title: Relationships between depression, pain and sleep quality with doctor visits among community-based adults in north-west China.
abstract: OBJECTIVE
  Previous studies have suggested that the high rates of unmet need for mental health services in China among depressed people are related to a cultural tendency to deny mental and emotional symptoms and instead express them somatically. Such somatization may lead a sufferer to a consultation with a healthcare professional but rarely leads to appropriate mental health treatment. This study aimed to elucidate the relationships of depression, sleep quality and perceived physical pain with doctor visits among community-based adults in China, and thus to help guide the development of clinical practices aimed at reducing unmet mental health service need.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  In total, 7602 north-west Chinese adults aged >40 years were included in the survey. The Center for Epidemiologic Studies Depression Scale-Chinese Edition was used to assess depressive symptoms. Subjective sleep quality was evaluated using the Pittsburgh Sleep Quality Index. The Brief Pain Inventory-Chinese Version was used to measure pain severity and pain interference.
  
  
  RESULTS
  In this study, 16.2% of people reported physical pain, and 20.0% of those who reported poor sleep quality had seen a doctor in the past month. Only 14.4% of those with depression had seen a doctor. The results of the logistic regression analyses indicated that subjects with pain were significantly more likely to have seen a doctor than subjects without pain (odds ratio [OR] 1.61; 95% confidence interval [CI] 1.32-1.97). Poor sleep quality was significantly associated with doctor visits (OR 1.76, 95% CI 1.40-2.21). Depression was not associated with doctor visits after adjusting for pain, sleep quality and potentially confounding factors.
  
  
  CONCLUSIONS
  When attempting to screen for depression and risk of depression in middle-aged and older adults in China, mental health professionals should focus on perceived physical pain and poor sleep quality.
authors.affiliation: School of Sociology, Huazhong University of Science and Technology, Wuhan, PR China. Electronic address: jing624218@163.com.
authors.forename: J
authors.initials: J
authors.lastname: Guo
authors.affiliation: School of Sociology, Huazhong University of Science and Technology, Wuhan, PR China.
authors.forename: C
authors.initials: C
authors.lastname: Liu
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, PR China.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, PR China.
authors.forename: Z
authors.initials: Z
authors.lastname: Qu
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, PR China.
authors.forename: W
authors.initials: W
authors.lastname: Zhang
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, PR China.
authors.forename: X
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003153:Community Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000523:psychology*
keywords: Depression; Doctor visits; Pain; Sleep quality