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俄亥俄州美国陆军国民警卫队士兵精神科服务的终身使用情况及12个月使用情况

Lifetime and 12-month use of psychiatric services among U.S. Army National Guard soldiers in Ohio.

作者信息

Fink David S, Sampson Laura, Tamburrino Marijo B, Liberzon Israel, Slembarski Renee, Chan Philip, Cohen Gregory H, Shirley Edwin, Goto Toyomi, D'Arcangelo Nicole, Fine Thomas, Reed Philip, Galea Sandro, Calabrese Joseph R

机构信息

Mr. Fink and Mr. Cohen are with the Department of Epidemiology, Columbia University, New York City (e-mail:

出版信息

Psychiatr Serv. 2015 May 1;66(5):514-20. doi: 10.1176/appi.ps.201400128. Epub 2015 Feb 2.

Abstract

OBJECTIVE

The individual and economic burden of psychiatric illnesses is substantial. Although treatment of psychiatric disorders mitigates the burden of illness, over half of military personnel with disorders do not receive mental health care. However, there is a paucity of research examining the relationship between psychiatric disorder categories and treatment-seeking behavior in representative military populations. This study aimed to document, by psychiatric disorder category, the annualized rate of Guard members who obtained psychiatric services and the factors associated with service utilization.

METHODS

Face-to-face clinical assessments were conducted between 2008 and 2012 to assess lifetime and current psychiatric disorders and recent psychiatric service use among 528 Ohio Army National Guard soldiers.

RESULTS

An annualized rate of 31% of persons per year accessed psychiatric services between 2010 and 2012. Persons with substance use disorders had the lowest annualized rate of service use, and these were the only disorders not predictive of accessing services. Current mood disorder, current anxiety disorder, and lifetime history of service use were the strongest predictors of recent service use. There were no socioeconomic or other group predictors of psychiatric service use.

CONCLUSIONS

About half of the soldiers who could benefit from mental health services used them, yet soldiers with substance use disorders were predominantly going untreated. There were no differences in treatment utilization by group characteristics, suggesting no systematic barriers to care for particular groups. Efforts to encourage broader adoption of treatment seeking, particularly among persons with substance use disorders, are necessary to mitigate psychiatric health burden in this population.

摘要

目的

精神疾病的个人负担和经济负担都很沉重。虽然精神疾病的治疗可减轻疾病负担,但超过半数患有精神疾病的军人未接受心理健康护理。然而,在具有代表性的军人群体中,研究精神疾病类别与寻求治疗行为之间关系的研究却很少。本研究旨在按精神疾病类别记录国民警卫队成员获得精神科服务的年化率以及与服务利用相关的因素。

方法

2008年至2012年期间,对528名俄亥俄州陆军国民警卫队士兵进行了面对面临床评估,以评估其终生和当前的精神疾病以及近期的精神科服务使用情况。

结果

2010年至2012年期间,每年有31%的人获得精神科服务。患有物质使用障碍的人服务使用率年化率最低,且这些是唯一不能预测获得服务情况的障碍。当前的情绪障碍、当前的焦虑障碍以及终生服务使用史是近期服务使用的最强预测因素。精神科服务使用情况不存在社会经济或其他群体预测因素。

结论

约半数可从心理健康服务中受益的士兵使用了这些服务,但患有物质使用障碍的士兵大多未得到治疗。按群体特征划分的治疗利用率没有差异,这表明不存在针对特定群体的系统性护理障碍。有必要努力鼓励更广泛地寻求治疗,尤其是在患有物质使用障碍的人群中,以减轻该人群的精神健康负担。

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