Elhai Jon D, Don Richardson J, Pedlar David J
Disaster Mental Health Institute, The University of South Dakota, Vermillion, SD, USA.
J Anxiety Disord. 2007;21(4):580-9. doi: 10.1016/j.janxdis.2006.07.001. Epub 2006 Sep 11.
We investigated general medical and psychological treatment use predictors among peacekeeping veterans with health problems, aiming to find those characteristics most associated with treatment use intensity (i.e., visit counts). One thousand one hundred and thirty-two male Canadian Forces peacekeeping veterans registered with Veterans Affairs for health problems were randomly recruited for a prospective national survey. Regression analyses for treatment use intensity controlled for age, total time deployed and health problems (covariates), and examined the incremental contribution of depression and post-traumatic stress disorder (PTSD) severity on health service use intensity. Results revealed that after controlling for covariates, the depression and PTSD model was associated with increased medical and psychological treatment use intensity. Medical use intensity was significantly predicted by married status, greater depression and health problems; psychological treatment use intensity was predicted by younger age, greater PTSD severity and health problems. This study highlights the importance of an integrated primary care-mental health service delivery model for veterans.
我们调查了有健康问题的维和退伍军人使用一般医疗和心理治疗的预测因素，旨在找出与治疗使用强度（即就诊次数）最相关的那些特征。1132名因健康问题在退伍军人事务部登记的加拿大军队男性维和退伍军人被随机招募参加一项全国性前瞻性调查。对治疗使用强度进行回归分析时控制了年龄、总部署时间和健康问题（协变量），并检验了抑郁和创伤后应激障碍（PTSD）严重程度对医疗服务使用强度的增量贡献。结果显示，在控制协变量后，抑郁和PTSD模型与医疗和心理治疗使用强度增加相关。医疗使用强度由婚姻状况、更严重的抑郁和健康问题显著预测；心理治疗使用强度由年龄较小、更严重的PTSD严重程度和健康问题预测。本研究强调了为退伍军人提供综合初级保健-心理健康服务模式的重要性。
