Straub Laura E, Cisternas Miriam G
Emory University, Atlanta, GA.
Immune Tolerance Network, San Francisco, CA.
Open Access Rheumatol. 2017 May 11;9:101-110. doi: 10.2147/OARRR.S129358. eCollection 2017.
Mental health conditions can increase the risk of disability among adults with arthritis. The objective of this analysis was to compare the prevalence of serious psychological distress (SPD), depression, and anxiety among US adults with arthritis vs. those without; characterize adults with arthritis with and without SPD; and determine correlates of seeing a mental health professional during the year for adults with arthritis and SPD.
Cross-sectional analysis of adults in the 2011-2013 National Health Interview Survey.
Higher proportions of adults with arthritis had SPD (6.8% vs. 2.4%), depression (19.4% vs. 7.3%), and anxiety (29.3% vs. 16.3%) compared to those without. Of the estimated 3.5 million adults with arthritis and SPD, only 39% saw a mental health professional during the year. Adjusted analyses identified the following statistically significant relationships: those who were older (45-64 and ≥65 [vs.18-44], prevalence ratio [PR]=0.8 and 0.4, respectively), less educated (PR=0.5 and 0.7 for high school or less vs. college degree, respectively), and without health insurance coverage (vs. any private, PR=0.7), were less likely to see a mental health professional, whereas the disabled or unemployed (vs. employed, PR=1.6 and 1.5, respectively), and those unable to afford mental health care throughout the year (PR=1.3) were more likely.
The high prevalence of SPD, anxiety, and depression in adults with arthritis suggests the need for increased mental health screening, with subsequent referral to mental health professionals or other treatment programs, in that population.
心理健康状况会增加患关节炎成年人的残疾风险。本分析的目的是比较美国患关节炎成年人与未患关节炎成年人中严重心理困扰(SPD)、抑郁和焦虑的患病率;描述患关节炎且有和没有SPD的成年人特征;并确定患关节炎且有SPD的成年人在一年内寻求心理健康专业人员帮助的相关因素。
对2011 - 2013年国家健康访谈调查中的成年人进行横断面分析。
与未患关节炎的成年人相比,患关节炎的成年人中SPD(6.8%对2.4%)、抑郁(19.4%对7.3%)和焦虑(29.3%对16.3%)的比例更高。在估计的350万患关节炎且有SPD的成年人中,只有39%在这一年里寻求过心理健康专业人员的帮助。校正分析确定了以下具有统计学意义的关系:年龄较大者(45 - 64岁和≥65岁[对比18 - 44岁],患病率比[PR]分别为0.8和0.4)、受教育程度较低者(高中及以下对比大学学历的PR分别为0.5和0.7)以及没有医疗保险者(对比任何私人保险,PR = 0.7)寻求心理健康专业人员帮助的可能性较小,而残疾或失业者(对比就业者,PR分别为1.6和1.5)以及全年无力承担心理健康护理费用者(PR = 1.3)寻求帮助的可能性较大。
患关节炎成年人中SPD、焦虑和抑郁的高患病率表明,该人群需要加强心理健康筛查,并随后转介至心理健康专业人员或其他治疗项目。