部署後の精神障害のスクリーニングと,英国の軍隊で助けを求めるための調整された助言:クラスターランダム化制御試験
Roberto J Rona1, Howard Burdett1, Mizanur Khondoker2
1King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK.
Lancet (London, England)
|February 21, 2017
まとめ
部署後の精神障害のスクリーニングは,軍人の罹患率を低下させたり,助けを求める傾向を増加させなかった. これらの発見は,現在の精神疾患のスクリーニングプログラムを再評価する必要性を示唆しています.
科学分野:
- 軍人の精神的健康
- 心理学的スクリーニング
- 公衆衛生の介入
背景:
- 精神障害の部署後のスクリーニングには,ランダム化制御試験 (RCT) の証拠がありません.
- 以前の評価では,精神的健康状態の軽減や助けを求める行動の改善の効果は評価されなかった.
研究 の 目的:
- トラウマ後ストレス障害 (PTSD),うつ病,不安,アルコール乱用に対する派遣後のスクリーニングの有効性を評価する.
- メンタルヘルスの結果と メンタルヘルスの行動に対する 一般的なアドバイスと対比して 調整された援助を求めるアドバイスの影響を評価する.
主な方法:
- アフガニスタンへの配備後,イギリス軍 (ロイヤル・マリンズと陸軍) を含むクラスターRCT.
- 階層化されたブロックのランダム化により,スクリーニングに割り当てられた部隊は,個別的な助言または一般的な助言を受けた.
- フォローアップの評価では PTSD,うつ,不安,アルコール乱用,自己報告の助けを求めることが測定されました.
主要な成果:
- 追跡調査では,スクリーニング群と対照群の間で,PTSD,うつ病,不安,またはアルコール乱用の有意な差異はなかった.
- 部署後のスクリーニングは 精神疾患の治療を求める人数を 大きく増加させなかった.
- 精神疾患を患っている人は 専門的なアドバイスを受けやすいのです
結論:
- 部署後のスクリーニングは メンタルヘルス障害の蔓延を減らすのに効果的ではなく 軍人の助けを求める傾向も増加しました
- 配備後のスクリーニングプログラムがある国は,その有効性と結果を監視すべきである.
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