title: Subjective distress predicts treatment seeking for depression, bipolar, anxiety, panic, neurasthenia and insomnia severity spectra.
abstract: OBJECTIVE
  To examine correlates of mental health treatment seeking such as gender, diagnosis, impairment, distress and mastery.
  
  
  METHODS
  Longitudinal epidemiological data from the Zurich Study of common psychiatric syndromes, including unipolar and bipolar depression, panic, anxiety, neurasthenia and insomnia, were utilized. In longitudinal Generalized Estimating Equations, treatment seeking was regressed on measures of subjective distress and impairment, childhood family problems, mastery and number of comorbid diagnoses.
  
  
  RESULTS
  Approximately half of all treated participants across all six syndromes suffered from subthreshold disorders. Meeting full or subthreshold diagnostic criteria was associated with treatment seeking for insomnia. Being female was associated with treatment seeking for depression. The only variable highly and consistently associated with treatment seeking, across all syndromes, was subjective distress. Treated participants reported high levels of distress, work and social impairment in both diagnostic and subthreshold groups.
  
  
  CONCLUSIONS
  Subjective distress may be a better indicator of treatment seeking than symptom count.
authors.affiliation: Zurich University Psychiatric Hospital, Switzerland. jangst@bli.uzh.ch
authors.forename: J
authors.initials: J
authors.lastname: Angst
authors.forename: A
authors.initials: A
authors.lastname: Gamma
authors.forename: D
authors.initials: D
authors.lastname: Clarke
authors.forename: V
authors.initials: V
authors.lastname: Ajdacic-Gross
authors.forename: W
authors.initials: W
authors.lastname: Rössler
authors.forename: D
authors.initials: D
authors.lastname: Regier
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D001714:Bipolar Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D009440:Neurasthenia / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D016584:Panic Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult