Chan Sarah, Weich Scott
School of Health and Related Research, University of Sheffield, UK.
Mental Health Research Unit, School of Health and Related Research, University of Sheffield, UK.
BJPsych Open. 2020 Jun 18;6(4):e66. doi: 10.1192/bjo.2020.46.
Mental illness and mental well-being are independent but correlated dimensions of mental health. Both are associated with social functioning (in opposite directions), but it is not known whether they modify the effects of one another. New treatment targets might emerge if improving mental well-being in people with serious mental illness improved functional outcomes independent of clinical status.
To describe associations between mental well-being and functioning in people classified according to mental illness status.
Cross-sectional data from 5485 respondents to the Health Survey for England 2014 were analysed. Mental illness status (including whether diagnosed by a professional) was by self-report and grouped into four categories, including 'diagnosis of serious mental illness'. Mental well-being was measured using the Warwick-Edinburgh Mental Well-Being Scale, and functioning by items from the EQ-5D. Mental distress was assessed using General Health Questionnaire (GHQ-12) items. Associations were examined using moderated regression models with group membership as an interaction term.
Mental well-being score was associated with (higher) functioning score (P < 0.05). This association varied between mental illness groups, even after adjusting for age, gender, ethnicity, physical health and symptoms of mental distress (F(3) = 14.60, P < 0.001). The gradient of this association was greatest for those with diagnosed serious mental illness.
Mental well-being was associated with higher functional status in people with mental illness, independent of the symptoms of mental distress and other confounders. The association was strongest in the diagnosed serious mental illness group, suggesting that mental well-being may be important in recovery from mental illness.
精神疾病和心理健康是心理健康中相互独立但又相关的维度。两者都与社会功能相关（方向相反），但尚不清楚它们是否会相互影响。如果改善严重精神疾病患者的心理健康能独立于临床状态改善功能结局，那么可能会出现新的治疗靶点。
描述根据精神疾病状态分类的人群中心理健康与功能之间的关联。
分析了来自2014年英格兰健康调查的5485名受访者的横断面数据。精神疾病状态（包括是否由专业人员诊断）通过自我报告获得，并分为四类，包括“严重精神疾病诊断”。使用沃里克 - 爱丁堡心理健康量表测量心理健康，使用EQ - 5D项目测量功能。使用一般健康问卷（GHQ - 12）项目评估精神痛苦。使用以组成员身份作为交互项的调节回归模型检验关联。
心理健康得分与（更高的）功能得分相关（P < 0.05）。即使在调整了年龄、性别、种族、身体健康和精神痛苦症状后，这种关联在精神疾病组之间也有所不同（F(3) = 14.60，P < 0.001）。这种关联的梯度在诊断为严重精神疾病的人群中最大。
心理健康与精神疾病患者较高的功能状态相关，独立于精神痛苦症状和其他混杂因素。这种关联在诊断为严重精神疾病的组中最强，表明心理健康在精神疾病康复中可能很重要。
