Jones G N, Ames S C, Jeffries S K, Scarinci I C, Brantley P J
Center for Primary Care Research, EKL Hospital, Baton Rouge, LA 70805-2498, USA.
Int J Psychiatry Med. 2001;31(2):183-98. doi: 10.2190/2X44-CR14-YHJC-9EQ3.
Anxiety disorders appear to influence morbidity and medical utilization. However, little is known about the relationship between Generalized Anxiety Disorder, quality of life, and medical utilization, especially among low-income patients. The goals of this investigation were to 1) determine if low-income patients with GAD utilize medical services more than patients with other Axis I diagnoses, or no psychopathology, and 2) compare the health-related quality of life of these three groups.
Participants were randomly recruited from public primary care clinics and administered intake assessments of demographics, stress, and health-related self-report questionnaires. At the end of the first year a structured psychiatric interview was administered (N = 431). Over the second year, patients (n = 360) were administered a health-related quality of life measure every three months for four assessments. Medical charts were abstracted to collect information about chronic illnesses and visits to outpatient clinics and the emergency department during the two years.
Patients were predominantly middle-aged, low-income, uninsured African-American females. In this low-income sample, patients with GAD utilized the emergency department more and reported poorer quality of life than patients with other Axis I disorders and patients without any psychopathology.
Low-income patients with GAD utilize the emergency department more and report poorer quality of life than patients with other Axis I disorders and patients without any psychopathology. Programs to identify and treat patients with GAD may yield improvements in quality of life, as well as reduce emergency department utilization.
焦虑症似乎会影响发病率和医疗服务利用情况。然而，对于广泛性焦虑症、生活质量和医疗服务利用之间的关系，人们知之甚少，尤其是在低收入患者中。本研究的目的是：1）确定患有广泛性焦虑症的低收入患者是否比患有其他轴I诊断疾病的患者或无精神病理学症状的患者更多地利用医疗服务；2）比较这三组患者与健康相关的生活质量。
从公共初级保健诊所随机招募参与者，并对其进行人口统计学、压力和与健康相关的自我报告问卷的入院评估。在第一年结束时进行了结构化精神科访谈（N = 431）。在第二年期间，每三个月对患者（n = 360）进行一次与健康相关的生活质量测量，共进行四次评估。提取医疗记录以收集有关慢性病以及两年内门诊和急诊科就诊情况的信息。
患者主要是中年、低收入、未参保的非裔美国女性。在这个低收入样本中，患有广泛性焦虑症的患者比患有其他轴I疾病的患者和没有任何精神病理学症状的患者更多地使用急诊科，并且报告的生活质量较差。
患有广泛性焦虑症的低收入患者比患有其他轴I疾病的患者和没有任何精神病理学症状的患者更多地使用急诊科，并且报告的生活质量较差。识别和治疗广泛性焦虑症患者的项目可能会改善生活质量，并减少急诊科的使用。
