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Gen Hosp Psychiatry. 2016 Mar-Apr;39:73-9. doi: 10.1016/j.genhosppsych.2015.11.009. Epub 2015 Dec 1.

Social Support and Health Service Use in Depressed Adults: Findings From the National Health and Nutrition Examination Survey.

Author information

1
VA Portland Health Care System and HSR&D Center to Improve Veteran Involvement in Care, Portland, OR, USA; OHSU-PSU School of Public Health, Portland, OR, USA.
2
OHSU-PSU School of Public Health, Portland, OR, USA.
3
VA Portland Health Care System and HSR&D Center to Improve Veteran Involvement in Care, Portland, OR, USA; OHSU-PSU School of Public Health, Portland, OR, USA. Electronic address: teoa@ohsu.edu.

Abstract

OBJECTIVE:

We investigated the relationship between social support and health service use among men and women with depression.

METHODS:

Participants were 1379 adults with symptoms of depression (Patient Health Questionnaire-9 score ≥ 5) in the National Health and Nutrition Examination Survey. Using the framework of the Andersen Behavioral Model of Health Services Use, multivariable regression models used social support, stratified by depression severity, to estimate association with utilization of mental health and nonmental health services. Partial F-tests examined a priori interactions between social support and gender.

RESULTS:

Among those with adequate social support, odds of seeing a nonmental health provider were much higher when depression was moderate [Odds Ratio (OR): 2.6 (1.3-5.3)] or severe [OR: 3.2 (1.2-8.7)], compared to those lacking social support. Conversely, odds of mental health service use were 60% lower among those with moderate depression [OR: 0.4 (0.2-1.0)] when social support was adequate as opposed to inadequate. Social support was unrelated to service use when depression was mild. Gender moderated the relationship between social support and health service use among individuals with severe depression.

CONCLUSIONS:

Social support has opposite associations with mental and nonmental health service use among adults with clinically significant depression. This association is largely attributable to the effect of male gender on the relationship between social support and health service use.

KEYWORDS:

Depression; Gender; Health service use; NHANES; Social support

[Indexed for MEDLINE]
Free PMC Article

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