Okoro Catherine A, Strine Tara W, Balluz Lina S, Crews John E, Dhingra Satvinder, Berry Joyce T, Mokdad Ali H
National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, USA.
Int J Public Health. 2009 Jun;54 Suppl 1:52-60. doi: 10.1007/s00038-009-0077-z.
Our objective was to examine the extent to which serious psychological distress (SPD) is associated with behavioral and social correlates among US adults with self-reported disabilities.
Self-reported data on disability, SPD, and behavioral and social correlates were collected from 202,383 participants (aged > or = 18 years) of the 2007 Behavioral Risk Factor Surveillance System. Adults with self-reported disabilities were identified using two standardized questions--one relating to activity limitation, the other to special equipment.
The age-adjusted prevalence of SPD among adults with disabilities was nearly seven times higher than among adults without disabilities (14.1 % vs. 1.8 %, respectively). Adults with disabilities who have both activity limitations and who use assistive technology, and those with activity limitations only consistently experienced a higher prevalence of SPD than those who used assistive technology only (age-adjusted prevalence: 21.0 % and 12.7 % vs. 4.9 %). After adjusting for age, sex, race/ethnicity, educational attainment, marital status, and employment status, in the past 30 days SPD was more common among Hispanic persons, and was significantly associated with younger age, lower educational attainment, marital history, and employment status. Adults with SPD and disabilities experienced increased levels of risk behaviors, life dissatisfaction, and inadequate social support. Most importantly, just over half of adults with disabilities and SPD (51.6 % [95 % CI = 48.6-54.6]) were receiving medical care for a mental health condition compared to 20.6 % (95 % CI = 19.9-21.3) without SPD.
Given that SPD is strongly associated with both the behavioral and psychosocial determinants of health, this work underscores the need for evidence-based interventions that may reduce its prevalence among people living with disabilities.
我们的目的是研究在美国自我报告有残疾的成年人中，严重心理困扰（SPD）与行为和社会相关因素之间的关联程度。
从2007年行为危险因素监测系统的202383名参与者（年龄≥18岁）中收集了关于残疾、SPD以及行为和社会相关因素的自我报告数据。使用两个标准化问题来识别自我报告有残疾的成年人——一个与活动受限有关，另一个与特殊设备有关。
残疾成年人中SPD的年龄调整患病率几乎是无残疾成年人的七倍（分别为14.1%和1.8%）。既有活动受限又使用辅助技术的残疾成年人，以及仅活动受限的残疾成年人，其SPD患病率始终高于仅使用辅助技术的残疾成年人（年龄调整患病率：21.0%和12.7%对比4.9%）。在调整年龄、性别、种族/族裔、教育程度、婚姻状况和就业状况后，在过去30天里，SPD在西班牙裔人群中更为常见，并且与年龄较小、教育程度较低、婚姻史和就业状况显著相关。患有SPD和残疾的成年人经历了更高水平的危险行为、生活不满和社会支持不足。最重要的是，超过一半（51.6%[95%CI=48.6-54.6]）患有残疾和SPD的成年人因心理健康状况接受医疗护理，而无SPD的成年人这一比例为20.6%（95%CI=19.9-21.3）。
鉴于SPD与健康的行为和心理社会决定因素密切相关，这项研究强调了需要有基于证据的干预措施，以降低其在残疾人群中的患病率。
