Depression, healthcare utilization, and comorbid psychiatric disorders after spinal cord injury
Depression, healthcare utilization, and comorbid psychiatric disorders after spinal cord injury
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DOI：
10.1179/2045772313y.0000000137
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发表时间：
2014-01-01
影响因子：
1.7
通讯作者：
Weaver, Frances M.
中科院分区：
文献类型：
--
作者：
Ullrich, Philip M.;Smith, Bridget M.;Weaver, Frances M.
背景：在普通人群中，抑郁症通常与其他精神疾病共存，从而影响病情的严重程度和医疗保健的利用。目前尚不清楚脊髓损伤 (SCI) 患者的这种情况在多大程度上也是如此。 目的：本研究调查了 SCI 后精神疾病与抑郁症共存的比率，以及抑郁症诊断与医疗保健和药物使用之间的关联。方法：对 1997 财年至 2007 财年 (FY) 期间从退伍军人健康管理局行政数据库中提取的数据 (N = 41 213) 进行回顾性分析，以检查抑郁症的总体发病率。 2007 财年的行政数据用于检查与抑郁症共存的精神疾病发生率，并将患有 SCI 和抑郁症的退伍军人与患有 SCI 但没有抑郁症的退伍军人在医疗保健和药物使用方面进行比较。 结果：在 1997 财年至 2007 财年期间接受 SCI 护理的 41 213 名退伍军人中，28% (n = 11 506) 被诊断患有抑郁症。在 2007 年诊断出患有 SCI 和抑郁症的退伍军人中（n = 2615），70% 的人还被诊断出患有另一种精神疾病，其中创伤后应激障碍和其他焦虑症是最常见的。与没有抑郁症的退伍军人相比，患有 SCI 和抑郁症的退伍军人接受了更多的医疗就诊，并获得了更多的药物处方。结论：患有 SCI 和抑郁症的退伍军人可能会经历共病精神疾病，从而导致医疗就诊和药物使用的增加。 SCI 后抑郁症的研究和理论应朝着描述和解决该人群中常见的精神和医学共病的方向发展。
Background: Depression is often comorbid with other psychiatric conditions in the general population, with resultant impact on severity of conditions and healthcare utilization. It is unclear to what degree this is also true among persons with spinal cord injury (SCI).Objective: This study examined rates at which psychiatric conditions were comorbid with depression after SCI, and the association between a depression diagnosis and healthcare and pharmaceutical drug use.Methods: Retrospective analysis of data (N = 41 213) abstracted from Veterans Health Administration administrative databases between fiscal years (FYs) 1997 and 2007 to examine overall rates of depression. Administrative data from FY 2007 was used to examine rates of psychiatric disorders comorbid with depression, and to compare veterans with SCI and depression to veterans with SCI but no depression on healthcare and pharmaceutical use.Results: Twenty-eight percent (n = 11 506) of 41 213 veterans who received SCI care between FY 1997 and FY 2007 were diagnosed with depressive disorders. Among the veterans with SCI and depression diagnoses in 2007 (n = 2615), 70% were also diagnosed with another psychiatric illness, with posttraumatic stress disorder and other anxiety disorders being the most common. Veterans with SCI and depression had more healthcare visits and received more pharmaceutical prescriptions than their counterparts without depression.Conclusions: Persons with SCI and depression are likely to experience comorbid psychiatric illnesses, with associated increased healthcare visits and medication use. Research and theory on depression after SCI should develop toward describing and addressing psychiatric and medical co-morbidities that are normative in this population.