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法国精神障碍患者一生中未使用精神卫生治疗的流行情况和预测因素:来自“一般人群精神卫生”(MHGP)调查的结果。

Prevalence and predictors of no lifetime utilization of mental health treatment among people with mental disorders in France: findings from the 'Mental Health in General Population' (MHGP) survey.

机构信息

Centre Collaborateur de l'Organisation Mondiale de la Santé, 211 rue Roger Salengro, 59 260, Hellemmes, France.

Département de Biostatistiques, Univ. Lille, CHU Lille, EA 2694, Santé publique: épidémiologie et qualité des soins, Lille, France.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2018 Jun;53(6):567-576. doi: 10.1007/s00127-018-1507-0. Epub 2018 Apr 4.

DOI:10.1007/s00127-018-1507-0
PMID:29619580
Abstract

PURPOSE

No lifetime utilization of mental health treatment (NUMT) is an indicator of the treatment gap among people in need of treatment. Until now, the overall prevalence and predictors of NUMT have never been explored in France.

METHODS

In a 39,617-respondent survey, participants were assessed for NUMT, i.e., no lifetime psychotherapy, psychopharmacotherapy, or psychiatric hospitalization. Mental disorders were investigated using the Mini International Neuropsychiatric Interview (MINI 5.0.0). MINI diagnoses were grouped into five categories: mood disorders (MDs); anxiety disorders (ADs); alcohol use disorders (AUDs); substance use disorders (SUDs); and psychotic disorders (PDs). Using multivariable logistic regression models, we explored the factors associated with NUMT among the MINI-positive respondents. The odds ratio and 95% confidence interval were calculated for each factor.

RESULTS

In total, 12,818 (32.4%) respondents were MINI-positive, 46.5% of them reported NUMT (35.6% for MDs, 39.7% for PDs, 42.8% for ADs, 56.0% for AUDs, and 56.7% for SUDs). NUMT was positively associated with being male [OR 1.75 (1.59-1.91)] and practising religion [OR 1.13 (1.02-1.25)] and negatively associated with ageing [per 10-year increase: OR 0.88 (0.85-0.91)], being single [OR 0.74 (0.66-0.84)], being a French native [OR 0.67 (0.60-0.75)], and experiencing MDs [OR 0.39 (0.36-0.43)], ADs [OR 0.47 (0.43-0.52)], AUDs [OR 0.83 (0.73-0.96)], SUDs [OR 0.77 (0.65-0.91)], or PDs [OR 0.50 (0.43-0.59)].

CONCLUSIONS

In France, NUMT rates were the highest for AUDs and SUDs. Additionally, suffering from MDs or ADs increased the lifetime treatment utilization for people having any other mental disorder. This finding emphasizes the need to better screen AUDs and SUDs among people treated for MDs or ADs.

摘要

目的

精神健康治疗的终身利用率(NUMT)为衡量需要治疗的人群中治疗缺口的指标。在此之前,法国从未对 NUMT 的总体流行率及其预测因素进行过研究。

方法

在一项 39617 名应答者的调查中,对参与者进行了 NUMT 的评估,即没有接受过终身心理治疗、精神药理学治疗或精神病住院治疗。使用迷你国际神经精神访谈(MINI 5.0.0)调查精神障碍。MINI 诊断分为五类:心境障碍(MDs);焦虑障碍(ADs);酒精使用障碍(AUDs);物质使用障碍(SUDs);和精神病障碍(PDs)。使用多变量逻辑回归模型,我们探讨了 MINI 阳性应答者中与 NUMT 相关的因素。计算了每个因素的比值比和 95%置信区间。

结果

共有 12818 名(32.4%)应答者为 MINI 阳性,其中 46.5%报告有 NUMT(MDs 为 35.6%,PDs 为 39.7%,ADs 为 42.8%,AUDs 为 56.0%,SUDs 为 56.7%)。NUMT 与男性[比值比(OR)1.75(1.59-1.91)]和宗教信仰[OR 1.13(1.02-1.25)]呈正相关,与年龄增长[每增加 10 岁:OR 0.88(0.85-0.91)]、单身[OR 0.74(0.66-0.84)]、法国本地人[OR 0.67(0.60-0.75)]呈负相关,与 MDs[OR 0.39(0.36-0.43)]、ADs[OR 0.47(0.43-0.52)]、AUDs[OR 0.83(0.73-0.96)]、SUDs[OR 0.77(0.65-0.91)]或 PDs[OR 0.50(0.43-0.59)]呈负相关。

结论

在法国,AUDs 和 SUDs 的 NUMT 率最高。此外,患有 MDs 或 ADs 会增加任何其他精神障碍患者的终身治疗利用率。这一发现强调了需要更好地筛查 MDs 或 ADs 治疗人群中的 AUDs 和 SUDs。

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