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1. E-Mental Health Care Among Young Adults and Help-Seeking Behaviors: A Transversal Study in a Community Sample

Author

Younes, Nadia, Chollet, Aude, Menard, Estelle, and Melchior, Maria

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract

BackgroundThe Internet is widely used by young people and could serve to improve insufficient access to mental health care. Previous information on this topic comes from selected samples (students or self-selected individuals) and is incomplete. ObjectiveIn a community sample of young adults, we aimed to describe frequency of e-mental health care study-associated factors and to determine if e-mental health care was associated with the use of conventional services for mental health care. MethodsUsing data from the 2011 wave of the TEMPO cohort study of French young adults (N=1214, aged 18-37 years), we examined e-mental health care and associated factors following Andersen’s behavioral model: predisposing factors (age, sex, educational attainment, professional activity, living with a partner, children, childhood negative events, chronic somatic disease, parental history of depression), enabling factors (social support, financial difficulties, parents’ income), and needs-related factors (lifetime major depression or anxiety disorders, suicidal ideation, ADHD, cannabis use). We compared traditional service use (seeking help from a general practitioner, a psychiatrist, a psychologist; antidepressant or anxiolytics/hypnotics use) between participants who used e-mental health care versus those who did not. ResultsOverall, 8.65% (105/1214) of participants reported seeking e-mental health care in case of psychological difficulties in the preceding 12 months and 15.7% (104/664) reported psychological difficulties. Controlling for all covariates, the likelihood of e-mental health care was positively associated with 2 needs-related factors, lifetime major depression or anxiety disorder (OR 2.36, 95% CI 1.36-4.09) and lifetime suicidal ideation (OR 1.91, 95% CI 1.40-2.60), and negatively associated with a predisposing factor: childhood life events (OR 0.60, 95% CI 0.38-0.93). E-mental health care did not hinder traditional care, but was associated with face-to-face psychotherapy (66.2%, 51/77 vs 52.4%, 186/355, P=.03). ConclusionsE-mental health care represents an important form of help-seeking behavior for young adults. Professionals and policy makers should take note of this and aim to improve the quality of online information on mental health care and to use this fact in clinical care.

Published
2015
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4. Tobacco and alcohol use in pregnancy in France: The role of migrant status: The nationally representative ELFE study

Author

Melchior, Maria, Chollet, Aude, Glangeaud-Freudenthal, Nine, Saurel-Cubizolles, Marie-Josèphe, Dufourg, Marie-Noëlle, Van Der Waerden, Judith, Sutter-Dallay, Anne-Laure, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Ined Inserm joint unit Elfe, Université de Bordeaux (UB), Pharmacoepidemiologie et évaluation de l'impact des produits de santé sur les populations, Université Bordeaux Segalen - Bordeaux 2-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), University Department of Adult Psychiatry, Centre Hospitalier Charles PERRENS, Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC) - Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), Institut National de la Recherche Agronomique (INRA) - Université Paris Diderot - Paris 7 (UPD7) - Université Paris Descartes - Paris 5 (UPD5) - Université Paris 13 - Institut National de la Santé et de la Recherche Médicale (INSERM), Pharmacoepidemiologie et Evaluation de l'Impact des Produits de Sante Sur les Populations, Université Bordeaux Segalen - Bordeaux 2 - Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Bordeaux Segalen - Bordeaux 2-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), and Administateur, HAL Sorbonne Université

Subjects
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Pregnancy, Tobacco, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Socioeconomic factors, Alcohol, Migrants
Abstract

International audience; Introduction : Tobacco and alcohol use in pregnancy are modifiable yet frequent risk factors of poor perinatal outcomes. We examined whether characteristics associated with substance use in pregnancy vary between native and migrant women, who often differ in terms of socio-demographic characteristics.Methods : Data come from a nationally representative sample of children born in France in 2011 (ELFE study, n = 18,014). Maternal substance use in pregnancy (tobacco: ≥ 1 cigarette/day, alcohol: ≥ 1 time, binge drinking: ≥ 3 units of alcohol on one occasion) was assessed using survey methodology by a) trained interviewers and b) self-reports. Migration status was determined based on country of birth (native-born vs. migrant). The sample included 2330 migrant women, predominantly from North Africa (35.4% — primarily Algeria and Morocco), Sub-Saharan Africa (27.3% — primarily Senegal, Ivory Coast, the Congo and Cameroun), Europe (20.2% — primarily Portugal and Germany) and Asia (10.2% — primarily Turkey). Characteristics potentially associated with substance use included socio-demographics (maternal age, number of children, relationship status, educational attainment, employment status), health (psychological difficulties, incomplete prenatal care) and partner's characteristics (migration status, employment).Results : Compared to the native-born, migrant women had lower levels of tobacco smoking (8.8 vs. 21.9%) and alcohol use (23.4 vs. 40.7%), but not binge drinking (2.9 vs. 3.3%). Unfavorable socioeconomic circumstances were associated with tobacco smoking in native-born women only. Single parenthood was associated with alcohol use only in migrant women. In migrant women, co-occurring use of another substance and psychological difficulties were more strongly associated with use of tobacco, alcohol or binge drinking than in native-born women.Conclusions : Migrant women have less favorable socioeconomic characteristics than native women but are generally less likely to use tobacco and alcohol in pregnancy. However those who experience single-parenthood need special attention, as they are disproportionately likely to use psychoactive substances which put them and their children at risk of poor health outcomes.

Published
2015

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