"Help-negation" preventing at-risk heart patients from consulting GP

25 October, 2013

Many people experiencing heart disease symptoms won't tell their doctor, even though they recognise the need for medical care for such symptoms, according to University of Wollongong behavioural scientist Dr Coralie Wilson.

"Heart disease is the leading cause of death in Australia so we really need to understand people's behaviour in regard to seeking treatment," Dr Wilson said, who presented the research to the Australian Psychological Society Annual Conference in Cairns recently.

Dr Wilson said the focus of prevention and intervention has been on education and then promoting "help-seeking"— encouraging people to recognise their symptoms and get appropriate medical attention.

Yet Dr Wilson's broader research program indicates that other factors affect people's behaviour and ability to recognise symptoms and seek help.

Two members of her team, Gamze Abramov and Erin Fraser, with the help of Dr Peter Caputi and Dr Rod McMahon surveyed over 600 people waiting to see their doctor about non-heart related matters.

The researchers asked patients about their levels of depression and anxiety symptoms, current symptoms of undiagnosed heart disease, and current intention to talk to their GP about their heart symptoms.

The team's research found that about 20 per cent of patients had undiagnosed moderate to severe symptoms of heart disease and those with the most significant symptoms were the least likely to talk to their GP.

"Our research showed that patients with symptoms of heart disease that had not yet been diagnosed by a doctor had reduced intention to tell their doctor about these symptoms, even though they also acknowledged that a person with such symptoms should see a doctor," Dr Wilson said.

She said this behaviour was known as "help-negation" and had been previously found among people with depression, anxiety and those with suicidal thoughts, but not associated with heart symptoms.

"This study indicates that help-negation is a major reason for why people aren't getting help," Dr Wilson said.

"As people become unwell it is common for them to withdraw and their ability to clearly recognise their symptoms and take action becomes diminished."

In the past it has been assumed that people didn't seek help for psychological reasons such as fear or denial but she said evidence is pointing to neurological reasons for help-negation that relate to changes in the brain which impact functioning, and limit people's ability to recognise their symptoms and take appropriate action.

"This information changes the way we think about engaging with people at risk of heart disease, as well as co-occurring mental health problems and increases our understanding of people's behaviour in relation to getting help," she said.