title: Reasons and determinants for not receiving treatment for common mental disorders.
abstract: OBJECTIVE
  This study focused on patients in the general population whose anxiety or depressive disorder is untreated. It explored reasons for not receiving treatment and compared four groups of patients-three that did not receive treatment for different reasons (no problem perceived, no perceived need for care, and unmet need for care) and one that received treatment-regarding their predisposing, enabling, and need factors.
  
  
  METHODS
  Cross-sectional data were used for 743 primary care patients with current anxiety or depressive disorder from the Netherlands Study of Depression and Anxiety (NESDA). Diagnoses were confirmed with the Composite International Diagnostic Interview. Patients' perception of the presence of a mental problem, perceived need for care, service utilization, and reasons for not receiving treatment were assessed with the Perceived Need for Care Questionnaire.
  
  
  RESULTS
  Forty-three percent of the respondents with a six-month anxiety or depression diagnosis did not receive treatment. Twenty-one percent of all respondents with depression or anxiety expressed a need for care but did not receive any. Preferring to manage the problem themselves was the most common reason for respondents to avoid seeking treatment. There were no significant differences in clinical need factors between treated patients and untreated patients with a perceived need for care. Compared with patients in the other two untreated groups, untreated patients with a perceived need for care were more hindered in regard to symptom severity, functional disability, and psychosocial functioning.
  
  
  CONCLUSIONS
  General practitioners should pay considerable attention to patients whose need for care is unmet. Furthermore, findings support the implementation of patient empowerment in mental health care in order to contribute to easily accessible and patient-centered care.
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), 3500 BN Utrecht, the Netherlands. p.verhaak@nivel.nl
authors.forename: Ilse
authors.initials: I
authors.lastname: van Beljouw
authors.forename: Peter
authors.initials: P
authors.lastname: Verhaak
authors.forename: Marijn
authors.initials: M
authors.lastname: Prins
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
authors.forename: Brenda
authors.initials: B
authors.lastname: Penninx
authors.forename: Jozien
authors.initials: J
authors.lastname: Bensing
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D009426:Netherlands; D011795:Surveys and Questionnaires; D055815:Young Adult