 concerns and experiences (e.g., COVID-19 diagnosis, death of close friends or family due to COVID-19, unable to attend important events). The pandemic has raised public awareness of the negative consequences of social isolation and acted to destigmatize mental illness, and this could encourage middle-aged and older adults to seek professional help for depression.

1Development of persuasive message to encourage help-seeking for depression

Abstract Background Delayed initial treatment contact for mental disorders is an important public health problem. The objective of this study was to develop persuasive messages to encourage help-seeking for depression. Methods Firstly, we conducted a questionnaire survey among Japanese adults to understand the reasons why people avoid seeking professional help for depression (BMC Public Health 2016). Secondly, we created 6 depression help-seeking messages with 3 frames× 2 formats and assessed their effectiveness in eliciting help-seeking intentions for depression (BMJ Open 2018). Thirdly, we redesigned the loss-framed formatted message to make it more visually appealing and made a trial of repeated message exposure with the aim of sustaining the messaging effect over time. Results Less than 40 % of survey participants reported a positive help-seeking intention for depression. The neutral-, loss-, and gain-framed messages were selected so as to be matched against the top 3 reasons for having no help-seeking intention, respectively. The loss-framed formatted message functioned better than the others; help-seeking intentions increased from 36% to 47% after the message exposure. Repeated message exposure increased the message retention rate (once 26% vs. twice 48% at 2-week follow-up) which enhanced the elicitation of help-seeking intentions. Conclusions The depression help-seeking message can elicit the intent to do so among people who otherwise lack this. Key messages The Step approach to Message Design and Testing is useful for developing public health messages and materials. Acknowledge: This work was supported by JSPS KAKENHI Grant Number JP25460815, JP16K09147 and the Uehara Memorial Foundation Research Grant.

Mental Health Literacy of University Students

The purpose of this study is to observe: (1) Gender difference in mental health literacy of Yogyakarta State University students and (2) Differences in mental health literacy of Yogyakarta State University students based on vignette character’s gender. The type of this study was factorial survey. In this study, respondents were presented with short descriptions called vignette that were constructed and contained elements that had been manipulated by the researcher to control certain variables, namely gender and mental disorders that the characters had. Then, subjects were asked to answer closed questions (Mental Health Literacy Test) based on the vignettes. The subjects in this study were 377 undergraduate students from Yogyakarta State University. The sampling techniques used in this study were cluster random sampling and incidental sampling. Chi-Square was performed to analyze the data. The results of this study indicated that: (1) There were gender differences in mental health literacy aspect positive attitudes toward professional help where more male respondents did not recommend seeking professional help for depression (2) There were differences in mental health literacy aspects knowledge about the causes of mental disorders and positive attitudes towards professional help based on gender vignette characters for depression.

Young People's Response to Six Smartphone Apps for Anxiety and Depression: Focus Group Study.

BackgroundSuicide is one of the most frequent causes of death in young people worldwide. Depression lies at the root of this issue, a condition that has a significant negative impact on the lives of those who experience it and on society more generally. However, 80% of affected young people do not obtain professional help for depression and other mental health issues. Therefore, a key challenge is to find innovative and appealing ways to engage young people in learning to manage their mental health. Research suggests that young people prefer to access anonymous Web-based programs rather than get face-to-face help, which has led to the development of numerous smartphone apps. However, the evidence indicates that not all of these apps are effective in engaging the interest of young people who are most in need of help.ObjectiveThe study aimed to investigate young people’s response to six currently available smartphone apps for mental health and to identify features that young people like and dislike in such apps.MethodsFocus groups were conducted with 23 young people aged 13 to 25 years in which they viewed and used six smartphone apps for mental health. A general inductive approach following a realist paradigm guided data analysis.ResultsThe results revealed that young people value autonomy and the opportunity to personalize experiences with these apps above other things. Finding a balance between simplicity and informativeness is also an important factor.ConclusionsApp developers need to consider using participant-design frameworks to ensure that smartphone apps are providing what young people want in a mental health app. Solutions to the need for personalization and increasing user engagement are also crucially needed.

Intention to seek help for depression and associated factors among residents of Aykel town, Northwest Ethiopia: cross-sectional study

BackgroundDepression is the leading cause of disability at a population level and globally 350 million people are suffering from depression. Despite a high prevalence and serious consequences, people with depression are reluctant to seek help and a large proportion remains untreated. The aim of this study was to assess intention to seek help for depression and associated factors among residents of Aykel town, Northwest Ethiopia.MethodsThis cross-sectional population based study included 832 participants. We used a major depressive disorder case vignette and general help-seeking questionnaire (GHSQ) to assess intention. Study participants selected by multistage cluster sampling technique. Face-to-face interview used to collect data. We performed adjusted multiple linear regression analyses to identify factors for intention to seek help.ResultsThe mean score on intention to seek help from any health professionals was 3.72 (SD = 1.23) with a range of (1 “very unlikely” to 5 “very likely”). Majority of the respondents had an intention to visit health professionals to get a remedy for their illness depicted in the vignette. The proportion of those who had an intention to seek help from any health professionals if they were having depression was 71.2%. Favorable attitude towards seeking professional help for depression positively associated with an intention to seek help with (unstandardized β = 0.03, 95% CI (0.01, 0.05), p-value < 0.001). Other factors positively associated with an intention to seek help for depression were age (β = 0.02, CI (0.01, 0.03) p < 0.001), and perceived need of treatment for depression (β = 0.19, CI (0.01, 0.38), p < 0.05). Poor social support was negatively associated with an intention to seek help for depression (β = − 0.39 CI − 0.68, − 0.10, p < 0.05).ConclusionsThe results suggest that over two-third of the respondents reported that they were likely or very likely to seek help from health professionals if they were having depression. Increased age, favorable attitude to depression, and perceived need for treatment were factors for intention to seek help. Interventions focusing on awareness creation and attitude change towards depression are necessary.

Studying depression among Arab adolescents: Methodological considerations, challenges, and lessons learned from Jordan.

The purpose of this study was to evaluate the methodology for research examining depression severity, depression sigma, and attitudes toward seeking professional help for depression among Jordanian adolescents aged 12 to 17 years. Because this was a novel area of research in the Arab countries generally, and Jordan specifically, we aimed to (a) assess the feasibility of collaboration with recruitment sites, (b) evaluate the sampling method and recruitment strategies, and (c) confirm the utility of the measures translated from English to Arabic, namely, the Depression Stigma Scale (DSS; Griffiths, Christensen, & Jorm, 2008) and the Attitudes Toward Seeking Professional Psychological Help Scale (ASPPH; Fischer & Farina, 1995). Cross-sectional data were collected using self-report questionnaires from 88 adolescents attending public schools in Jordan. Active parental consents and adolescent assents were obtained as required by an American institutional review board (IRB), which was 1 of 2 entities providing approval for the study protocol. Depression was evaluated using a validated Arabic version of the Beck Depression Inventory II (BDI-II; Beck, Steer, & Brown, 1996). A systematic translation procedure was utilized for the DSS and ASPPH scales. Feasibility of collaboration with recruitment sites was established. However, the active consent procedure reduced the response rate and influenced sample characteristics. Both the BDI-II and the DSS showed adequate reliability. Reliability of the ASPPH scale was questionable. Conducting cross-cultural research requires careful considerations of all ethical, methodological, cultural, linguistic, and logistical issues that might potentially affect the validity and reliability of collected data. This study taps a significant gap in the literature, and provides important recommendations on how to address the potential impacts of the consent process on subjects’ decision to participate or opt out of studies addressing stigmatizing issues, such as mental illness.

Psychosocial Correlates of Jordanian Adolescents' Help-Seeking Intentions for Depression: Findings From a Nationally Representative School Survey.

Little is known about help-seeking for depression among Jordanian adolescents who are a vulnerable population with high rates of depressive symptoms and few mental health services. The purpose of this study was to (1) explore Jordanian adolescents' helpseeking intentions for depression and (2) examine whether depression stigma, depression severity, or their interaction are associated with Jordanian adolescents' willingness to seek help for depression and the type of treatment they would seek. In collaboration with the Jordanian Ministry of Education, we conducted a nationally representative, school-based survey of adolescents aged 12-17 years ( N = 2,349). One fourth of the adolescents reported they would not seek professional help for depression, and those respondents had higher average depression scores. Among those adolescents willing to seek help, the most likely sources included family member (57%), school counselor (46%), psychiatrist (43%), religious leader (39%), and general health practitioner (28%). Lower stigma scores were associated with greater likelihood to seek psychotherapy or visit a psychiatrist, while higher stigma scores were associated with increased likelihood to seek help from a school counselor or a family member. Jordanian adolescents experience significant barriers to seeking professional help for depression. However, even among adolescents with greater depression severity and depression stigma, school counselors were identified as a key resource for help. These findings suggest that school-based interventions may fill a critical service need for adolescents with depression and other mental health problems. School nurses should be leveraged along with counselors to address mental health issues in this vulnerable population.

A pilot study of depression, stigma, and attitudes towards seeking professional psychological help among Arab adolescents.

The Arab region has the largest proportion of young people in the world and many of the factors that contribute to the onset of depression. Yet, very little is known about the current situation of depression and its associated stigma in this region. The purpose of this pilot study was to obtain preliminary data examining clinically significant depressive symptoms, depression stigma, and attitudes towards seeking professional help for depression among a sample of Arab adolescents from Jordan. Cross-sectional data were collected from 88 adolescents attending public schools in Jordan using self-report questionnaires that were available in, or translated into, Arabic. Among the 88 adolescents, 22% reported scores suggesting mild depression and 19% reported scores suggesting moderate depression, while 24% reported scores suggesting severe depression. The most frequently reported depressive symptoms were changes in sleep patterns (76%), changes in appetite (63%), agitation (62%), and crying (61%). The majority (73%) had moderate depression stigma, and 43% had negative attitudes towards seeking professional help. Yet, 67% believed they would find relief in psychotherapy if they ever had a serious emotional crisis. Findings suggest that the prevalence of depressive symptoms may be high among Jordanian adolescents. Further, many of these adolescents may experience depression-related stigma that affects their attitudes and willingness to seek professional help. To determine the true scope of these issues, including the prevalence of depression among Jordanian adolescents, future research should obtain data from a nationally representative sample.

Willingness to disclose a mental disorder and knowledge of disorders in others: Changes in Australia over 16 years

To assess whether willingness to disclose experience of a mental disorder and treatment, and awareness of others' experiences have changed over a 16-year period. In 2011, telephone interviews were carried out with 6019 Australians aged 15+. The survey interview used the same questions as those of the 1995 and 2003/4 national mental health literacy surveys, in which participants were presented with a case vignette describing either depression, depression with suicidal thoughts (2003/4 only), early schizophrenia or chronic schizophrenia (2003/4 only). Participants were asked whether they had a close friend or family member who had experienced a problem similar to that described in the vignette and whether the person received professional help. They were also asked whether they had experienced such a problem and whether they received professional help. The numbers of those disclosing experiences of depression and early schizophrenia, and of having received professional help for depression, have increased since 1995. Awareness of a family member or close friend with experiences of depression and early schizophrenia also increased between these years, as did awareness that the person received professional help. The numbers of those disclosing experiences of and treatment for mental disorders has increased in the last 16 years. This is likely to be due to increased willingness to disclose rather than increased prevalence of disorders or increased rates of help-seeking.

Why don't academic physicians seek needed professional help for psychological distress?

Suicidal thoughts, burnout and other signs of psychological distress are prevalent among physicians. There are no studies concerning help-seeking for psychological distress among university hospital physicians, who face a particularly challenging, competitive work environment. We compare psychologically-distressed university hospital physicians who have not sought needed help with those who have sought such help. We thereby aim to identify factors that may hinder help-seeking and factors that may trigger seeking help. Analysis was performed among university hospital physicians reporting recent suicidal thoughts and/or showing other indications of current psychological ill-health. These distressed physicians were a subgroup (42.7%) from the cross-sectional phase I HOUPE study (Health and Organization among University Hospital Physicians in Europe): 366 from Sweden and 150 from Italy. Having sought professional help for depression or burnout was the outcome variable. Multiple logistic regression was performed with socio-demographic factors as covariates. Altogether 404 (78.3%) of these distressed physicians had never sought professional help for depression/burnout. Physicians who were currently involved in medical research, taking night call, surgical specialists, male, or Italian were least likely to have sought help. Physicians who faced harassment at work or who self-diagnosed and self-treated were more likely to have sought help. Very few of these university hospital physicians with signs of psychological distress sought help from a mental-health professional. This has implications for physicians themselves and for patient care, clinical research, and education of future physicians. More study, preferably of interventional design, is warranted concerning help-seeking among these physicians in need.

Attitudes toward depression among a sample of Muslim adolescents in the Midwestern United States

Little is known about how Muslim youth in non-Muslim countries perceive depression and its treatment and prevention. We investigated the barriers and suggest treatment models for depressive disorders in Muslim adolescents and young adults residing in the United States. We conducted a thorough literature review to identify previous study on the beliefs of American Muslim adolescents about depression and its treatment. We identified the gaps and developed a survey to ascertain this information from American Muslim adolescents. The survey was administered to a convenience sample of 125 Muslim subjects (60.0% males) aged 14-21 years. The sample was ethnically diverse with Pakistani (44.8%) encompassing the majority of the sample. Most responders believed that recitation from the Koran relieves mental distress. Multiple linear regression analysis revealed that those who reported strong emotional support from parents or a greater acceptance of taking depression medication prescribed from a physician were more likely to accept a physician's diagnosis, whereas believing in prayer to heal depression was associated with a lower likelihood of the same. Youth were accepting of Internet and preventive approaches. Planning of culturally sensitive mental health services is useful to accommodate the needs of Muslim youth served by primary care physicians and mental health practitioners in the United States. Muslim adolescents tend to be more traditional with family, social, and religious values. This value system plays an important role in their likelihood of seeking and accepting professional help for depression.

Depression treatment preferences among Japanese undergraduates: Using conjoint analysis

Treatment preferences may contribute to seeking and adhering to professional help for depression. Few studies have considered practical barriers and controlled for individual difference factors. To clarify depression treatment preferences among Japanese undergraduates while considering practical barriers and controlling for individual difference factors. This was a cross-sectional study of 985 undergraduates. Depression treatment preferences were assessed by presenting them with nine hypothetical clinics. Conjoint analysis was performed using a random effect ordered probit model, controlling for the effects of gender, age, department, lifetime use of healthcare services, perceived etiology of depression, stigma towards depression, transportation time, opening hours, and treatment options. Transportation time and treatment options had the greatest average discrete changes than other factors. Although information is presented about treatment costs in the order medication (3,000 yen), psychotherapy (7,000 yen) and combination (10,000 yen), the order of predicted probabilities for positive ratings was combination (61.4%), psychotherapy (54.9%) and medication (23.2%). Sensitivity analyses showed similar results. Transportation time and treatment options have greater utility than other factors, and a combination of psychotherapy and medication is the most preferred treatment option despite having the highest treatment costs. Efforts to overcome these effects could help increase depression treatment preferences.

Asian Americans' lay beliefs about depression and professional help seeking

Guided by a culturally informed illness representation self-regulation model (CIRSRM), this study analyzed the relations among 223 Asian Americans' lay beliefs about depression, enculturation to Asian values, and their likelihood of seeking professional help for depression. Participants' lay beliefs were assessed through an analysis of written responses to open-ended questions about depression. Enculturation as well as beliefs in biological causes, situational causes, and a short duration of depression were significantly related to the likelihood of professional help seeking. In addition, enculturation moderated the association between several lay beliefs and the endorsement of professional help seeking. The findings are discussed in light of how clinicians can incorporate mental illness lay beliefs in their work with Asian Americans.

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Survey on recent suicidal ideation among female university hospital physicians in Sweden and Italy (the HOUPE study): Cross-sectional associations with work stressors

Suicide rates among physicians are higher than in the general population, and rates among female physicians are particularly high. More female than male physicians report suicidal thoughts, with suicidal ideation being a well-recognized precursor of suicide. The urgent need to find the reasons for suicide risk in female physicians is underscored by society's increasing dependence on this group of health care providers. The aim of this paper was to identify potential risk and protective factors associated with recent suicidal ideation in female physicians. A cross-sectional survey analysis of work-related health, organizational culture, career paths, and working conditions was performed among permanently employed female physicians from the HOUPE (Health and Organisation among University Physicians in four European countries) study: 385 in Sweden and 126 in Italy. The main outcome measure was recent (within the prior 12 months) suicidal thoughts. Overall, 13.7% and 14.3% of the participants from Sweden and Italy, respectively, reported suicidal thoughts within the prior 12 months. Among the physicians from Sweden, the most powerful multivariate model for such thoughts included 2 independent variables related to work: degrading experiences/harassment at work (odds ratio [OR], 3.03; 95% CI, 1.48-6.23), and work meetings to discuss stressful situations (OR, 0.36; 95% CI, 0.19-0.69). The model included self-diagnosis and self-treatment as a significant factor. Work meetings to discuss stressful situations were also in the multivariate model for the Italian physicians (OR, 0.21; 95% CI, 0.05-0.86), together with being given work assignments without adequate resources (OR, 5.0; 95% CI, 1.32-18.8). Significant non-work-related factors in the Italian model were younger age and seeking professional help for depression or burnout. In both Sweden and Italy, work stressors have been identified that may increase the risk for suicide for female physicians. A potential protective factor was meetings to discuss stressful work experiences. These findings suggest that such meetings should be more broadly implemented.

The mental health status of Chinese rural–urban migrant workers

There are currently around 120 million rural-urban migrants in China. Elsewhere migration has been associated with increased vulnerability to mental health problems. This study was conducted to explore the mental health status and help seeking behaviours of migrant workers in Hangzhou city, Zhejiang Province, and to compare them with permanent urban and rural dwellers. A self-completion questionnaire including items relating to sociodemographics, health and lifestyles and mental health, was completed by 4453 migrant workers and 1957 urban workers in Hangzhou city, and by 1909 rural residents in Western Zhejiang Province. The mean age of the migrants was 27 years, (male 29 years, female 25 years). They worked long hours (28% >12 h per day, 81% 6 or 7 days per week) and their living conditions were very basic. On the SF-36 mental health scale migrants had lower scores (52.4) than rural residents (60.4, P < 0.0001) but scored higher than urban residents (47.2, P = 0.003). The difference between urbanites and migrants disappeared after adjustment for confounders (P = 0.06). Independent predictors of better mental health status among migrants were being unmarried, migrating with a partner, higher salary, good self-reported health and good relationships with co-workers. There were small significant differences in suicide ideation and attempts between the three groups with suicide ideation commonest in migrants and suicide attempts most common in the rural population. Fewer than 1% across all three groups had received any professional help for depression or anxiety. Rural-urban migrant workers in this part of China are not especially vulnerable to poor mental health. This may result from a sense of well being associated with upward economic mobility and improved opportunities, and the relatively high social capital in migrant communities.

Actions Taken to Cope with Depression in Patients Seeking Specialist Care

To assess the rates and perceived effectiveness of actions used to cope with depression and the factors influencing these in an outpatient sample seeking help for depression. One hundred and seventy-six patients (74 male, 102 female) aged 16-82 years (M = 42, SD = 14.4 years) with a major depressive episode (DSM-IV criteria) were assessed using a number of measures that covered sociodemographics, history of psychiatric illness, actions taken to alleviate depression and their perceived effectiveness. Logistic regression analyses assessed age, gender and illness characteristics associated with the use and perceived effectiveness of strategies adopted to manage depression. Medical interventions were used and perceived to be effective in alleviating depressive symptoms by most of the sample, as were self-help and complementary therapies. Sociodemographic and illness-related characteristics had a significant influence, with younger age and having experienced an episode of anxiety disorder found to be the strongest predictors for the use of coping strategies. Being female was the strongest predictor for their effectiveness. A range of actions for depression, including medical and complementary interventions, were used and found to be helpful in a sample that had sought professional help for depression. Gender, age, depression and anxiety factors were all found to predict the use and perceived effectiveness of these strategies.