Hu Hsou Mei, Kline Anna, Huang Frederick Y, Ziedonis Douglas M
Institute for Health, Health Care Policy, and Aging Research at Rutgers, The State University of New Jersey, New Brunswick, USA.
Am J Public Health. 2006 Oct;96(10):1785-93. doi: 10.2105/AJPH.2005.072736.
We assessed the detection of mental illness in an adult population of substance abuse patients and the rate of referral for mental health treatment.
We obtained combined administrative records from 1994 to 1997 provided by the New Jersey substance abuse and mental health systems and estimated detection and referral rates of patients with co-occurring disorders (n = 47,379). Mental illness was considered detected if a diagnosis was in the record and considered undetected if a diagnosis was not in the record but the patient was seen in both treatment systems within the same 12-month period. Predictors of detection and referral were identified.
The detection rate of co-occurring mental illness was 21.9% (n=10364); 57.9% (n=6001) of these individuals were referred for mental health treatment. Methadone maintenance clinics had the lowest detection rate but the highest referral rate. Male, Hispanic, and African American patients, as well as those who used heroin or were in the criminal justice system, had a higher risk of mental illness not being detected. Once detected, African American patients, heroin users, and patients in the criminal justice system were less likely to be referred for treatment.
There is a need to improve the detection of mental illness among substance abuse patients and to provide integrated treatment.
我们评估了成年药物滥用患者群体中精神疾病的检出情况以及心理健康治疗的转诊率。
我们获取了新泽西州药物滥用和心理健康系统提供的1994年至1997年的综合管理记录，并估计了共病患者（n = 47379）的检出率和转诊率。如果记录中有诊断，则认为精神疾病被检出；如果记录中没有诊断，但患者在同一12个月内在两个治疗系统中都接受过诊治，则认为精神疾病未被检出。确定了检出和转诊的预测因素。
共病精神疾病的检出率为21.9%（n = 10364）；其中57.9%（n = 6001）的个体被转诊接受心理健康治疗。美沙酮维持治疗诊所的检出率最低，但转诊率最高。男性、西班牙裔和非裔美国患者，以及使用海洛因或处于刑事司法系统中的患者，精神疾病未被检出的风险更高。一旦被检出，非裔美国患者、海洛因使用者和刑事司法系统中的患者被转诊接受治疗的可能性较小。
有必要提高药物滥用患者中精神疾病的检出率并提供综合治疗。
