Social Class Differences in Patients' Self-Perceived Treatment Needs

Abstract

A comparison of the factor structure of patients' self-perceived treatment needs between psychiatric patients of low and high social class showed strong similarity on several factors. Reports of need for help with marital and economic-vocational difficulties and psychotic symptoms were identical. The phenomenological experience of anxiety and depression was indistinguishable, but patients of high social class expected relief in improved interpersonal relations while patients of lower class sought relief in escape. Guilt appeared to be without specific referent in the lower-class group but associated with behavioral acts among higher class Ss. Groups differed in their reported feelings of inadequacy. Patients of higher class failed to attribute psychological difficulties to physical causes. The influence of patients' self-definition of disturbance upon choice of treatment is discussed.