Ahmad Farah, Shakya Yogendra, Ginsburg Liane, Lou Wendy, Ng Peggy T, Rashid Meb, Ferrari Manuela, Ledwos Cliff, McKenzie Kwame
Associate Professor in the School of Health Policy and Management at York University in Toronto, Ont, and Research Scientist at the North York General Hospital.
Senior Research Scientist at Access Alliance Multicultural Health and Community Services and Assistant Professor in the Dalla Lana School of Public Health at the University of Toronto.
Can Fam Physician. 2016 Dec;62(12):e758-e766.
To examine the rates of common mental disorders (CMDs) such as depression, anxiety, posttraumatic stress disorder (PTSD), and alcohol use in an urban community health care centre (CHC) serving vulnerable immigrant and ethnoracial communities in order to improve knowledge on the rates of CMDs specific to these groups accessing primary care settings.
English or Spanish, self-administered, tablet-based survey known as the Interactive Computer-Assisted Client Assessment Survey (iCCAS).
Access Alliance Multicultural Health and Community Services CHC in Toronto, Ont.
Adult patients waiting to see a clinician.
The iCCAS screened for depression (using the PHQ-9 [Patient Health Questionnaire]), anxiety (using the GAD-7 [Generalized Anxiety Disorder 7-item scale]), PTSD (using the PC-PTSD [Primary Care PTSD Screen]), and alcohol dependency (using the CAGE questionnaire); those with an existing diagnosis and active treatment for one of these conditions were not asked to complete that condition-specific screening scale. An exit survey measured demographic characteristics and relevant indicators.
A response rate of 78.6% was achieved. The iCCAS survey was completed by 75 patients (26 men and 49 women) with a mean age of 36.5 years. Almost all were first-generation immigrants: 32.0% originated from Latin America, 28.0% from South Asia, and 17.3% from Africa or the Middle East. Major depression was found among 44.0% of participants (11 with diagnosis and treatment, 22 with a score of 10 or greater on the PHQ-9). Generalized anxiety disorder was present in 26.7% of participants (7 with diagnosis and treatment, 13 with a score of 10 or greater on the GAD-7 scale). Posttraumatic stress disorder was detected in 37.3% of participants (7 with diagnosis and treatment, 21 with a score of 3 or greater on the PC-PTSD tool). Alcohol dependency was found among 10.7% of participants (1 with diagnosis and treatment, 7 with a score of 2 or greater on the CAGE questionnaire).
The high rates of probable depression, generalized anxiety, and PTSD that were found in the studied population suggest a need for systematic assessment of CMDs in CHCs, as well as training and resources to increase readiness to handle identified cases.
在为弱势移民和少数族裔社区服务的城市社区医疗中心（CHC），调查抑郁症、焦虑症、创伤后应激障碍（PTSD）和酒精使用等常见精神障碍的发生率，以增进对这些在初级医疗环境中就诊的特定群体的精神障碍发生率的了解。
采用英语或西班牙语、基于平板电脑的自我管理式调查，即交互式计算机辅助客户评估调查（iCCAS）。
安大略省多伦多市的Access Alliance多元文化健康与社区服务CHC。
等待看诊的成年患者。
iCCAS筛查了抑郁症（使用患者健康问卷-9[PHQ-9]）、焦虑症（使用广泛性焦虑症7项量表[GAD-7]）、PTSD（使用初级保健PTSD筛查量表[PC-PTSD]）和酒精依赖（使用CAGE问卷）；已对其中一种疾病进行诊断和积极治疗的患者未被要求完成该特定疾病的筛查量表。一份出院调查问卷测量了人口统计学特征和相关指标。
应答率达到78.6%。iCCAS调查由75名患者（26名男性和49名女性）完成，平均年龄为36.5岁。几乎所有人都是第一代移民：32.0%来自拉丁美洲，28.0%来自南亚，17.3%来自非洲或中东。44.0%的参与者患有重度抑郁症（11人已确诊并接受治疗，22人在PHQ-9上的得分达到或超过10分）。26.7%的参与者患有广泛性焦虑症（7人已确诊并接受治疗，13人在GAD-7量表上的得分达到或超过10分）。37.3%的参与者检测出创伤后应激障碍（7人已确诊并接受治疗，21人在PC-PTSD工具上的得分达到或超过3分）。10.7%的参与者存在酒精依赖（1人已确诊并接受治疗，7人在CAGE问卷上的得分达到或超过2分）。
在所研究的人群中发现的可能的抑郁症、广泛性焦虑症和创伤后应激障碍的高发生率表明，有必要在社区医疗中心对精神障碍进行系统评估，以及提供培训和资源，以提高处理已确诊病例的准备程度。
