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与情绪和焦虑障碍的新兴成年人开始社区治疗相关的因素。

Factors associated with initiation of community-based therapy for emerging adults with mood and anxiety disorders.

机构信息

Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, First Episode Mood and Anxiety Program (FEMAP), London Health Sciences Centre, Lawson Health Research Institute, London, ON, Canada.

出版信息

Early Interv Psychiatry. 2021 Feb;15(1):123-132. doi: 10.1111/eip.12920. Epub 2020 Jan 23.

Abstract

AIM

The First Episode Mood and Anxiety Program (FEMAP) is a community-based early intervention program that has been shown to improve health outcomes for emerging adults (EAs) with mood and anxiety disorders. However, not all EAs who are admitted to the program initiate treatment. Our aim was to identify factors that distinguish those who initiated treatment from those who did not.

METHODS

FEMAP administered questionnaires to EAs upon first contact with the program, collecting information on a range of socioeconomic, patient and condition-related factors. We compared EAs who initiated treatment in the program (n = 318, 87.4%) to those who did not (n = 46, 12.6%). To examine factors associated with treatment initiation, we specified a parsimonious logistic regression model, using the method of purposeful selection to choose from a range of candidate variables.

RESULTS

Anxiety Sensitivity Index - Revised (ASI-R), binge drinking and cannabis use were included in the final logistic regression model. Each one-point increment in the ASI-R score was associated with a 1% increase in the odds of treatment initiation (OR = 1.014; 95% CI [1.003, 1.026]). No other variable was significantly associated with treatment initiation.

CONCLUSIONS

Our study provides insight on the differences between EAs with mood and anxiety disorders who initiated targeted treatment services and those who did not. Anxiety sensitivity was significantly associated with treatment initiation at FEMAP. Our findings suggest that it may be anxiety sensitivity, rather than depression or functional impairment per se that drive treatment initiation among EAs.

摘要

目的

第一幕情绪和焦虑计划(FEMAP)是一个基于社区的早期干预计划,已被证明可以改善有情绪和焦虑障碍的新兴成年人(EAs)的健康结果。然而,并非所有被纳入该计划的 EAs 都开始接受治疗。我们的目的是确定区分那些开始治疗和那些没有开始治疗的因素。

方法

FEMAP 在首次接触该计划时向 EAs 发放问卷,收集一系列社会经济、患者和病情相关因素的信息。我们比较了在该计划中开始治疗的 EAs(n = 318,87.4%)和未开始治疗的 EAs(n = 46,12.6%)。为了研究与治疗启动相关的因素,我们指定了一个简约的逻辑回归模型,使用有目的选择的方法从一系列候选变量中进行选择。

结果

焦虑敏感指数修订版(ASI-R)、狂饮和大麻使用被纳入最终的逻辑回归模型。ASI-R 评分每增加 1 分,治疗启动的几率就会增加 1%(OR = 1.014;95%CI [1.003, 1.026])。没有其他变量与治疗启动显著相关。

结论

我们的研究提供了对有情绪和焦虑障碍的 EAs 中开始接受目标治疗服务和未开始接受治疗的 EAs 之间差异的深入了解。焦虑敏感性与 FEMAP 中的治疗启动显著相关。我们的研究结果表明,可能是焦虑敏感性,而不是抑郁或功能障碍本身,推动了 EAs 开始治疗。

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