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. 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

Sarah B Andrea  1 , Sarah A R Siegel  2 , Alan R Teo  3
Affiliations

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

Sarah B Andrea et al. Gen Hosp Psychiatry. 2016 Mar-Apr.

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.

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Conflict of interest statement

Disclosures

The authors declare that they have no conflict of interest. This material is the result of work supported with resources and the use of facilities at the VA Portland Health Care System and Oregon Health & Science University. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. All authors report no competing interests.

Figures

Fig. 1
Fig. 1
(a–d) Utilization of health services among those individuals with moderately severe to severe depression (n=185) by gender.
See this image and copyright information in PMC

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