title: Use of the Behavioral Model of Health Care Use to identify correlates of use of treatment for panic attacks in the community.
abstract: BACKGROUND
  The aim of this study was to identify predisposing, enabling, and need factors associated with health service use for panic attacks among adults in the United States using the Behavioral Model of Health Care Use.
  
  
  METHODS
  Data were drawn from the National Comorbidity Survey (n = 8098), a community-based household sample representative of the United States adult (age 15-54) population. Stepwise logistic regression models were used to compute odds ratios (with 95 % confidence intervals) measuring the association between predisposing, enabling, and need factors and the self-reported health service use for treatment of panic attacks.
  
  
  RESULTS
  In addition to perceived (perception of poor mental health) and evaluated need (severity of panic attacks, psychiatric morbidity), predisposing (being older, married, more educated, white) factors were independently associated with use of treatment for panic attacks. Distinct correlates for use of primary care, specialized mental health treatment, and use of psychotropic medication were found. In addition to need factors, predisposing factors are independently associated with the use of services for panic attacks in the community.
  
  
  CONCLUSIONS
  These results suggest that factors other than severity of panic and degree of psychiatric morbidity may influence use of services for panic. Future studies that examine whether these factors reflect barriers to care for those in need of mental health treatment may help to inform programs aimed at targeting those with unmet need in the community.
authors.affiliation: Department of Epidemiology, Columbia University, Unit 43, 1051 Riverside Drive, New York, NY 10032, USA. rdg66@columbia.edu
authors.forename: Renee
authors.initials: R
authors.lastname: Goodwin
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Andersen
mesh_terms: D000293:Adolescent; D000328:Adult; D000379:Agoraphobia / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D001521:Behavior Therapy / Q000706:statistics & numerical data*; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006302:Health Services Research; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D014481:United States; D014600:Utilization Review