School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
J Psychiatr Res. 2024 Apr;172:236-243. doi: 10.1016/j.jpsychires.2024.02.008. Epub 2024 Feb 2.
Trauma is commonly overlooked or undiagnosed in clinical care settings. Undetected trauma has been associated with elevated substance use highlighting the need to prioritize identifying individuals with undetected trauma through common characteristics.
The purpose of this study is to identify classifications of traumatic life experiences and substance use among persons admitted to inpatient psychiatry in Ontario and to identify covariates associated with classification membership.
A population-based retrospective cohort study was conducted using interRAI Mental Health (MH) assessment data. Individuals were included who experienced traumatic life events (N = 10,125), in Ontario, Canada between January 1, 2015, to December 31, 2019.
Eight latent classes were identified that ranged from low (i.e., Class 1: Interpersonal Issues, Without Substance use) to high (i.e., Class 8: Widespread Trauma, Alcohol & Cannabis Addiction) complexity patterns of traumatic life events and substance use indicators. Classifications with similar trauma profiles were differentiated by patterns of substance use. For example, individuals in Class 2: Safety & Relationship Issues, Without Substance use and Class 3: Safety & Relationship Issues, Alcohol & Cannabis both had many estimates centered around the experience of victimization (e.g., victim of sexual assault, victim of physical assault, victim of emotional abuse). Multinomial logistic regression models highlighted additional factors associated with classifications such as homelessness, where those who were homeless were 2.09-4.02 times more likely to be in Class 6: Widespread Trauma & Substance Addiction.
Trauma exposures are complex and varied among persons in inpatient psychiatry and can be further differentiated by substance use patterns. These findings provide a population-based estimate of the trauma experiences of persons in inpatient settings in Ontario, Canada. Findings demonstrate the importance of using comprehensive assessment to support clinical decision making in relation to trauma and substance.
创伤在临床护理环境中经常被忽视或诊断不足。未被发现的创伤与物质使用的增加有关，这突出表明需要通过常见特征优先确定未被发现创伤的个体。
本研究旨在确定安大略省住院精神病患者创伤生活经历和物质使用的分类，并确定与分类成员资格相关的协变量。
这是一项使用跨机构研究评估计划心理健康（MH）评估数据进行的基于人群的回顾性队列研究。纳入了在加拿大安大略省 2015 年 1 月 1 日至 2019 年 12 月 31 日期间经历过创伤生活事件的个体（N=10125）。
确定了 8 个潜在类别，范围从低（即第 1 类：人际关系问题，无物质使用）到高（即第 8 类：广泛创伤，酒精和大麻成瘾）复杂的创伤生活事件和物质使用指标模式。具有相似创伤特征的分类通过物质使用模式进行区分。例如，在第 2 类：安全和人际关系问题，无物质使用和第 3 类：安全和人际关系问题，酒精和大麻中，有许多估计值集中在受害经历上（例如，性侵犯受害者，身体攻击受害者，情感虐待受害者）。多项逻辑回归模型强调了与分类相关的其他因素，例如无家可归，无家可归者成为第 6 类：广泛创伤和物质成瘾的可能性是其他人的 2.09-4.02 倍。
创伤暴露在住院精神病患者中是复杂且多样的，并且可以通过物质使用模式进一步区分。这些发现为加拿大安大略省住院环境中个体的创伤经历提供了基于人群的估计。研究结果表明，使用全面评估支持与创伤和物质相关的临床决策的重要性。
