Patients withhold issues of depression, suicidality, abuse due to embarrassment, fear of being judged
FRIDAY, Aug. 16, 2019 (HealthDay News) — Up to 47.5 percent of patients withhold potentially life-threatening issues from their physicians, including depression, suicidal feelings, domestic violence, and sexual assault, according to a study published online Aug. 14 in JAMA Network Open.
Andrea Gurmankin Levy, Ph.D., of Middlesex Community College in Middletown, Connecticut, and colleagues studied responses from a total of 4,510 respondents to two nationwide surveys. One survey was via Amazon Mechanical Turk (MTurk), a crowdsourcing website (1,210 participants), and one was via Survey Sampling International (SSI; 2,499 participants).
The authors found that among respondents who had experienced at least one of four threats (depression, suicidality, abuse, and sexual assault), 47.5 percent of respondents to the MTurk survey and 40.0 percent of respondents to the SSI survey withheld information from their physicians. Respondents cited embarrassment (MTurk, 72.7 percent; SSI, 70.9 percent); not wanting to be judged or lectured (MTurk, 66.4 percent; SSI, 53.4 percent); and concern about follow-up requirements, such as taking medication or seeing a therapist (MTurk, 62.4 percent; SSI, 51.1 percent). Respondents who were younger (MTurk: odds ratio [OR], 0.99 [95 percent confidence interval (CI), 0.98 to 1.00]; SSI: OR, 0.98 [95 percent CI, 0.97 to 1.00]) and female (MTurk: OR, 1.66 [95 percent CI, 1.30 to 2.11]; SSI: OR, 1.33 [95 percent CI, 1.07 to 1.67]) had higher rates of nondisclosure. Poorer self-reported health was also linked to nondisclosure in the SSI group (OR, 0.85 [95 percent CI, 0.74 to 0.96]).
“These results highlight the continued need to develop effective interventions that improve the trust and communication between patients and their clinicians, particularly for sensitive, potentially life-threatening topics,” the authors write.
One author reported financial ties to pharmaceutical companies and Blue Cross Blue Shield of Michigan.
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