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).
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.
Netherlands Institute of Mental Health and Addiction, 725, 3500, AS Utrecht, The Netherlands. mhave@trimbos.nl
Margreet
M
ten Have
Albertine
A
Oldehinkel
Wilma
W
Vollebergh
Johan
J
Ormel
D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D016013:Likelihood Functions; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009426:Netherlands; D009497:Neurotic Disorders / Q000453:epidemiology*; D010552:Personality Assessment; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014600:Utilization Review / Q000706:statistics & numerical data