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社区诊所患者的精神疾病家族史及频繁的精神困扰

Family history of mental illness and frequent mental distress in community clinic patients.

作者信息

Rohrer James, Rohland Barbara, Denison Anne, Pierce J Rush, Rasmussen Norman H

机构信息

Department of Family Medicine, Mayo Clinic, Rochester, MN 55944, USA.

出版信息

J Eval Clin Pract. 2007 Jun;13(3):435-9. doi: 10.1111/j.1365-2753.2006.00737.x.

Abstract

OBJECTIVE

The objective of this study was to investigate the importance of family history of mental illness as a risk factor for self-reported frequent mental distress among patients who use community-based clinics.

DESIGN

A cross-sectional survey was distributed to a convenience sample in three community clinics serving largely low-income patients. Forms were completed by 793 clinic patients. Multiple logistic regression analysis was to control for the effects of demographic variables.

RESULTS

In this sample of primary care patients, 27.1% had frequent mental distress. Having a family history of mental illness or substance abuse was found to be associated with frequent mental distress in this population [adjusted odds ratio (OR) = 2.24, P = 0.000]. Also associated with increased odds of frequent mental distress were avoiding medical care owing to cost (OR = 1.86, P = 0.003) and obesity (OR = 1.73, P = 0.006).

CONCLUSIONS

Having a family history of mental illness or substance abuse is independently associated with increased odds of frequent mental distress among primary care patients seen in community clinics. Three strategies are suggested for using this information to prevent frequent mental distress: health education via mass communication to the general population of primary care patients being followed in a clinic, health education to at-risk patients, and targeted screening of clinic patients who have the risk factor.

摘要

目的

本研究的目的是调查精神疾病家族史作为在社区诊所就诊患者自我报告频繁精神困扰的危险因素的重要性。

设计

对主要服务低收入患者的三家社区诊所的便利样本进行横断面调查。793名诊所患者完成了表格。采用多元逻辑回归分析来控制人口统计学变量的影响。

结果

在这个初级保健患者样本中,27.1%有频繁的精神困扰。发现有精神疾病或药物滥用家族史与该人群频繁的精神困扰相关[调整后的优势比(OR)=2.24,P=0.000]。因费用而避免就医(OR=1.86,P=0.003)和肥胖(OR=1.73,P=0.006)也与频繁精神困扰的几率增加相关。

结论

有精神疾病或药物滥用家族史与社区诊所中初级保健患者频繁精神困扰几率增加独立相关。建议采用三种策略利用这些信息预防频繁的精神困扰:通过大众传播对诊所中随访的初级保健患者总体进行健康教育、对高危患者进行健康教育以及对有危险因素的诊所患者进行针对性筛查。

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