title: Determinants of attitudes towards professional mental health care, informal help and self-reliance in people with subclinical depression.
abstract: BACKGROUND
  Although little is known about which people with subclinical depression should receive care to prevent the onset of depression, it is clear that remediating symptoms of depression is important. However, depending on the beliefs people hold about help, some people will seek professional help, while others seek informal help or solve problems on their own.
  
  
  OBJECTIVE
  This study examined associations between attitudes about help and socio-demographic variables, mastery, severity of depressive symptoms, accessibility to care, and health care utilization at baseline and 4-year follow-up.
  
  
  METHODS
  Data were derived from a large cohort study, the Netherlands Study of Depression and Anxiety (NESDA). A total of 235 respondents with subclinical depression completed questionnaires at baseline and follow-up. Attitude was assessed using a short version of the 'Trust in mental health care' questionnaire.
  
  
  RESULTS
  Positive attitude towards professional care was associated with being male, younger age, higher mastery and easy accessibility to care. Positive attitude towards informal help was associated with higher mastery and unemployment. Older age, less accessibility to care and lower mastery were associated with positive attitude towards self-reliance. A change in care utilization was associated with positive attitudes towards professional care at follow-up.
  
  
  CONCLUSIONS
  People differ in the way they cope with symptoms which may influence their preferred care. Higher levels of mastery were positively associated with professional and informal care, but negatively associated with self-reliance. Both age and mastery showed relatively large effect sizes.
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands k.van.zoonen@vu.nl.
authors.forename: Kim
authors.initials: K
authors.lastname: van Zoonen
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Annet
authors.initials: A
authors.lastname: Kleiboer
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
authors.affiliation: EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Smit
authors.affiliation: EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Brenda
authors.initials: B
authors.lastname: Penninx
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Verhaak
authors.affiliation: EMGO institute for Health Care and Research, VU University Medical Centre, Amsterdam, The Netherlands Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Aartjan
authors.initials: A
authors.lastname: Beekman
mesh_terms: D000328:Adult; D003863:Depression / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000523:psychology; D012648:Self Care
keywords: Attitude towards care; informal care; mental health care; subclinical depression