Racial Disparities in Clinical Outcomes of Veterans Affairs Residential PTSD Treatment Between Black and White Veterans
Racial Disparities in Clinical Outcomes of Veterans Affairs Residential PTSD Treatment Between Black and White Veterans
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DOI：
10.1176/appi.ps.202000783
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发表时间：
2022-02-01
影响因子：
3.8
通讯作者：
Harpaz-Rotem, Ilan
中科院分区：
文献类型：
--
作者：
Gross, Georgina M.;Smith, Noelle;Harpaz-Rotem, Ilan
目的：在卫生保健的各个领域的种族差异是一个长期存在的公共卫生问题，影响到各种临床服务和健康结果。心理健康研究表明，与白色退伍军人相比，黑人退伍军人的创伤后应激障碍（PTSD）患病率较高，一些研究表明患有PTSD的黑人退伍军人的临床结果较差。本研究的目的是研究种族差异的影响纵向在美国退伍军人事务部（VA）住宅康复治疗计划（RRT）。参与者包括2，870名在2017财政年度接受VA PTSD RRT治疗的退伍军人。退伍军人在加入该计划时提供了人口统计数据。在入院、出院和4个月随访时收集创伤后应激障碍和抑郁症状。分层线性模型用于检查整个治疗过程中和治疗后的症状变化。结果如下：与白色退伍军人相比，黑人退伍军人在治疗期间经历了减弱的PTSD症状减轻以及出院后4个月更大的抑郁症状复发。结论：这项研究增加了文献的主体，记录了与白色退伍军人相比，黑人创伤后应激障碍的治疗结果较差。虽然黑人和白色退伍军人的症状总体上有所减少，但未来的研究应侧重于了解原因，机制和潜在的解决方案，以减少心理健康治疗中的种族差异。精神病学服务2022; 73：126-132; doi：10.1176/appi.ps.202000783
Objective: Racial disparities across various domains of health care are a long-standing public health issue that affect a variety of clinical services and health outcomes. Mental health research has shown that prevalence rates of posttraumatic stress disorder (PTSD) are high for Black veterans compared with White veterans, and some studies suggest poorer clinical outcomes for Black veterans with PTSD. The aim of this study was to examine the impact of racial disparities longitudinally in the U.S. Department of Veterans Affairs (VA) residential rehabilitation treatment programs (RRTPs). Methods: Participants included 2,870 veterans treated nationally in VA PTSD RRTPs in fiscal year 2017. Veterans provided demographic data upon admission to the program. Symptoms of PTSD and depression were collected at admission, discharge, and 4-month follow-up. Hierarchical linear modeling was used to examine symptom change throughout and after treatment. Results: Black veterans experienced attenuated PTSD symptom reduction during treatment as well as greater depression symptom recurrence 4 months after discharge, relative to White veterans. Conclusions: This study adds to the body of literature that has documented poorer treatment outcomes for Black compared with White veterans with PTSD. Although both Black and White veterans had an overall reduction in symptoms, future research should focus on understanding the causes, mechanisms, and potential solutions to reduce racial disparities in mental health treatment. Psychiatric Services 2022; 73:126-132; doi: 10.1176/appi.ps.202000783