Nobles Carrie J, Valentine Sarah E, Gerber Monica W, Shtasel Derri L, Marques Luana
Department of Psychiatry, Massachusetts General Hospital, 70 Everett Ave. Suite 516, Chelsea, MA 02150, USA; Harvard Medical School.
Department of Psychiatry, Massachusetts General Hospital, 70 Everett Ave. Suite 516, Chelsea, MA 02150, USA; Harvard Medical School.
Gen Hosp Psychiatry. 2016 Nov-Dec;43:38-45. doi: 10.1016/j.genhosppsych.2016.09.001. Epub 2016 Sep 9.
Posttraumatic stress disorder (PTSD) is a chronic psychiatric condition associated with significant disability that often remains untreated. Sociodemographic and family-level factors may serve as predictors of unmet treatment need, identifying groups that would most benefit from policies aimed at increasing access to the mental health care system.
Data from the nationally representative Collaborative Psychiatric Epidemiologic Surveys were used to identify predictors of mental health treatment utilization, both with a mental health specialist and with a general health practitioner, and self-reported unmet treatment need among individuals who endorsed past-year PTSD. We defined unmet treatment need as self-reporting a mental health problem and not accessing mental health care in the general or specialty mental health care system.
Among 600 participants, predictors of unmet treatment need included being non-Latino black [odds ratio (OR) 2.11, 95% confidence interval (CI) 1.25-3.54], having a high school education versus some college (OR 2.45, 95% CI 1.34-4.48), and being employed or unemployed versus not being in the workforce (OR 1.74, 95% CI 1.00-3.02 and OR 4.95, 95% CI 1.60-15.34, respectively). Recursive partitioning identified younger age and being married as predictors of low treatment utilization.
Future research should elucidate barriers to accessing treatment among those with PTSD in these underserved groups.
创伤后应激障碍(PTSD)是一种慢性精神疾病,常伴有严重残疾且往往得不到治疗。社会人口统计学和家庭层面的因素可能是未满足治疗需求的预测指标,有助于识别那些最能从旨在增加获得心理健康护理系统机会的政策中受益的群体。
利用具有全国代表性的协作精神病流行病学调查数据,确定心理健康治疗利用情况的预测指标,包括与心理健康专家和全科医生的治疗利用情况,以及在过去一年认可患有创伤后应激障碍的个体中自我报告的未满足治疗需求。我们将未满足治疗需求定义为自我报告有心理健康问题但未在一般或专科心理健康护理系统中接受心理健康护理。
在600名参与者中,未满足治疗需求的预测因素包括非拉丁裔黑人(优势比[OR]2.11,95%置信区间[CI]1.25 - 3.54)、高中教育程度与大专学历相比(OR 2.45,95%CI 1.34 - 4.48),以及就业或失业与未就业相比(分别为OR 1.74,95%CI 1.00 - 3.02和OR 4.95,95%CI 1.60 - 15.34)。递归划分确定年龄较小和已婚是治疗利用率低的预测因素。
未来的研究应阐明这些服务不足群体中创伤后应激障碍患者获得治疗的障碍。