在108,457名患有抑郁症的阿富汗和伊拉克退伍军人中,心理健康治疗利用模式
Vanessa Panaite1, Nathan J Cohen2, Stephen L Luther1
1Research and Development Service, James A. Haley Veterans' Hospital.
Psychological services
|February 1, 2024
概括
许多患有抑郁症的退伍军人没有充分利用心理健康护理. 识别有风险的患者对于改善抑郁症治疗准入和治疗结果至关重要.
科学领域:
- 心理健康服务研究 心理健康服务研究
- 临床信息学 临床信息学
- 卫生服务管理卫生服务管理
背景情况:
- 抑郁症是一种普遍的疾病,通常与心理健康服务的不足使用有关.
- 识别患有使用护理不足风险的患者对于开发有针对性的干预措施至关重要.
- 临床决策支持工具可以帮助积极识别护理缺口.
研究的目的:
- 描述美国退伍军人中抑郁症治疗利用模式.
- 确定与使用不足和早期终止抑郁症治疗相关的因素.
- 评估模型的预测准确性,以识别患有使用护理不足风险的患者.
主要方法:
- 追溯对108,457名在2001年至2021年期间被诊断患有抑郁症的美国退伍军人的队列分析.
- 被定义为使用不足,即少于四次心理治疗或少于84天的抗抑郁药.
- 利用后勤回归和机器学习模型来识别预测因素并评估预测精度 (AUC).
主要成果:
- 超过五分之一 (21.6%) 的退伍军人接受的抑郁症护理低于最低推水平.
- 低利用率与缺乏退伍军人管理局福利,男性性别,少数群体地位和先前的心理健康治疗有关.
- 创伤后应激障碍的并发症与治疗利用率的增加有关.
- 预测模型在识别利用不足方面显示了适度的准确性 (AUC = 0.595).
结论:
- 很大一部分退伍军人没有充分利用抑郁症治疗.
- 目前基于人口统计和临床数据的模型在预测不足利用的准确性有限.
- 未来的预测工具需要整合标准医疗记录之外的额外临床信息.
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