Posttraumatic Stress Disorder and Barriers to Care in Eastern Cape Province, South Africa

A range of barriers to seeking mental health care in low- and middle-income countries has been investigated. Little, however, is known of the barriers to care and help-seeking behavior among people with posttraumatic stress disorder (PTSD) in low- and middle-income countries. This was a population-based study including 977 people aged 18-40 years from the Eastern Cape Province in South Africa. Current PTSD was assessed by using a diagnostic questionnaire (Mini International Psychiatric Interview). An additional questionnaire captured socioeconomic and health-related data. The prevalence of current PTSD was 10.8%. Only 48.1% of people with current PTSD accessed health care services. Younger people aged 18 to 29 years were less likely to seek health care, OR = 0.36, 95% CI [0.15, 0.85]. People earning a salary or wage, OR = 2.91, 95% CI [1.26, 6.71]; and those with tuberculosis, OR = 11.63, 95% CI [1.42, 95.56], were more likely to seek health care. A range of barriers to seeking care were identified, the most striking being stigma and a lack of knowledge regarding the nature and treatment of mental illness. People with current PTSD may seek help for other health concerns and brief screening means those affected may be readily identified. Resumen TEPT y Barreras de Atencion Una gama de barreras a la busqueda de atencion de salud mental en los paises con ingresos bajos y medios ha sido investigada. Sin embargo, poco se sabe de las barreras a la atencion y busqueda de ayuda entre las personas con trastorno por estres post traumatico (TEPT) en paises con ingresos bajos y medios. Este fue un estudio basado en una poblacion que incluyo a 977 personas de edades entre 18-40 anos de la Provincia Oriental del Cabo, Sudafrica. El TEPT actual fue evaluado usando un cuestionario diagnostico (Entrevista Psiquiatrica Internacional Mini). Un cuestionario adicional pesquiso datos socioeconomicos y asociados a la salud. La prevalencia del TEPT actual fue de un 10.8%. Solo el 48.1% de las personas que presentaron TEPT accedieron a los servicios de salud. Personas mas jovenes entre los 18-29 anos eran menos propensas a consultar en los servicios de salud (OR = 0.36; 95% CI = [0.15, 0.85]). Personas que reciben un salario o sueldo (OR = 2.91; 95% CI = [1.26, 6.71]) y aquellas con tuberculosis (OR = 11.63; 95% CI = [1.42, 95.56]) fueron mas propensas a consultar en los servicios de salud. Se identificaron una serie de barreras a la busqueda de atencion, la mas llamativa fue el estigma y la falta de conocimiento sobre la naturaleza y el tratamiento de las enfermedades mentales. Las personas con TEPT actual pueden pedir ayuda por otras preocupaciones de salud y el tamizaje breve implica que aquellas afectadas pueden ser facilmente identificadas. Traditional and Simplified Chinese Abstracts by AsianSTSS ?? : ????????????????????? ??: ?????????????????????????????,?????????????????(PTSD) ????????????????????,?????????????18?40??977????????(????????????)???????PTSD,???????????????????????PTSD?????10.8%???48.1%???PTSD???????????????????18?29????????????(OR = 0.36; 95% CI = [0.15, 0.85])?????(OR = 2.91; 95% CI = [1.26, 6.71])??????(OR = 11.63; 95% CI = [1.42, 95.56])???????????????????????,???????????????????????????PTSD?????????????????,???????????????? ?? : ????????????????????? ??: ?????????????????????????????,?????????????????(PTSD) ????????????????????,?????????????18?40??977????????(????????????)???????PTSD,?????????????????????PTSD?????10.8%???48.1%???PTSD???????????????????18?29????????????(OR = 0.36; 95% CI = [0.15, 0.85])?????(OR = 2.91; 95% CI = [1.26, 6.71])??????(OR = 11.63; 95% CI = [1.42, 95.56])???????????????????????,???????????????????????????PTSD?????????????????,????????????????