安大略省首次出现精神病的种族多样性和治疗途径。

Ethnic diversity and pathways to care for a first episode of psychosis in Ontario.

机构信息

McMaster University, Hamilton, Ontario, Canada.

出版信息

Schizophr Bull. 2010 Jul;36(4):688-701. doi: 10.1093/schbul/sbn137. Epub 2008 Nov 5.

Abstract

OBJECTIVE

To examine ethnic variations in the pathways to care for persons accessing early intervention (EI) services in Ontario.

METHOD

The pathways to care and the duration of untreated psychosis were assessed for first-episode psychosis patients who entered specialized EI services in Ontario. The sample was assigned to the following ethnic classifications: the White (Caucasian), Black (African descent), and Asian (ancestry from the continent) groups, plus all the "other ethnicities" group.

RESULTS

There were 200 participants: 78% were male; 61% from the White, 15% Black, 13% Asian, and 11% were from the other ethnicities group. At the first point of contact, more participants used nonmedical contacts (12%), such as clergy and naturopathic healers, than psychologists (8%) or psychiatrists (7%). There were no ethnic differences for duration of untreated psychosis (median 22 weeks) or for initiation of help seeking by family/friends (53%), police (15%), or self (33%). After adjusting for relevant clinical and demographic factors, the Asian and other ethnicities groups were 4 and 3 times (respectively) more likely than the White or Black groups (P = .017) to use emergency room services as the first point of contact in the pathways to care. Participants from the Asian group experienced less involuntary hospitalizations (P = .023) than all the other groups. Yet overall, there were many more similarities than significant differences in the pathways to care.

CONCLUSION

EI services should monitor the pathways to care for young people of diverse ethnic backgrounds to address any disparities in accessing care.

摘要

目的

探讨安大略省接受早期干预(EI)服务的个体在获得医疗服务途径方面的种族差异。

方法

对进入安大略省专门 EI 服务的首发精神病患者的获得医疗服务途径和未治疗精神病的持续时间进行评估。将样本分为以下种族分类:白种人(高加索人)、黑种人(非洲裔)和亚洲人(来自大陆的血统),以及所有“其他种族”群体。

结果

共有 200 名参与者:78%为男性;61%为白种人,15%为黑种人,13%为亚洲人,11%为其他种族群体。在首次接触时,更多的参与者使用非医疗接触(12%),如神职人员和顺势疗法治愈者,而不是心理学家(8%)或精神科医生(7%)。未治疗精神病的持续时间(中位数 22 周)或家庭/朋友(53%)、警察(15%)或自身(33%)开始寻求帮助方面,各种族之间无差异。在调整了相关临床和人口统计学因素后,亚洲组和其他种族组比白种人或黑种人组(P =.017)更有可能将急诊室服务作为获得医疗服务途径的第一站,分别为 4 倍和 3 倍。来自亚洲组的参与者经历的非自愿住院治疗较少(P =.023),比所有其他组都少。然而,总体而言,在获得医疗服务途径方面,相似之处远多于显著差异。

结论

EI 服务应监测不同种族背景的年轻人的获得医疗服务途径,以解决在获得医疗服务方面的任何差异。

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