Kavanagh Bianca E, Gwini Stella M, Pasco Julie A, Stuart Amanda L, Quirk Shae E, Gaston James, Holloway-Kew Kara L, Turner Alyna, Berk Michael, Dean Olivia M, Chanen Andrew M, Koivumaa-Honkanen Heli, Moran Paul, Borschmann Rohan, Williams Lana J
School of Medicine, Institute for Physical and Mental Health and Clinical Translation, Barwon Health, Deakin University, Geelong, VIC, Australia.
University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.
Front Glob Womens Health. 2021 Mar 23;2:615057. doi: 10.3389/fgwh.2021.615057. eCollection 2021.
This study aimed to investigate health service utilization among women with mental state disorder only (MSD-PD), mental state disorder plus personality disorder (MSD+PD), and controls in a population-based sample. Women ( = 635) from the Geelong Osteoporosis Study completed mental health assessments and were categorized into groups (MSD-PD, MSD+PD, controls). General practitioner (mental and non-mental health encounters) and specialized mental health service utilization was ascertained from data linkage to the Medicare Benefits Schedule, Australia (01/09/2008-31/12/2012). Negative binomial and binary logistic regression models were employed to assess health service utilization differences between groups. Results indicated that women with MSD+PD had more encounters of non-mental health service utilization than women with MSD-PD and controls. Age significantly modified these relationships: women with MSD+PD and MSD-PD had more encounters of health service utilization at midlife and in the seventh decade of life. No significant differences were found in the frequency of general practitioner mental health service utilization or specialized mental health service utilization between groups. These data suggest that the presence of co-occurring PD is associated with increased health service utilization among women with other common mental health problems. Healthcare providers should be vigilant to the presence of PD when establishing management plans with patients presenting with common mental health problems.
本研究旨在调查仅患有精神状态障碍（MSD-PD）、患有精神状态障碍合并人格障碍（MSD+PD）的女性以及基于人群样本中的对照组的卫生服务利用情况。来自吉朗骨质疏松症研究的635名女性完成了心理健康评估，并被分为不同组（MSD-PD组、MSD+PD组、对照组）。通过与澳大利亚医疗保险福利计划（2008年9月1日至2012年12月31日）的数据链接，确定了全科医生（心理健康和非心理健康诊疗）及专科心理健康服务的利用情况。采用负二项回归模型和二元逻辑回归模型评估各组之间卫生服务利用的差异。结果表明，与患有MSD-PD的女性和对照组相比，患有MSD+PD的女性有更多的非心理健康服务利用诊疗次数。年龄显著改变了这些关系：患有MSD+PD和MSD-PD的女性在中年及七十岁时卫生服务利用的诊疗次数更多。各组之间在全科医生心理健康服务利用频率或专科心理健康服务利用频率上未发现显著差异。这些数据表明，共病的人格障碍与患有其他常见心理健康问题的女性卫生服务利用增加有关。在为患有常见心理健康问题的患者制定管理计划时，医疗服务提供者应警惕人格障碍的存在。
