Felleman Benjamin I, Athenour Dylan R, Ta Minhdan T, Stewart David G
Department of Clinical Psychology, Seattle Pacific University, 3307 Third Ave. W., Ste. 107, Seattle, WA, 98119, USA,
J Clin Psychol Med Settings. 2013 Dec;20(4):415-26. doi: 10.1007/s10880-013-9367-y.
Although research has shown benefits of integrating psychological care in primary care settings, it is unclear how this form of treatment impacts individuals with comorbid substance use and depression. The findings are also mixed concerning how frequently this comorbid population seeks primary care services. This study examined the associations between substance use, depression, and medical treatment utilization among 224 primary care patients. The aim of the investigation was twofold. First, to determine if depression increases medical treatment utilization among patients with substance use disorders; second, to evaluate if behavioral health treatment reduces medical service utilization. A moderated mediation model with bootstrapping analyses revealed that depression strengthened the relationship between substance use and primary care treatment utilization (both medical and behavioral health). The model also indicated that behavioral health services were associated with fewer primary care visits for individuals with comorbid substance use and depression. Clinical and social implications are discussed.
尽管研究表明在初级保健机构中整合心理护理有诸多益处，但尚不清楚这种治疗形式对同时患有物质使用障碍和抑郁症的个体有何影响。关于这一共病群体寻求初级保健服务的频率，研究结果也存在分歧。本研究调查了224名初级保健患者的物质使用、抑郁与医疗服务利用之间的关联。该调查有两个目的。其一，确定抑郁症是否会增加患有物质使用障碍患者的医疗服务利用；其二，评估行为健康治疗是否会减少医疗服务利用。采用自抽样分析的调节中介模型显示，抑郁症强化了物质使用与初级保健治疗利用（包括医疗和行为健康）之间的关系。该模型还表明，行为健康服务与同时患有物质使用障碍和抑郁症的个体较少的初级保健就诊次数相关。文中讨论了临床和社会意义。
