Harpaz-Rotem Ilan, Rosenheck Robert A, Pietrzak Robert H, Southwick Steven M
*Department of Psychiatry, Yale University School of Medicine, New Haven, CT; †Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, West Haven, CT; and ‡VA New England Mental Illness, Research, Education and Clinical Center, West Haven, CT.
J Nerv Ment Dis. 2014 Feb;202(2):97-104. doi: 10.1097/NMD.0000000000000078.
There is considerable public and professional concern about the mental health status of veterans deployed to Iraq and Afghanistan as well as how to engage and retain symptomatic veterans in treatment. This study examined demographic, psychiatric, and psychosocial determinants of prospective initiation and retention in mental health services among symptomatic Iraq/Afghanistan veterans. One hundred thirty-seven symptomatic veterans who were referred to mental health screening completed a survey at the time of their first mental health visit. Associations between survey variables and subsequent Veterans Affairs service utilization were evaluated. The most consistent determinants of mental health service initiation and retention were severity of posttraumatic stress disorder (PTSD) and depressive symptoms. Notably, whereas PTSD-related re-experiencing symptoms were independently associated with initiation of mental health treatment, PTSD-related numbing symptoms were independently associated with retention in treatment. Stigma, barriers to care, and beliefs about mental health treatment were not associated with either mental health initiation or retention.
公众和专业人士对被部署到伊拉克和阿富汗的退伍军人的心理健康状况以及如何使有症状的退伍军人参与并坚持接受治疗极为关注。本研究调查了有症状的伊拉克/阿富汗退伍军人在心理健康服务方面预期开始和坚持治疗的人口统计学、精神病学和社会心理决定因素。137名被转介进行心理健康筛查的有症状退伍军人在首次心理健康就诊时完成了一项调查。评估了调查变量与随后退伍军人事务部服务利用之间的关联。心理健康服务开始和坚持治疗最一致的决定因素是创伤后应激障碍（PTSD）和抑郁症状的严重程度。值得注意的是，与PTSD相关的重现症状与开始心理健康治疗独立相关，而与PTSD相关的麻木症状与坚持治疗独立相关。耻辱感、护理障碍以及对心理健康治疗的信念与心理健康治疗的开始或坚持均无关联。
