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分析边缘智力障碍成年人精神疾病、治疗及服务利用随时间的变化趋势:一项针对私人住户的横断面研究

Analysing trends of psychiatric disorders, treatment and service use across time in adults with borderline intellectual impairment: A cross-sectional study of private households.

作者信息

Lim Amanda, Totsika Vaso, Ali Afia

机构信息

University College London, United Kingdom.

University College London, United Kingdom.

出版信息

J Psychiatr Res. 2022 Jul;151:339-346. doi: 10.1016/j.jpsychires.2022.04.026. Epub 2022 Apr 25.

DOI:10.1016/j.jpsychires.2022.04.026
PMID:35533517
Abstract

While there is evidence that mental health problems are more prevalent in people with borderline intellectual functioning (BIF) compared to the general population, it is not known to what extent this has varied or changed over time and whether there have been changes in access to services. This paper compares the prevalence rates of psychiatric disorders and monitors trends in treatment and services in this population compared to the general population. We conducted secondary analysis on the Adult Psychiatric Morbidity Surveys carried out in England in 2000, 2007 and 2014. The total sample analysed included 21,796 participants, with 12.8% of individuals identified with BIF (n = 2786). Regression models were used to examine trends in psychiatric disorders, treatment and service use across the three datasets. People with BIF had significantly higher odds of developing mood and anxiety disorders, psychosis, drug dependence and suicidal behaviour than the general population, increasing at each subsequent timepoint. They received significantly more pharmacological treatments than the general population but have had increasingly more access to general practitioners, community care and daycare services over time. This study shows increasing prevalence rates of several mental disorders in people with BIF. Access to day-care, community care and healthcare services has increased over time for this group but not formal psychiatric care. These changes over time underline some of the problems this population faces, emphasizing a need to recognize that this is a population often overlooked in research and clinical practice.

摘要

虽然有证据表明,与普通人群相比,边缘智力功能(BIF)人群中心理健康问题更为普遍,但尚不清楚这种情况随时间变化的程度以及获得服务的情况是否发生了变化。本文比较了该人群与普通人群中精神障碍的患病率,并监测了治疗和服务的趋势。我们对2000年、2007年和2014年在英格兰进行的成人精神病患病率调查进行了二次分析。分析的总样本包括21796名参与者,其中12.8%的个体被确定为边缘智力功能(n = 2786)。使用回归模型来研究三个数据集中精神障碍、治疗和服务使用的趋势。与普通人群相比,边缘智力功能人群患情绪和焦虑障碍、精神病、药物依赖和自杀行为的几率显著更高,且在随后的每个时间点都在增加。他们接受的药物治疗比普通人群显著更多,但随着时间的推移,他们获得全科医生、社区护理和日托服务的机会越来越多。这项研究表明边缘智力功能人群中几种精神障碍的患病率在上升。随着时间的推移,该群体获得日托、社区护理和医疗服务的机会有所增加,但获得正规精神病护理的机会没有增加。这些随时间的变化突显了该人群面临的一些问题,强调需要认识到这是一个在研究和临床实践中经常被忽视的人群。

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