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2017年至2020年3月大流行前期间,患有心脏代谢和抑郁症状的人群接受心理健康治疗的种族/民族差异:美国国家健康与营养检查调查

Racial/ethnic differences in mental health treatment received among people with comorbid cardiometabolic and depressive symptomology: National Health and Nutrition Examination Survey, 2017 to March 2020 Pre-Pandemic.

作者信息

Dark Tyra, Harris Rachel, Burns Desiree, Chernicky Jacob, Reid-Marks Laura, Rust George

机构信息

Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, United States of America.

College of Social Work, Florida State University, Tallahassee, Florida, United States of America.

出版信息

PLoS One. 2025 Jan 2;20(1):e0316430. doi: 10.1371/journal.pone.0316430. eCollection 2025.

Abstract

BACKGROUND

Individuals with chronic physical conditions and comorbid mental illness have increased probability of adverse health outcomes. As minority populations have limited access to both medical care and culturally appropriate mental health services, having a comorbid mental health condition can further impede their ability to manage chronic conditions and widen racial disparities in health outcomes. Further, racial/ethnic disparities in treatment patterns are likely to exacerbate disparities in adverse health outcomes.

OBJECTIVE

To identify the racial/ethnic mental health treatment patterns among individuals with cardiometabolic and depressive symptomology co-occurrence.

METHODS

This study utilized National Health and Nutrition Examination Survey data, 2017 to March 2020 Pre-Pandemic. The primary analysis was an adjusted linear logistic regression analysis of race/ethnicity, comorbidity status and mental health treatment type. Regression models were estimated to determine the likelihood of receiving counseling and medication therapy, and to determine if the likelihood is associated with race/ethnicity.

RESULTS

Primary findings indicate that depressive symptomology only was the most common designation and fewer than half of persons received any mental health treatment. Across all racial/ethnic groups, receiving no mental health treatment was the most common designation. Sixty-one percent of Non-Hispanic White persons and more than three out of four Hispanic and Non-Hispanic Black persons with only depressive symptoms received no mental health treatment. Adjusted regression analyses revealed that participants with comorbid cardiometabolic and depressive symptomology have 28% lower odds of receiving combined mental health professional and medication therapy than participants with depressive symptomology only.

CONCLUSIONS

Simultaneously treating both mental illness and cardiometabolic symptoms properly is complicated, but there may be untapped synergies in treating both concurrently. Therefore, to achieve favorable health outcomes, policy should be implemented to optimize clinical treatment by addressing aspects of both conditions in an integrated approach and may need to be culturally tailored to be effective.

摘要

背景

患有慢性身体疾病且合并精神疾病的个体出现不良健康结果的可能性增加。由于少数族裔获得医疗保健和符合文化背景的心理健康服务的机会有限,合并心理健康状况会进一步阻碍他们管理慢性病的能力,并扩大健康结果方面的种族差距。此外,治疗模式上的种族/族裔差异可能会加剧不良健康结果方面的差距。

目的

确定患有心脏代谢和抑郁症状共现的个体的种族/族裔心理健康治疗模式。

方法

本研究利用了2017年至2020年3月疫情前的国家健康和营养检查调查数据。主要分析是对种族/族裔、共病状况和心理健康治疗类型进行调整后的线性逻辑回归分析。估计回归模型以确定接受咨询和药物治疗的可能性,并确定这种可能性是否与种族/族裔相关。

结果

主要研究结果表明,仅患有抑郁症状是最常见的情况,不到一半的人接受过任何心理健康治疗。在所有种族/族裔群体中,未接受心理健康治疗是最常见的情况。仅患有抑郁症状的非西班牙裔白人中有61%以及超过四分之三的西班牙裔和非西班牙裔黑人未接受心理健康治疗。调整后的回归分析显示,患有心脏代谢和抑郁症状共病的参与者接受心理健康专业人员和药物联合治疗的几率比仅患有抑郁症状的参与者低28%。

结论

同时妥善治疗精神疾病和心脏代谢症状很复杂,但同时治疗两者可能存在尚未开发的协同作用。因此,为了实现良好的健康结果,应实施政策,通过综合解决两种疾病的各个方面来优化临床治疗,并且可能需要根据文化进行调整以提高有效性。

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