在被诊断患有创伤后应激障碍的自杀风险分层退伍军人中评估基于证据的心理治疗利用模式
Maxwell Levis1,2, Monica Dimambro1, Joshua Levy3
1Mental Health, VAMC White River Junction, White River Junction, Vermont, USA.
Clinical psychology & psychotherapy
|January 27, 2025
概括
基于证据的心理治疗 (EBP) 在自杀死亡的PTSD的美国退伍军人中使用率很低. 幸存下来的对照组接受了更多的EBP会议,这表明对高风险个体的护理存在差距.
科学领域:
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 创伤后应激障碍 (PTSD) 在美国退伍军人中显著增加了自杀风险.
- 美国退伍军人事务部 (VA) 建议基于证据的心理治疗 (EBP) 用于PTSD治疗.
- 了解与自杀风险相关的心理治疗利用模式对于有针对性的干预至关重要.
研究的目的:
- 评估VA患者中非差异化心理治疗与EBP的利用率,这些患者被诊断患有自杀导致死亡的PTSD.
- 为了比较因自杀而死亡的患者 (病例) 和仍然活着的匹配对照之间的EBP利用率.
- 分析自杀风险水平如何影响接受非差异化心理治疗和EBP.
主要方法:
- 分析了被诊断患有PTSD,死于自杀的VA患者的国家样本 (病例) 和匹配的活体对照.
- 患者根据诊断,人口统计和自杀风险 (高,中等,低) 进行了匹配.
- 追踪了在死亡前一年/研究间隔期间使用心理治疗,包括非差异化和EBP会话.
主要成果:
- 基于证据的心理治疗 (EBP) 的利用率在自杀 (案例) 死亡的患者中显著较低.
- 与匹配的病例相比,中度和低风险对照的比例更高,获得了EBP.
- 控制组在风险级别中接受的EBP会话比匹配案例对手更多.
结论:
- 尽管有VA的举措,但EBP的吸收仍然有限,特别是在高自杀风险的PTSD患者中.
- 自杀死亡的患者和幸存者之间在EBP利用方面存在显著的差异.
- 进一步的研究是必不可少的,以识别和解决障碍,EBP交付给这个弱势群体的障碍.
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