うつ病患者の受療行動に関する研究

Help-seeking Behavior in Patients with Depression

　【抄録】　長崎市立市民病院精神科外来を初めて受診して本格的に治療を開始したうつ病患者92例の受療行動を分析した。初回の受療行動が治療に結びついたのは9例（9.8％）にすぎず，全患者の延べ受療行動回数は286回にも上っていた。特に多かったのは，一般診療科の延べ105回，家族・同僚の延べ63回であった。精神科を受診しながら，すぐ治療に結びつかなかった患者は10例であり，複数の精神科を受診した患者は3例もいた。受療行動の中途から，伝統的治療者へは延べ9回訪れていた。つまり，精神的な病気であるという説明を受けながらも多くのうつ病患者が精神科以外の診療科や相談者を頻回に訪れていること，精神科や一般診療科で医学的判断を受けながらも伝統的治療者への指向も同時に存在すること，社会的能力障害度が中等度に至るまで本格的な治療を始めないことなどが確認された。

　We examined the help-seeking behavior of 92 patients with depression who visited the outpatient clinic of the psychiatric department of Nagasaki Municipal Hospital for the first time and started to receive treatment. Only nine of them (9.8%) made their initial approach to the outpatient clinic of the psychiatric department. The total number of help-seeking visits to psychiatric or general clinics was 286, of which 105 were visits to general clinics, while the total number of visits by family members and colleagues was 63. Ten of the patients visited a psychiatric clinic but did not continue to receive treatment, and three of them visited more than one psychiatric clinic. The total number of visits to traditional healers while visiting clinics was 9.

　It was found that even after patients had been told that they had a psychiatric disease, many of them visited clinics and counselors other than psychiatric clinics, and even after they received medical diagnosis at psychiatric or general clinics they sought help from traditional healers. It was also revealed that they did not seek help until their social disability had reached medium degree.