Department of Psychological Medicine, King's College London, London, UK
Department of Psychological Medicine, King's College London, London, UK.
BMJ Open. 2022 Jul 15;12(7):e059257. doi: 10.1136/bmjopen-2021-059257.
Explore inequalities in risk factors, mental and physical health morbidity in non-pregnant women of reproductive age in contact with mental health services and how these vary per ethnicity.
Retrospective cohort study.
Data from Lambeth DataNet, anonymised primary care records of this ethnically diverse London borough, linked to anonymised electronic mental health records ('CRIS secondary care database').
Women aged 15-40 years with an episode of secondary mental health care between January 2008 and December 2018 and no antenatal or postnatal Read codes (n=3817) and a 4:1 age-matched comparison cohort (n=14 532).
Preconception risk factors including low/high body mass index, smoking, alcohol, substance misuse, micronutrient deficiencies and physical diagnoses.
Women in contact with mental health services (whether with or without severe mental illness (SMI)) had a higher prevalence of all risk factors and physical health diagnoses studied. Women from minority ethnic groups were less likely to be diagnosed with depression in primary care compared with white British women (adjusted OR 0.66 (0.55-0.79) p<0.001), and black women were more likely to have a SMI (adjusted OR 2.79 (2.13-3.64) p<0.001). Black and Asian women were less likely to smoke or misuse substances and more likely to be vitamin D deficient. Black women were significantly more likely to be overweight (adjusted OR 3.47 (3.00-4.01) p<0.001), be diagnosed with hypertension (adjusted OR 3.95 (2.67-5.85) p<0.00) and have two or more physical health conditions (adj OR 1.94 (1.41-2.68) p<0.001) than white British women.
Our results challenge the perspective that regular monitoring of physical health in primary care should be exclusively encouraged in people with a l diagnosis. The striking differences in multimorbidity for women in contact with mental health services and those of ethnic minority groups emphasise a need of integrative models of care.
探讨接触精神卫生服务的育龄非孕妇在风险因素、精神和身体健康发病率方面的不平等现象，以及这些不平等现象在不同种族之间的差异。
回顾性队列研究。
伦巴第 DataNet 数据，这是一个种族多样化的伦敦自治市的匿名初级保健记录，与匿名电子精神健康记录（“CRIS 二级保健数据库”）相关联。
2008 年 1 月至 2018 年 12 月期间有二级精神保健治疗记录且无产前或产后 Read 代码的 15-40 岁女性（n=3817）和 4：1 年龄匹配的对照组（n=14532）。
包括低/高体重指数、吸烟、饮酒、药物滥用、微量营养素缺乏和身体诊断在内的孕前风险因素。
接触精神卫生服务的女性（无论是否患有严重精神疾病（SMI）），所有研究的风险因素和身体健康诊断的患病率均较高。少数族裔群体的女性在初级保健中被诊断为抑郁症的可能性低于英国白人女性（调整后的比值比 0.66（0.55-0.79），p<0.001），而黑人女性更有可能患有 SMI（调整后的比值比 2.79（2.13-3.64），p<0.001）。黑人女性和亚裔女性吸烟或药物滥用的可能性较小，而维生素 D 缺乏的可能性较大。黑人女性超重的可能性明显更高（调整后的比值比 3.47（3.00-4.01），p<0.001），被诊断为高血压的可能性更高（调整后的比值比 3.95（2.67-5.85），p<0.001），且患有两种或更多种身体疾病的可能性更高（调整后的比值比 1.94（1.41-2.68），p<0.001），而英国白人女性。
我们的结果挑战了这样一种观点，即在初级保健中，仅鼓励对诊断出的患者进行身体健康的常规监测。接触精神卫生服务的女性和少数民族群体之间在多种疾病方面的显著差异强调了需要整合护理模式。
