Advertisement

Does neuroticism explain variations in care service use for mental health problems in the general population?

Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS)
  • Margreet ten Have
  • Albertine Oldehinkel
  • Wilma Vollebergh
  • Johan Ormel
ORIGINAL PAPER

Abstract

Background

Little is known about the role of personality characteristics in service utilisation for mental health problems. We investigate whether neuroticism: 1) predicts the use of primary and specialised care services for mental health problems, independently of whether a person has an emotional disorder; and 2) modifies any association between emotional disorder and service use.

Methods

Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) a prospective cohort study in the general population aged 18–64. Neuroticism was recorded at baseline, and emotional disorder and service use at 12-month follow-up, in a representative sample (N=7076), using the Composite International Diagnostic Interview.

Results

People with high neuroticism were more likely to receive care in the specialised mental health sector, and after entry to care they made more visits to the services, whether or not they had an emotional disorder. If they had an emotional disorder, their likelihood of receiving specialised mental health care showed an additional increase. Neuroticism also predicted the use of primary care for mental health problems, but greater numbers of visits were made only by clients with both high neuroticism and an emotional disorder.

Conclusions

It would be useful to incorporate personality characteristics into models to understand variations in service utilisation for mental health problems. The findings suggest that professionals would be wise to focus not just on their clients’ emotional problems and disorders, but also on strengthening their problem-solving abilities through approaches like cognitive behavioural therapy.

Key words

cohort studies mental health services personality mental disorders mental health 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Katz SJ, Kessler RC, Frank RG, Leaf P, Lin E, Edlund M (1997) The Use of Outpatient Mental Health Services in the United States and Ontario: The Impact of Mental Morbidity and Perceived Need for Care. Am J Pub Health 87:1136–1143PubMedGoogle Scholar
  2. 2.
    Alegría M, Bijl RV, Lin E, Walters EE, Kessler RC (2000) Income differences in persons seeking outpatient treatment for mental disorders: a comparison of the United States with Ontario and The Netherlands. Arch Gen Psychiatry 57:383–391PubMedGoogle Scholar
  3. 3.
    Bijl RV, Ravelli A (2000) Psychiatric morbidity, service use and need for care in the general population: results of the Netherlands Mental Health Survey and Incidence Study. Am J Pub Health 90:602–607PubMedGoogle Scholar
  4. 4.
    ten Have M, Vollebergh W, Bijl R, Ormel J (2002) Combined effect of mental disorder and low social support on care service use for mental health problems in the Dutch general population. Psychol Med 32:311–323PubMedGoogle Scholar
  5. 5.
    ten Have M, Oldehinkel A, Vollebergh W, Ormel J (2003) Does educational background explain inequalities in care service use for mental health problems in the Dutch general population? Acta Psychiatr Scand 107:178–187PubMedGoogle Scholar
  6. 6.
    Ormel J, Wohlfarth T (1991) How neuroticism, long-term difficulties, and life situation change influence psychological distress: A longitudinal model. J Pers Soc Psychol 60:744–755PubMedGoogle Scholar
  7. 7.
    Krueger RF, Caspi A, Moffitt TE, Silva PA (1996) Personality traits are differentially linked to mental disorders: a multitrait-multidiagnosis study of an adolescent birth cohort. J Abnorm Psychol 3:299–312Google Scholar
  8. 8.
    Jorm AF, Christensen H, Henderson AS, Jacomb PA, Korten AE, Rodgers B (2000) Predicting anxiety and depression from personality: Is there a synergistic effect of neuroticism and extraversion? J Abnorm Psychol 109:145–149PubMedGoogle Scholar
  9. 9.
    Kempen GIJM, van Heuvelen MJG, van Sonderen E, van den Brink RHS, Kooijman AC, Ormel J (1999) The relationship of functional limitations to disability and the moderating effects of psychological attributes in community-dwelling older persons. Soc Sci Med 48:1161–1172PubMedGoogle Scholar
  10. 10.
    van Hemert AM, Bakker CH, Vandenbroucke JP, Valkenburg HA (1993) Psychological distress as a longterm predictor of medical utilisation. Int J Psychiatry Med 23:295–305PubMedGoogle Scholar
  11. 11.
    Parslow RA, Jorm AF (2000) Who uses mental health services in Australia? An analysis of data from the National Survey of MentalHealth and Wellbeing. Aust N Z J Psychiatry 34:997–1008PubMedGoogle Scholar
  12. 12.
    Goodwin RD, Hoven CW, Lyons JS, Stein MB (2002) Mental health service utilization in the United States. The role of personality factors. Soc Psychiatry Psychiatr Epidemiol 37:561–566PubMedGoogle Scholar
  13. 13.
    Issakidis C, Andrews G (2002) Service utilisation for anxiety in an Australian community sample. Soc Psychiatry Psychiatr Epidemiol 37:153–163PubMedGoogle Scholar
  14. 14.
    Bijl RV, van Zessen G, Ravelli A, de Rijk C, Langendoen Y (1998) The Netherlands Mental Health Survey and Incidence Study (NEMESIS): objectives and design. Soc Psychiatry Psychiatr Epidemiol 33:581–586PubMedGoogle Scholar
  15. 15.
    de Graaf R, Bijl RV, Smit F, Ravelli A, Vollebergh WAM (2000) Psychiatric and sociodemographic predictors of attrition in a longitudinal study: the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Am J Epidemiol 152:1039–1047PubMedGoogle Scholar
  16. 16.
    Smeets RMW, Dingemans PMAJ (1993) Composite International Diagnostic Interview (CIDI), Version 1.1. WHO, Amsterdam/GenevaGoogle Scholar
  17. 17.
    Robins LN, Wing J, Wittchen H-U, Helzer JE, Babor TF, Burke J, Farmer A, Jablenski A, Pickens R, Regier DA (1988) The Composite International Diagnostic Interview. An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 45:1069–1077PubMedGoogle Scholar
  18. 18.
    World Health Organization (1990) Composite International Diagnostic Interview (CIDI), Version 1.0. WHO, GenevaGoogle Scholar
  19. 19.
    Wacker HR, Battegay R, Mullejans R, Schlosser C (1990) Using the CIDI-C in the general population. Psychiatry: a world perspective (ed. Stefanis CN, Rabavilas AD, Soldatos CR). Elsevier Science Publishers, Amsterdam, pp 138–143Google Scholar
  20. 20.
    Wittchen H-U, Robins LN, Cottler LB, Sartorius N, Burke JD, Regier DA (1991) Cross-cultural feasibility, reliability and sources of variance in the Composite International Diagnostic Interview (CIDI). The Multicentre WHO/ADAMHA Field Trials. Br J Psychiatry 159:645–653PubMedGoogle Scholar
  21. 21.
    Farmer AE, Jenkins PL, Katz R, Ryder L (1991) Comparison of CATEGO-derived ICD-8 and DSM-III classifications using the Composite International Diagnostic Interview in severely ill subjects. Br J Psychiatry 158:177–182PubMedGoogle Scholar
  22. 22.
    Wittchen H-U (1994) Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res 28:57–84PubMedGoogle Scholar
  23. 23.
    Ormel J (1983) Neuroticism and well-being inventories: measuring traits or states? Psychol Med 13:165–176PubMedGoogle Scholar
  24. 24.
    Ormel J, Oldehinkel AJ, Brilman EI (2001) The interplay and etiological continuity of neuroticism, difficulties, and life events in the etiology of major and subsyndromal, first and recurrent depressive episodes in later life. Am J Psychiatry 158:885–891PubMedGoogle Scholar
  25. 25.
    Vollebergh WAM, Iedema J, Bijl RV, de Graaf R, Smit F, Ormel J (2001) The structure and stability of common mental disorders: the Nemesis-study. Arch Gen Psychiatry 58:597–603PubMedGoogle Scholar
  26. 26.
    Kessler RC, Zhao S, Katz SJ, Kouzis AC, Frank RG, Edlund M, Leaf P (1999) Past-year use of outpatient services for psychiatric problems in the National Comorbidity Survey. Am J Psychiatry 156:115–123PubMedGoogle Scholar
  27. 27.
    Dohr KB, Bush AJ, Bernstein IH (1989) Cognitive biases and depression. J Abnorm Psychol 98:263–267PubMedGoogle Scholar
  28. 28.
    Aday A, Awe WC (1997) Health services utilization models. In: Gochman DS (ed) Handbook of Health Behavior Research I: Personal and Social Determinants. Plenum Press, New York, pp 153–172Google Scholar
  29. 29.
    Egger JIM, de Mey HRA, Derksen JJL, van der Staak CPF (2003) Cross-cultural replication of the five-factor model and comparison of the NEO-PI-R and MMPI-2 PSY-5 scales in a Dutch psychiatric sample. Psychol Assess 15:81–88PubMedGoogle Scholar

Copyright information

© Steinkopff-Verlag 2005

Authors and Affiliations

  • Margreet ten Have
    • 1
  • Albertine Oldehinkel
    • 2
  • Wilma Vollebergh
    • 1
  • Johan Ormel
    • 2
  1. 1.Netherlands Institute of Mental Health and AddictionAS UtrechtThe Netherlands
  2. 2.Department of PsychiatryUniversity of GroningenGroningenThe Netherlands

Personalised recommendations