An integrative collaborative care model for people with mental illness and physical comorbidities.
An integrative collaborative care model for people with mental illness and physical comorbidities.
复制标题
DOI：
10.1186/s13033-020-00410-6
复制
发表时间：
2020-11-11
影响因子：
3.6
通讯作者：
Sarris J
中科院分区：
文献类型：
--
作者：
Ee C;Lake J;Firth J;Hargraves F;de Manincor M;Meade T;Marx W;Sarris J
许多有精神健康问题的人都有共同的身体状况，或者可能出现药物/酒精滥用或滥用问题。这导致了复杂的治疗挑战，而仅由单个临床医生使用单一干预提供的护理模式可能无法充分解决这些挑战。心理健康问题的主流药物治疗往往在完全缓解症状方面疗效有限，并可能引起不良反应。辅助性治疗方法，包括营养食品、生活方式和行为改变干预，被广泛用于协助治疗精神健康问题。然而，虽然这些药物通常更安全，副作用更少，但它们有不同程度的证据支持。在这些情况下，有必要重新调整目前的治疗方法，以建立一种更加循证的综合模式，这种模式可能更好地应对精神障碍和并存的身体状况的现实挑战。本质上，这意味着开发一种综合护理模式，该模式体现了一种循证、个性化的循序渐进的方法，通过应用协作护理方法，既使用传统的药物治疗，又使用新的辅助治疗(在适用的情况下)。为了了解这一情况，本文简要回顾了有关精神疾病常见共病模式的研究结果，随后确定了常规治疗的局限性，以及综合医学干预措施的潜在应用。然后讨论了综合精神卫生保健的优势和挑战，协作护理模式，选择综合方法的研究重点，以及对潜在的成本优势的评论。我们建议，结合循证综合医学干预的协作式护理模式可能更好地解决精神健康问题与共病的医疗条件。现在需要对这样一个模型进行强有力的研究，可能是在综合临床实践中。
Many individuals with mental health problems have comorbid physical conditions, or may present with substance/alcohol misuse or abuse issues. This results in complex treatment challenges that may not be adequately addressed by a model of care that is solely delivered by an individual clinician using a sole intervention. Mainstream pharmacotherapeutic treatment of mental health problems often have limited effectiveness in completely resolving symptoms, and may cause adverse side effects. Adjunctive treatment approaches, including nutraceuticals, lifestyle and behaviour change interventions, are widely used to assist with treatment of mental health problems. However, whilst these can be generally safer with fewer side effects, they have varying levels of evidentiary support. These circumstances warrant reframing the current treatment approach towards a more evidence-based integrative model which may better address the real-world challenges of psychiatric disorders and comorbid physical conditions. In essence, this means developing an integrative model of care which embodies an evidence-informed, personalized stepwise approach using both conventional pharmacological treatments alongside novel adjunctive treatments (where applicable) via the application of a collaborative care approach. In order to inform this position, a brief review of findings on common patterns of comorbidity in mental illness is presented, followed by identification of limitations of conventional treatments, and potential applications of integrative medicine interventions. Advantages and challenges of integrative mental health care, collaborative models of care, review of research highlights of select integrative approaches, and comment on potential cost advantages are then discussed. We propose that a collaborative care model incorporating evidence-based integrative medicine interventions may more adequately address mental health problems with comorbid medical conditions. Robust research is now required of such a model, potentially within an integrative clinical practice.
登录
查看更多内容
影响因子：
4.5
作者：
Chatterton ML;Mihalopoulos C;O'Neil A;Itsiopoulos C;Opie R;Castle D;Dash S;Brazionis L;Berk M;Jacka F
通讯作者：
Jacka F
影响因子：
4.4
作者：
Beck, Arne;Crain, A. Lauren;Whitebird, Robin
通讯作者：
Whitebird, Robin
影响因子：
10.5
作者：
Camacho, Elizabeth M.;Davies, Linda M.;Coventry, Peter
通讯作者：
Coventry, Peter
DOI：
10.1016/b978-0-444-52002-9.00033-4
发表时间：
2012-01-01
期刊：
NEUROBIOLOGY OF PSYCHIATRIC DISORDERS
影响因子：
--
作者：
Ciaramella, Antonella;Spiegel, David
通讯作者：
Spiegel, David
影响因子：
3.3
作者：
Boulos, Christa;Salameh, Pascale;Barberger-Gateau, Pascale
通讯作者：
Barberger-Gateau, Pascale