Sex Differences in Mental Health and Substance Use Disorders and Treatment Entry Among Justice-involved Veterans in the Veterans Health Administration
Sex Differences in Mental Health and Substance Use Disorders and Treatment Entry Among Justice-involved Veterans in the Veterans Health Administration
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DOI：
10.1097/mlr.0000000000000271
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发表时间：
2015-04-01
期刊：
影响因子：
3
通讯作者：
Frayne, Susan
中科院分区：
文献类型：
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作者：
Finlay, Andrea K.;Binswanger, Ingrid A.;Frayne, Susan
背景：刑事司法系统中超过一半的退伍军人患有精神健康或药物使用障碍。然而，有一个严重缺乏的信息，女性退伍军人在刑事司法系统，以及如何诊断患病率和治疗进入不同的sex.Objectives：记录患病率的心理健康和物质使用障碍的诊断和治疗进入率的女性退伍军人相比，男性退伍军人在司法系统。研究设计：回顾性队列研究，使用2010- 2012财政年度退伍军人司法外展专家看到的退伍军人的国家退伍军人健康管理局临床/管理数据。共有1 535名女性和30 478名男性退伍军人被纳入。（例如，性别、年龄、居住地、无家可归状况）、精神健康障碍（如抑郁症、创伤后应激障碍）、物质使用障碍（例如，酒精和阿片类药物使用障碍）和治疗入组结果：在女性退伍军人中，精神健康和物质使用障碍的患病率分别为88%和58%，而男性退伍军人分别为76%和72%。与男性相比，女性被诊断为精神健康障碍的几率更高[调整后的比值比（AOR）= 1.98; 95%置信区间（CI），1.68-2.34]，被诊断为物质使用障碍的几率更低（AOR = 0.50; 95% CI，0.45-0.56）。女性进入精神健康住院治疗的几率较低（AOR = 0.69; 95%CI，0.57-0.83）。结论：参与司法系统的女性退伍军人有很高的心理健康障碍负担（88%），一半以上有物质使用障碍（58%）。妇女接受精神健康住院治疗是一项重要的质量改进目标。
Background: Over half of veterans in the criminal justice system have mental health or substance use disorders. However, there is a critical lack of information about female veterans in the criminal justice system and how diagnosis prevalence and treatment entry differ by sex.Objectives: To document prevalence of mental health and substance use disorder diagnoses and treatment entry rates among female veterans compared with male veterans in the justice system.Research Design: Retrospective cohort study using national Veterans Health Administration clinical/administrative data from veterans seen by Veterans Justice Outreach Specialists in fiscal years 2010-2012.Subjects: A total of 1535 females and 30,478 male veterans were included.Measures: Demographic characteristics (eg, sex, age, residence, homeless status), mental health disorders (eg, depression, posttraumatic stress disorder), substance use disorders (eg, alcohol and opioid use disorders), and treatment entry (eg, outpatient, residential, pharmacotherapy).Results: Among female veterans, prevalence of mental health and substance use disorders was 88% and 58%, respectively, compared with 76% and 72% among male veterans. Women had higher odds of being diagnosed with a mental health disorder [adjusted odds ratio (AOR) = 1.98; 95% confidence interval (CI), 1.68-2.34] and lower odds of being diagnosed with a substance use disorder (AOR = 0.50; 95% CI, 0.45-0.56) compared with men. Women had lower odds of entering mental health residential treatment (AOR = 0.69; 95% CI, 0.57-0.83).Conclusions: Female veterans involved in the justice system have a high burden of mental health disorders (88%) and more than half have substance use disorders (58%). Entry to mental health residential treatment for women is an important quality improvement target.