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心理健康障碍对家庭成员健康相关生活质量的溢出效应:来自美国样本的证据。

Spillover Effects of Mental Health Disorders on Family Members' Health-Related Quality of Life: Evidence from a US Sample.

机构信息

Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA.

Merck Research Laboratories, Merck & Co Inc, Rahway, NJ, USA.

出版信息

Med Decis Making. 2022 Jan;42(1):80-93. doi: 10.1177/0272989X211027146. Epub 2021 Aug 11.

Abstract

OBJECTIVES

This study aims to characterize the spillover effects of selected mental health disorders (episodic mood disorder (EMD), anxiety, substance use disorder (SUD), schizophrenia, attention-deficit/hyperactivity disorder (ADHD), and dementia) on family members' health-related quality of life and to compare the magnitude of spillover effects across these types.

METHODS

Using the 2000-2015 Medical Expenditure Panel Survey, households having individuals with mental health disorders were identified. The SF-12 and EQ-5D surveys were used to acquire utility and health status scores for household members. The outcomes in households including an individual with a mental health disorder were compared to those of the control group (absence of individuals with mental health disorders in the household). We also compared a total of 15 pairs of diseases based on the SF-6D scores. A beta generalized estimating equation model was employed.

RESULTS

Average scores of utility and health status among individuals living with a member with a mental health disorder in the household were statistically lower than those of the control group and; for the SF-6D, met the minimally important difference for SUD, schizophrenia, and dementia. Differences in the SF-6D scores were statistically significant for 5 pairs of the mental health disorders: EMD-anxiety, EMD-ADHD, dementia-anxiety, dementia-ADHD, and schizophrenia-ADHD.

CONCLUSIONS

This study provides evidence of family spillover effects in mental illness using both utility and health status measures from a US representative sample. Integrating this evidence into clinical and policy decision making as well as economic evaluations would allow for a more comprehensive valuation of the societal benefits of mental and behavioral health interventions.

摘要

目的

本研究旨在描述特定心理健康障碍(发作性心境障碍(EMD)、焦虑症、物质使用障碍(SUD)、精神分裂症、注意缺陷/多动障碍(ADHD)和痴呆症)对家庭成员健康相关生活质量的溢出效应,并比较这些类型的溢出效应的程度。

方法

使用 2000-2015 年医疗支出调查,确定有心理健康障碍患者的家庭。SF-12 和 EQ-5D 调查用于获取家庭成员的效用和健康状况评分。将有心理健康障碍患者的家庭的结果与对照组(家庭中没有心理健康障碍患者)进行比较。我们还根据 SF-6D 评分比较了总共 15 对疾病。采用贝塔广义估计方程模型。

结果

家庭中有成员患有心理健康障碍的个体的平均效用和健康状况评分明显低于对照组;对于 SF-6D,SUD、精神分裂症和痴呆症的最低重要差异。SF-6D 评分在 5 对心理健康障碍之间存在统计学差异:EMD-焦虑症、EMD-ADHD、痴呆症-焦虑症、痴呆症-ADHD 和精神分裂症-ADHD。

结论

本研究使用来自美国代表性样本的效用和健康状况衡量标准为精神疾病的家庭溢出效应提供了证据。将这一证据纳入临床和政策决策以及经济评估中,可以更全面地评估精神和行为健康干预措施对社会的益处。

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