Correlates of Concurrent Morbid Obesity and Tobacco Use Disorder Nationally in the Veterans Health Administration.
Correlates of Concurrent Morbid Obesity and Tobacco Use Disorder Nationally in the Veterans Health Administration.
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DOI：
10.1080/15504263.2020.1808749
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发表时间：
2020-10
影响因子：
2.2
通讯作者：
Rosenheck RA
中科院分区：
文献类型：
--
作者：
Roberts W;Rosenheck RA
研究多病TUD和病态肥胖的退伍军人与单独患有任一疾病的退伍军人相比的健康、人口统计学和服务利用特征。健康记录数据提取自退伍军人健康管理局的计算机化患者记录系统（VHA; 2011年10月1日至2012年9月30日）。使用双变量和多变量logistic回归模型比较TUD和病态肥胖（体重指数[BMI] ≥ 40）的退伍军人与单独患有每种疾病的退伍军人在一系列人口统计学，健康和服务利用结果变量上的差异，这些变量也从VHA管理记录中提取。同时患有病态肥胖和TUD的退伍军人比单独患有任何一种疾病的退伍军人显示出更高的医疗和精神共病率。然而，虽然患有烟草使用障碍（TUD）和病态肥胖的退伍军人的共病物质使用障碍（SUD）率高于仅患有病态肥胖的退伍军人，但患有这两种疾病的退伍军人的SUD率明显低于仅患有TUD的退伍军人。退伍军人与共同发生的病态肥胖和TUD似乎是在更大的风险，医疗疾病和精神状况。意外的发现，退伍军人与TUD单独有更多的并发SUDs比退伍军人与TUD和病态肥胖表明，暴饮暴食可能是一种替代物质使用的情况下，TUD。这里描述的多形态特征可能表明TUD和病态肥胖患者的独特治疗需求。
To examine health, demographic, and service utilization characteristics of veterans with multimorbid TUD and morbid obesity compared to those with either condition alone. Health record data were extracted from the Computerized Patient Record System of the Veteran Health Administration (VHA; October 1, 2011 to September 30, 2012). Bivariate and multivariate logistic regression models were used to compare veterans with both TUD and morbid obesity (body mass index [BMI] ≥ 40) to veterans with each condition alone on a range of demographic, health, and service utilization outcome variables that also were extracted from the VHA administrative record. Veterans with both morbid obesity and TUD showed higher rates of medical and psychiatric comorbidity than did veterans with either condition alone. However, while veterans with tobacco use disorder (TUD) and morbid obesity showed higher rates of comorbid substance use disorders (SUD) than veterans with morbid obesity alone, veterans with both conditions showed substantially lower rates of SUD than those with TUD alone. Veterans with co-occurring morbid obesity and TUD appear to be at greater risk for medical disease and psychiatric conditions. The unexpected finding that veterans with TUD alone had more concurrent SUDs than veterans with both TUD and morbid obesity suggest the possibility that overeating may be a substitute for substance use in the context of TUD. The multimorbidity profile described here may suggest unique treatment needs for individuals with both TUD and morbid obesity.
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