Kureshi Nelofar, Clarke David B, Feng Cindy
Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada.
Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
Inj Epidemiol. 2023 Mar 13;10(1):16. doi: 10.1186/s40621-023-00424-x.
Mental health disorders are a common sequelae of traumatic brain injury (TBI) and are associated with worse health outcomes including increased mental health care utilization. The objective of this study was to determine the association between TBI and use of mental health services in a population-based sample.
Using data from a national Canadian survey, this study evaluated the association between TBI and mental health care utilization, while adjusting for confounding variables. A log-Poisson regression model was used to estimate unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (CI).
The study sample included 158,287 TBI patients and 25,339,913 non-injured individuals. Compared with those were not injured, TBI patients reported higher proportions of chronic mental health conditions (27% vs. 12%, p < 0.001) and heavy drinking (33% vs. 24%, p = 0.005). The adjusted prevalence of mental health care utilization was 60% higher in patients with TBI than those who were not injured (PR = 1.60, 95%; CI 1.05-2.43).
This study suggests that chronic mental health conditions and heavy drinking are more common in individuals with TBI. The prevalence of mental health care utilization is 60% higher in TBI patients compared with those who are not injured after adjusting for sociodemographic factors, mental health conditions, and heavy drinking. Future longitudinal research is required to examine the temporality and direction of the association between TBI and the use of mental health services.
心理健康障碍是创伤性脑损伤(TBI)常见的后遗症,与更差的健康结果相关,包括心理健康护理利用率增加。本研究的目的是在基于人群的样本中确定TBI与心理健康服务使用之间的关联。
利用加拿大一项全国性调查的数据,本研究评估了TBI与心理健康护理利用率之间的关联,同时对混杂变量进行了调整。使用对数泊松回归模型来估计未调整和调整后的患病率比(PR)以及95%置信区间(CI)。
研究样本包括158,287名TBI患者和25,339,913名未受伤个体。与未受伤者相比,TBI患者报告的慢性心理健康状况比例更高(27%对12%,p < 0.001),酗酒比例也更高(33%对24%,p = 0.005)。调整后,TBI患者心理健康护理利用率的患病率比未受伤者高60%(PR = 1.60,95% CI 1.05 - 2.43)。
本研究表明,慢性心理健康状况和酗酒在TBI患者中更为常见。在调整社会人口统计学因素、心理健康状况和酗酒因素后,TBI患者心理健康护理利用率的患病率比未受伤者高6%。未来需要进行纵向研究,以检验TBI与心理健康服务使用之间关联的时间顺序和方向。