Piane Gina M, Smith Tyler C
Department of Community Health, School of Health and Human Services, National University, 3678 Aero Court, San Diego, CA 92123. E-mail:
National University, San Diego, California.
Prev Chronic Dis. 2014 Oct 23;11:E188. doi: 10.5888/pcd11.140211.
Mental disorders and chronic diseases have been reported to independently affect half of the US population. The objective of this study was to evaluate the comorbid nature of these conditions.
We analyzed data from 39,954 participants from the 2009 California Health Interview Survey who reported both psychological distress and impairment, on the basis of the Kessler 6 and the Sheehan Disability Scale, and 1 or more of 4 chronic diseases (type 2 diabetes, high blood pressure, asthma, heart disease). Weighted and nonweighted multivariable logistic regression were used to investigate the association between psychological distress and impairment and chronic disease, after adjusting for sex, age, race, current smoking, binge drinking in the previous year, moderate physical activity, and body mass index.
After controlling for covariates in the model, we found a significant dose-response relationship between reported chronic diseases and psychiatric distress and impairment that ranged from 1.50 for 1 reported chronic disease to 4.68 for 4 reported chronic diseases.
The growing chronic disease burden should be understood clinically in the context of mental health conditions. Further research is needed to identify ways to integrate mental health and chronic disease prevention in primary care.
据报道，精神障碍和慢性疾病各自影响着美国一半的人口。本研究的目的是评估这些疾病的共病性质。
我们分析了2009年加利福尼亚健康访谈调查中39954名参与者的数据，这些参与者根据凯斯勒6项心理困扰量表和希恩残疾量表报告了心理困扰和功能损害情况，以及4种慢性疾病（2型糖尿病、高血压、哮喘、心脏病）中的1种或更多种。在调整了性别、年龄、种族、当前吸烟状况、前一年的暴饮、适度体育活动和体重指数后，使用加权和非加权多变量逻辑回归来研究心理困扰和功能损害与慢性疾病之间的关联。
在控制了模型中的协变量后，我们发现报告的慢性疾病与精神困扰和功能损害之间存在显著的剂量反应关系，报告1种慢性疾病时为1.50，报告4种慢性疾病时为4.68。
在临床中应在心理健康状况的背景下理解日益加重的慢性疾病负担。需要进一步研究以确定在初级保健中将心理健康和慢性疾病预防相结合的方法。
