Kilbourne Amy M, McCarthy John F, Post Edward P, Welsh Deborah, Blow Frederic C
VA National Serious Mental Illness Treatment Research & Evaluation Center, 2215 Fuller Road, 48105, Ann Arbor, MI, USA.
Soc Psychiatry Psychiatr Epidemiol. 2007 Aug;42(8):639-46. doi: 10.1007/s00127-007-0212-1. Epub 2007 May 22.
We determined whether patients with serious mental illness were more likely to report low social support than those without serious mental illness.
We conducted a national, cross-sectional study of VA patients in Fiscal Year 1999 who were diagnosed with a serious mental illness, as well as a random sample of VA patients without a diagnosis of serious mental illness (N = 8,547) from the National Psychosis Registry who also completed the VA's Large Health Survey of Veteran Enrollees (LHSV) 9-item questionnaire on social support. Using generalized estimating equations; we assessed patient's likelihood of reporting low social support, while controlling for patient socio-economic and clinical factors.
In multivariable models adjusting for patient factors, patients with serious mental illness were more likely to report low instrumental support, e.g., having no one to help with chores (OR = 1.41, p < 0.001) and low emotional support, e.g., having no one to relax with (OR = 2.05, p < 0.001).
Patients diagnosed with serious mental illness reported low social support across different dimensions. Recovery-oriented services for persons with serious mental illness should focus on improving and sustaining emotional and instrumental supports for this vulnerable population.
我们确定患有严重精神疾病的患者是否比没有严重精神疾病的患者更有可能报告社会支持水平低。
我们对1999财年被诊断患有严重精神疾病的退伍军人事务部（VA）患者进行了一项全国性横断面研究，以及从国家精神病登记处随机抽取的未被诊断患有严重精神疾病的VA患者样本（N = 8547），这些患者也完成了VA对退伍军人参保者的大型健康调查（LHSV）中关于社会支持的9项问卷。使用广义估计方程，我们评估了患者报告社会支持水平低的可能性，同时控制患者的社会经济和临床因素。
在调整患者因素的多变量模型中，患有严重精神疾病的患者更有可能报告低工具性支持，例如，没有人帮忙做家务（比值比[OR]=1.41，p<0.001），以及低情感支持，例如，没有人可以一起放松（OR = 2.05，p<0.001）。
被诊断患有严重精神疾病的患者在不同维度上报告社会支持水平低。针对患有严重精神疾病患者的以康复为导向的服务应侧重于改善和维持对这一弱势群体的情感和工具性支持。
