Mitigating the mental health consequences of mass shootings: An in-silico experiment.
Mitigating the mental health consequences of mass shootings: An in-silico experiment.
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DOI：
10.1016/j.eclinm.2022.101555
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发表时间：
2022-09
影响因子：
15.1
通讯作者：
Galea, Sandro
中科院分区：
文献类型：
--
作者：
Abdalla, Salma M.;Cohen, Gregory H.;Tamrakar, Shailesh;Sampson, Laura;Moreland, Angela;Kilpatrick, Dean G.;Galea, Sandro
关键词：
越来越多的证据表明，大规模枪击事件与社区层面的不良心理健康结果有关。来自其他大规模创伤事件的数据检验了常规护理（UC）（即不进行分诊的心理急救方法）和分诊的阶梯式护理（SC）方法在减轻社区创伤后应激障碍（PTSD）负担方面的有效性。我们建立了一个基于主体的模型，其中有11.8万人，在人口统计学上与美国佛罗里达州帕克兰和珊瑚泉的人口相当。我们用其他创伤事件的数据来参数化模型。通过模拟，我们估计了斯通曼道格拉斯高中（美国佛罗里达州）枪击事件后一个月的社区PTSD患病率，并报告了两年内不同的假设治疗方案（SC或UC）的潜在影响、有效性和成本效益。大规模枪击事件发生一个月后，社区PTSD患病率为11.3% （95% CI: 11.1-11.5%）。SC的覆盖率为3461 / 10000 (95% CI: 3573-3736)， UC的覆盖率为2457 / 10000 （95% CI: 2401-2510）。SC在降低PTSD患病率方面优于UC，两年后的风险差异为- 0.044 (95% CI, - 0.046至- 0.042)，风险比为0.452 （95% CI, 0.437-0.468）。SC在减少PTSD持续性方面也优于UC，两年后的风险差异为- 0.39 (95% CI, - 0.401至- 0.379)，风险比为0.452 （95% CI， 0.439至0.465）。与UC相比，SC的成本效益增量为每节省伤残调整年2718.49美元，每无创伤后应激障碍日0.47美元。该模拟显示了不同社区层面的方法在减轻大规模枪击事件后创伤后应激障碍负担方面的潜在益处。这些结果值得进一步研究以社区为基础的干预措施，以减轻大规模枪击事件对心理健康的影响。没有。
There is emerging evidence that mass shootings are associated with adverse mental health outcomes at the community level. Data from other mass-traumatic events examined the effectiveness of usual care (UC), (i.e., psychological first aid approaches without triage), and stepped care (SC) approaches, with triage, in reducing the burden of post-traumatic stress disorder (PTSD) in a community. We built an agent-based model of 118,000 people that was demographically comparable to the population of Parkland and Coral Springs, Florida, US. We parametrized the model with data from other traumatic events. Using simulations, we then estimated the community prevalence of PTSD one month following the Stoneman Douglas High School (Florida, US) shooting and reported the potential reach, effectiveness, and cost effectiveness of different what-if treatment scenarios (SC or UC) over a two-year period. One month following the mass shooting, PTSD prevalence in the community was 11.3% (95% CI: 11.1–11.5%). The reach of SC was 3461 (95% CI: 3573–3736) per 10,000 and the reach of UC was 2457 (95% CI: 2401–2510) per 10,000. SC was superior to UC in reducing PTSD prevalence, yielding, after two years, a risk difference of −0.044 (95% CI, −0.046 to −0.042) and a risk ratio of 0.452 (95% CI, 0.437–0.468). SC was also superior to UC in reducing the persistence of PTSD, yielding, after two years, a risk difference of −0.39 (95% CI, −0.401 to −0.379) and a risk ratio of 0.452 (95% CI, 0.439–0.465). The incremental cost-effectiveness of SC compared to UC was $2718.49 per DALYs saved, and $0.47 per PTSD-free day. This simulation demonstrated the potential benefits of different community-level approaches in mitigating the burden of PTSD following a mass shooting. These results warrant further research on community-based interventions to mitigate the mental health consequences of mass shootings. None.
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影响因子：
25.8
作者：
Liu H;Petukhova MV;Sampson NA;Aguilar-Gaxiola S;Alonso J;Andrade LH;Bromet EJ;de Girolamo G;Haro JM;Hinkov H;Kawakami N;Koenen KC;Kovess-Masfety V;Lee S;Medina-Mora ME;Navarro-Mateu F;O'Neill S;Piazza M;Posada-Villa J;Scott KM;Shahly V;Stein DJ;Ten Have M;Torres Y;Gureje O;Zaslavsky AM;Kessler RC;World Health Organization World Mental Health Survey Collaborators
通讯作者：
World Health Organization World Mental Health Survey Collaborators
影响因子：
5.4
作者：
Norris, Fran H.;Tracy, Melissa;Galea, Sandro
通讯作者：
Galea, Sandro
影响因子：
5
作者：
Galea, S;Vlahov, D;Kilpatrick, D
通讯作者：
Kilpatrick, D
影响因子：
2.7
作者：
Lowe, Sarah R.;Sampson, Laura;Galea, Sandro
通讯作者：
Galea, Sandro
影响因子：
6.9
作者：
Joesch, J. M.;Sherbourne, C. D.;Sullivan, G.;Stein, M. B.;Craske, M. G.;Roy-Byrne, P.
通讯作者：
Roy-Byrne, P.