Razzano Lisa A, Cook Judith A, Yost Chantelle, Jonikas Jessica A, Swarbrick Margaret A, Carter Tina M, Santos Alberto
Center on Mental Health Services Research and Policy, Department of Psychiatry, University of Illinois at Chicago, 1601 West Taylor Street, M/C 912, Chicago, IL 60612, United States.
Center on Mental Health Services Research and Policy, Department of Psychiatry, University of Illinois at Chicago, 1601 West Taylor Street, M/C 912, Chicago, IL 60612, United States.
Schizophr Res. 2015 Feb;161(2-3):458-64. doi: 10.1016/j.schres.2014.11.021. Epub 2014 Dec 6.
This study examined the prevalence and treatment of 17 co-occurring physical health conditions among adults with serious mental health disorders, and factors associated with prevalence of the 5 most common medical co-morbidities.
Data were collected from 457 adults attending publicly funded mental health programs who participated in community health screenings held in 4 U.S. states. Face-to-face interviews included standardized items from the National Health Interview Survey and the National Health and Nutrition Examination Survey. Ordinary least squares regression analysis examined associations between prevalence of the 5 most common co-morbid conditions and respondents' demographic, clinical, attitudinal, and health insurance statuses.
Compared to the U.S. population, prevalence was significantly higher for 14 out of 17 medical conditions assessed. The 5 most common were hyperlipidemia (45%), hypertension (44%), asthma (28%), arthritis (22%), and diabetes (21%). Controlling for age, study site, and Medicaid status, racial/ethnic minorities were almost twice as likely as Caucasians to be diagnosed with hypertension and diabetes; women were almost twice as likely as men to be diagnosed with diabetes; and people with schizophrenia were around half as likely as those with other disorders to be diagnosed with hypertension and arthritis. Age was positively related to all conditions except asthma. Treatment prevalence was below 70% for approximately half of ongoing conditions.
These results suggest a high level of medical vulnerability and need for coordination of health and mental health services in this population. Associations with age, minority status, and gender point to the need for targeted health care strategies.
本研究调查了患有严重精神疾病的成年人中17种共病身体健康状况的患病率及治疗情况，以及与5种最常见的医学共病患病率相关的因素。
数据收集自457名参加公共资助心理健康项目的成年人，他们参与了在美国4个州举行的社区健康筛查。面对面访谈包括来自国家健康访谈调查和国家健康与营养检查调查的标准化项目。普通最小二乘法回归分析研究了5种最常见共病状况的患病率与受访者的人口统计学、临床、态度和健康保险状况之间的关联。
与美国总体人群相比，所评估的17种医疗状况中有14种的患病率显著更高。5种最常见的状况为高脂血症（45%）、高血压（44%）、哮喘（28%）、关节炎（22%）和糖尿病（21%）。在控制年龄、研究地点和医疗补助状况后，少数族裔被诊断患有高血压和糖尿病的可能性几乎是白种人的两倍；女性被诊断患有糖尿病的可能性几乎是男性的两倍；精神分裂症患者被诊断患有高血压和关节炎的可能性约为其他疾病患者的一半。年龄与除哮喘外的所有状况呈正相关。约一半持续存在的状况的治疗患病率低于70%。
这些结果表明该人群存在较高的医疗脆弱性，需要协调健康和心理健康服务。与年龄、少数族裔身份和性别的关联表明需要有针对性的医疗保健策略。
