社会脆弱性和心理健康和物质使用障碍的流行和治疗
Robert D Gibbons1,2,3, Mark Olfson4, Loren Saulsberry2
1Department of Medicine, Division of Biological Sciences, University of Chicago, Chicago, Illinois.
JAMA psychiatry
|July 24, 2024
概括
社会脆弱性与精神分裂症谱系障碍,阿片类药物使用障碍和兴奋剂使用障碍有关. 较高的社会脆弱性与较少的心理健康和物质使用障碍治疗有关,这表明需要综合护理模式.
科学领域:
- 公共卫生 公共卫生
- 心理健康研究 心理健康研究
- 社会学 社会学 社会学
背景情况:
- 在社区层面,社会脆弱性 (SV) 被认为与身体健康结果和死亡率有关.
- 在SV和精神健康 (MH) 障碍和物质使用障碍 (SUDs) 之间的关系需要进一步调查.
研究的目的:
- 在美国成年人的全国样本中检查SV与MH疾病,SUD和其治疗的临床诊断之间的关联.
- 确定SV是否影响诊断出MH疾病和SUDs的接受治疗的可能性.
主要方法:
- 在2020年10月至2022年10月期间,对4674名18岁及以上的美国成年人进行了一项全国性家庭调查.
- 在邮政编码层面使用社会脆弱性指标 (SVM) 和区域贫困指数 (ADI) 来评估社会脆弱性.
- 用DSM-5的结构化临床访谈以及自我报告的治疗数据来确定过去一年的MH疾病和SUDs的诊断.
主要成果:
- 较高的SV与精神分裂症谱系障碍 (SSD),阿片类药物使用障碍 (OUD),兴奋剂使用障碍和双相I型障碍的几率增加显著相关.
- SV也与创伤后应激障碍和任何MH障碍诊断有关,但不是主要抑郁症或泛性焦虑症.
- 在SSD,OUD或兴奋剂使用障碍患者中,较高的SV与减少MH和SUD治疗参与有关.
结论:
- 社会脆弱性是特定严重的精神健康和物质使用障碍的重要因素,包括SSD,OUD和兴奋剂使用障碍.
- 与之前的一些研究不同,SV和通用焦虑症或严重抑郁症之间没有发现任何关联.
- 调查结果表明,社会脆弱性指标可以帮助开发精神健康和物质使用障碍的综合护理模型,解决治疗机会的差异.
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