Ethnic inequities in multimorbidity among people with psychosis: a retrospective cohort study.
Ethnic inequities in multimorbidity among people with psychosis: a retrospective cohort study.
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精神病患者多种疾病并存的种族不平等：一项回顾性队列研究
DOI：
10.1017/s2045796022000385
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发表时间：
2022-07-18
影响因子：
8.1
通讯作者：
Bhui, K.
中科院分区：
文献类型：
--
作者：
de Freitas, D. Fonseca;Pritchard, M.;Shetty, H.;Khondoker, M.;Nazroo, J.;Hayes, R. D.;Bhui, K.
研究表明，在心理健康经历和结果方面持续存在种族不平等，少数民族群体的疾病发病率较高。患有精神病的人有多种长期疾病（MLTC;多发性硬化症）的风险增加。然而，关于精神病患者多发病中种族不平等的研究有限。本研究调查了一组精神病患者在身体健康方面的种族不平等。在这项回顾性队列研究中，使用临床记录交互式搜索（CRIS）系统，我们确定了南伦敦和莫兹利NHS信托的服务用户与精神分裂症谱系障碍，然后额外诊断为糖尿病，高血压，低血压，超重或肥胖和类风湿性关节炎。Logistic和多项Logistic回归分别用于调查多发病（精神病加一种身体健康状况）和多发病严重程度（有一种或两种身体健康状况，或三种或更多种状况）与无其他健康状况（无多发病）的种族不平等。回归模型调整了年龄和护理时间，并调查了性别和地区一级剥夺的影响。在20800名13-65岁精神病服务使用者的样本中，观察到多发病几率的种族差异。控制社会人口因素和护理持续时间，与白色英国人相比，非洲黑人的多重死亡几率更高[调整后的比值比= 1.41，95%置信区间（1.23-1.56）]、加勒比黑人[aOR = 1.79，95% CI（1.58-2.03）]和英国黑人[aOR = 1.64，95% CI（1.49-1.81）]种族。在中国人[aOR = 0.61，95%CI（0.43-0.88）]和其他种族[aOR = 0.67，95%CI（0.59-0.76）]背景的人群中观察到比值降低。对于任何黑人背景的人，也观察到严重的多发病（三种或更多种身体健康状况）的几率增加。在精神病患者中观察到多发病的种族不平等。需要进一步研究，以了解这些不平等的原因和影响。这些研究结果支持提供综合保健干预措施和公共卫生预防政策和行动。
Research shows persistent ethnic inequities in mental health experiences and outcomes, with a higher incidence of illnesses among minoritised ethnic groups. People with psychosis have an increased risk of multiple long-term conditions (MLTC; multimorbidity). However, there is limited research regarding ethnic inequities in multimorbidity in people with psychosis. This study investigates ethnic inequities in physical health multimorbidity in a cohort of people with psychosis. In this retrospective cohort study, using the Clinical Records Interactive Search (CRIS) system, we identified service-users of the South London and Maudsley NHS Trust with a schizophrenia spectrum disorder, and then additional diagnoses of diabetes, hypertension, low blood pressure, overweight or obesity and rheumatoid arthritis. Logistic and multinomial logistic regressions were used to investigate ethnic inequities in odds of multimorbidity (psychosis plus one physical health condition), and multimorbidity severity (having one or two physical health conditions, or three or more conditions), compared with no additional health conditions (no multimorbidity), respectively. The regression models adjusted for age and duration of care and investigated the influence of gender and area-level deprivation. On a sample of 20 800 service-users with psychosis, aged 13–65, ethnic differences were observed in the odds for multimorbidity. Controlling for sociodemographic factors and duration of care, compared to White British people, higher odds of multimorbidity were found for people of Black African [adjusted Odds Ratio = 1.41, 95% Confidence Intervals (1.23–1.56)], Black Caribbean [aOR = 1.79, 95% CI (1.58–2.03)] and Black British [aOR = 1.64, 95% CI (1.49–1.81)] ethnicity. Reduced odds were observed among people of Chinese [aOR = 0.61, 95% CI (0.43–0.88)] and Other ethnic [aOR = 0.67, 95% CI (0.59–0.76)] backgrounds. Increased odds of severe multimorbidity (three or more physical health conditions) were also observed for people of any Black background. Ethnic inequities are observed for multimorbidity among people with psychosis. Further research is needed to understand the aetiology and impact of these inequities. These findings support the provision of integrated health care interventions and public health preventive policies and actions.