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加拿大的哮喘和精神障碍:对功能障碍和精神卫生服务利用的影响。

Asthma and mental disorders in Canada: impact on functional impairment and mental health service use.

机构信息

Mailman School of Public Health, Columbia University, New York, NY 10032, USA.

出版信息

J Psychosom Res. 2010 Feb;68(2):165-73. doi: 10.1016/j.jpsychores.2009.06.005. Epub 2009 Oct 3.

Abstract

OBJECTIVE

The goal of this study is to examine the association between asthma and mental disorders and the impact of asthma and mental disorder comorbidity on functional impairment and mental health care service use among adults in the community.

METHODS

Data came from the Canadian Community Health Survey Cycle 1.2 (N=36,984; age >/=15 years; response rate, 77%). Mental disorders were assessed using the Composite International Diagnostic Interview. Chronic physical health conditions, quality of life, and disability were also assessed. Asthma diagnoses were based on self-report of having been diagnosed with asthma by a health care professional.

RESULTS

Asthma was associated with a significantly increased likelihood of a range of mental disorders among adults in Canada, with the strongest links between asthma and posttraumatic stress disorder, mania, and panic disorder. Adults with both mental disorders and asthma had significantly higher rates of functional impairment and use of mental health services, compared with those with either asthma or mental disorders but not both.

CONCLUSIONS

Our findings provide new information suggesting that adults in the community with asthma and mental disorders have higher levels of both short- and long-term health-condition-related functional disability and greater use of mental health services, compared with those with asthma without mental disorders. Results are also consistent with previous studies showing a significant link between asthma and mental disorders. Implications of these findings for efforts aimed at secondary prevention and improving treatment strategies for individuals with both asthma and mental disorders are discussed.

摘要

目的

本研究旨在探讨哮喘与精神障碍之间的关联,以及哮喘和精神障碍共病对社区成年人功能障碍和精神卫生保健服务使用的影响。

方法

数据来自加拿大社区健康调查周期 1.2(N=36984;年龄≥15 岁;应答率为 77%)。使用复合国际诊断访谈评估精神障碍。还评估了慢性身体健康状况、生活质量和残疾。哮喘诊断基于自我报告曾被医疗保健专业人员诊断为哮喘。

结果

哮喘与加拿大成年人一系列精神障碍的发生几率显著增加有关,其中哮喘与创伤后应激障碍、躁狂症和惊恐障碍之间的关联最强。与仅有哮喘或精神障碍但无两者共病的成年人相比,同时患有精神障碍和哮喘的成年人功能障碍和使用精神卫生服务的比率显著更高。

结论

我们的研究结果提供了新的信息,表明与无精神障碍的哮喘成年人相比,社区中患有哮喘和精神障碍的成年人在短期和长期与健康状况相关的功能障碍以及使用精神卫生服务方面的水平更高。这些结果与先前研究显示哮喘与精神障碍之间存在显著关联的结果一致。讨论了这些发现对旨在进行二级预防和改善同时患有哮喘和精神障碍个体治疗策略的努力的意义。

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