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全国家庭样本中 COVID-19 期间自我报告的心理健康治疗中断情况的差异:功能损害严重程度的影响。

Differences in self-reported disruptions in mental health treatment during COVID-19 in a national household sample: impact of severity of functional impairment.

作者信息

Wang Margaret, Graupensperger Scott, Olfson Mark, Bareis Natalie, Edlund Mark, Monroe-DeVita Maria, Kessler Ronald, Tennison Mackenzie, Winans Katherine, Chwastiak Lydia

机构信息

University of Washington.

Columbia University.

出版信息

Res Sq. 2024 Jul 29:rs.3.rs-4676128. doi: 10.21203/rs.3.rs-4676128/v1.

Abstract

OBJECTIVE

This report uses data from Mental Disorders Prevalence Study (MDPS), a large epidemiologic study that provided national prevalence estimates of seven mental disorders based on the Structured Clinical Interview for DSM-5 (SCID), to assess the odds of treatment disruption during COVID for SMI and non-SMI groups.

METHODS

This cross-sectional study conducted from 2020 to 2022 included 2,810 household participants with any lifetime mental health treatment. Weighted logistic regressions estimated the odds of reporting disruptions in access to mental health care or psychotropic prescriptions due to COVID. SMI was broadly defined as having an MDP diagnosis and serious functional impairment (GAF ≤50, a validated and widely used cutoff). Non-SMI groups were a mental diagnosis without serious impairment (MDPS diagnosis, GAF >50) and any lifetime treatment and no serious impairment (no MDPS diagnosis, GAF >50).

RESULTS

The SMI and mental disorder without serious impairment groups had approximately 6.4- and 2.4-greater odds, respectively, of reporting inability to access mental health care and 4- and 3- greater odds, respectively, of having prescriptions delayed, relative to the group with any lifetime treatment. Among those with serious mental illness, having Medicare insurance increased the odds of reporting inability to access mental health care.

CONCLUSIONS

Individuals with SMI were much more likely to experience treatment disruptions throughout the pandemic than non-SMI groups.

摘要

目的

本报告使用精神障碍患病率研究(MDPS)的数据,这是一项大型流行病学研究,基于《精神疾病诊断与统计手册》第5版(DSM-5)的结构化临床访谈提供了七种精神障碍的全国患病率估计,以评估COVID期间严重精神疾病(SMI)组和非SMI组治疗中断的几率。

方法

这项于2020年至2022年进行的横断面研究纳入了2810名有过任何精神健康治疗经历的家庭参与者。加权逻辑回归估计了因COVID导致心理健康护理或精神药物处方获取中断的报告几率。SMI被广泛定义为患有精神障碍诊断且有严重功能损害(总体功能评估量表[GAF]≤50,这是一个经过验证且广泛使用的临界值)。非SMI组包括有精神诊断但无严重损害(MDPS诊断,GAF>50)且有过任何治疗经历以及无严重损害(无MDPS诊断,GAF>50)的情况。

结果

与有过任何治疗经历的组相比,SMI组和无严重损害的精神障碍组报告无法获得心理健康护理的几率分别高出约6.4倍和2.4倍,处方延迟的几率分别高出4倍和3倍。在患有严重精神疾病的人群中,拥有医疗保险会增加报告无法获得心理健康护理的几率。

结论

在整个疫情期间,患有SMI的个体比非SMI组更有可能经历治疗中断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4d0/11326395/1b8f615e6bcb/nihpp-rs4676128v1-f0001.jpg

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