Médecins Sans Frontières - Operational Center, Geneva, Switzerland.
Int J Ment Health Syst. 2009 Jul 21;3(1):17. doi: 10.1186/1752-4458-3-17.
There is no description of outcomes for patients receiving treatment for mental illnesses in humanitarian emergencies. MSF has developed a model for integration of mental health into primary care in a humanitarian emergency setting based on the capacity of community health workers, clinical officers and health counsellors under the supervision of a psychiatrist trainer. Our study aims to describe the characteristics of patients first attending mental health services and their outcomes on functionality after treatment.
A total of 114 patients received mental health care and 81 adult patients were evaluated with a simplified functionality assessment instrument at baseline, one month and 3 months after initiation of treatment.
Most patients were diagnosed with epilepsy (47%) and psychosis (31%) and had never received treatment. In terms of follow up, 58% came for consultations at 1 month and 48% at 3 months. When comparing disability levels at baseline versus 1 month, mean disability score decreased from 9.1 (95%CI 8.1-10.2) to 7.1 (95%CI 5.9-8.2) p = 0.0001. At 1 month versus 3 months, mean score further decreased to 5.8 (95%CI 4.6-7.0) p < 0.0001.
The findings suggest that there is potential to integrate mental health into primary care in humanitarian emergency contexts. Patients with severe mental illness and epilepsy are in particular need of mental health care. Different strategies for integration of mental health into primary care in humanitarian emergency settings need to be compared in terms of simplicity and feasibility.
目前尚无针对人道主义紧急情况中接受精神疾病治疗的患者结局的描述。无国界医生组织（MSF）基于社区卫生工作者、临床医生和健康顾问的能力，并在精神科培训师的监督下，制定了一种在人道主义紧急情况下将精神卫生纳入初级保健的模式。我们的研究旨在描述首次接受精神卫生服务的患者的特征及其治疗后功能恢复的结局。
共有 114 名患者接受了精神卫生保健，81 名成年患者在治疗开始后的基线、1 个月和 3 个月接受了简化功能评估工具的评估。
大多数患者被诊断患有癫痫（47%）和精神病（31%），且从未接受过治疗。在随访方面，58%的患者在 1 个月时就诊，48%的患者在 3 个月时就诊。与基线相比，1 个月时残疾程度的平均残疾评分从 9.1（95%CI 8.1-10.2）降至 7.1（95%CI 5.9-8.2），p = 0.0001。在 1 个月与 3 个月时相比，平均评分进一步降至 5.8（95%CI 4.6-7.0），p<0.0001。
这些发现表明，有可能在人道主义紧急情况中整合精神卫生服务到初级保健中。患有严重精神疾病和癫痫的患者尤其需要精神卫生保健。需要比较人道主义紧急情况中精神卫生整合到初级保健中的不同策略，以确定其简单性和可行性。
