Applications of the epidemiological modelling outputs for targeted mental health planning in conflict-affected populations: the Syria case-study.
Applications of the epidemiological modelling outputs for targeted mental health planning in conflict-affected populations: the Syria case-study.
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DOI：
10.1017/gmh.2016.4
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Whiteford H
中科院分区：
文献类型：
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作者：
Charlson FJ;Lee YY;Diminic S;Whiteford H
流行病学模型经常被用来确定人群中的疾病流行情况；然而，这些估计可以有更广泛的实际应用，为有针对性地扩大和优化精神卫生服务提供信息。我们探索对受冲突影响的叙利亚人口的潜在应用。我们使用受冲突影响人群中重度抑郁症和创伤后应激障碍（PTSD）的患病率估计作为后续估计的输入。我们使用全球疾病负担 (GBD) 方法来估算叙利亚人口中因抑郁症和创伤后应激障碍 (PTSD) 导致的残疾寿命 (YLD)。使用世界卫生组织 mhGAP 成本计算工具对叙利亚 15 年内扩大针对 PTSD 和抑郁症的推荐护理方案的人力资源 (HR) 需求进行了建模。使用健康效益分析估计相关的可避免负担。叙利亚的创伤后应激障碍 (PTSD) 病例总数估计约为 220 万例，抑郁症病例总数约为 110 万例。据估计，每 1000 名叙利亚人口的年龄标准化重度抑郁率为 13.4（95% UI 9.8–17.5）YLD，而 GBD 2010 年全球年龄标准化 YLD 率为 9.2（95% UI 7.0–11.8）。使用 mhGAP 成本核算工具支持叙利亚线性扩展服务的人力资源需求表明，扩展后，从基线的每 10 万人口 0.3 个 FTE 稳步增加到 7.6 个 FTE。 15 年的线性扩展可以避免 7-9% 的疾病负担。精神障碍的流行病学估计是确定疾病负担和指导最佳精神卫生服务提供的关键投入，可用于目标人群，例如受冲突影响的人群。
Epidemiological models are frequently utilised to ascertain disease prevalence in a population; however, these estimates can have wider practical applications for informing targeted scale-up and optimisation of mental health services. We explore potential applications for a conflict-affected population, Syria. We use prevalence estimates of major depression and post-traumatic stress disorder (PTSD) in conflict-affected populations as inputs for subsequent estimations. We use Global Burden of Disease (GBD) methodology to estimate years lived with a disability (YLDs) for depression and PTSD in Syrian populations. Human resource (HR) requirements to scale-up recommended packages of care for PTSD and depression in Syria over a 15-year period were modelled using the World Health Organisation mhGAP costing tool. Associated avertable burden was estimated using health benefit analyses. The total number of cases of PTSD in Syria was estimated at approximately 2.2 million, and approximately 1.1 million for depression. An age-standardised major depression rate of 13.4 (95% UI 9.8–17.5) YLDs per 1000 Syrian population is estimated compared with the GBD 2010 global age-standardised YLD rate of 9.2 (95% UI 7.0–11.8). HR requirements to support a linear scale-up of services in Syria using the mhGAP costing tool demonstrates a steady increase from 0.3 FTE in at baseline to 7.6 FTE per 100 000 population after scale-up. Linear scale-up over 15 years could see 7–9% of disease burden being averted. Epidemiological estimates of mental disorders are key inputs into determining disease burden and guiding optimal mental health service delivery and can be used in target populations such as conflict-affected populations.