在21个国家有效治疗精神和物质使用障碍
Daniel V Vigo1,2,3, Dan J Stein4,5, Meredith G Harris6,7
1Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
JAMA psychiatry
|February 5, 2025
概括
在全球范围内,只有6.9%的精神和物质使用障碍患者接受了有效治疗. 关键障碍包括对护理需求的低感知和治疗接触不足,突出需要改善心理健康服务的获取和质量.
科学领域:
- 全球心理健康全球心理健康
- 精神疾病的流行病学 精神疾病的流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 对精神和物质使用障碍的有效治疗对于改善患者的治疗结果和评估医疗保健计划至关重要.
- 需要对治疗有效性的基线数据来评估精神卫生保健的质量改进努力.
研究的目的:
- 确定在多个国家接受指南一致治疗的精神和物质使用障碍患者的比例.
- 在个人和国家层面确定有效心理健康护理的障碍.
主要方法:
- 使用来自21个国家的世界心理健康 (WMH) 调查 (2001-2019) 进行的横截面研究.
- 使用复合国际诊断面试对9个DSM-IV疾病的12个月流行和治疗的评估.
- 使用交叉表格和多级回归模型来分析预测因素,估计有效治疗效果.
主要成果:
- 只有6.9%的12个月的人格障碍得到有效治疗.
- 主要障碍包括低感知需求 (46.5%),低治疗接触 (34.1%) 和治疗不足 (47.0%).
- 国家一级的通用医疗资源比专门的心理健康资源更具影响力.
结论:
- 在全球范围内,精神和物质使用障碍的有效治疗存在重大差距.
- 解决低感知需求,提高初级保健认可,改善护理连续性和针对特定的人口统计数据至关重要.
- 弥合有效治疗差距需要采取多方面的方法,解决个人和系统因素.
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