Unmet mental health care need 10-11 years after the 9/11 terrorist attacks: 2011-2012 results from the World Trade Center Health Registry.
Unmet mental health care need 10-11 years after the 9/11 terrorist attacks: 2011-2012 results from the World Trade Center Health Registry.
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DOI：
10.1186/1471-2458-14-491
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发表时间：
2014-05-22
影响因子：
4.5
通讯作者：
Cone JE
中科院分区：
文献类型：
--
作者：
Ghuman SJ;Brackbill RM;Stellman SD;Farfel MR;Cone JE
目前关于未满足的精神卫生保健需求（UMHCN）及其原因的信息很少，这些信息暴露于世界贸易中心（WTC）恐怖袭击事件中。本研究的目的是评估2011-2012年在WTC健康登记处（WTCHR）登记的有症状个体的UMHCN水平，并分析由于态度，成本和访问因素与精神健康症状严重程度，精神卫生保健利用，健康保险可用性和社会支持之间的关系。WTTRUNK是一项前瞻性队列研究，研究对象是报告暴露于2001年世贸中心袭击的个人。这项研究使用了9，803名成年人的数据，他们完成了2003-2004年（第1波）和2011-2012年（第3波）的调查，并在2011-2012年患有创伤后应激障碍（PTSD）或抑郁症。我们估计了logistic回归模型相关的感知态度，成本和访问障碍的症状严重程度，卫生保健利用，缺乏健康保险，社会支持调整后的社会人口特征。略多于三分之一（34.2%）的研究参与者报告了UMMCN。由于态度和感知成本和访问的原因，症状的严重程度是UMMCN的一个强有力的预测因素。UMHCN的态度在那些不使用精神卫生服务的人中很常见，特别是那些心理健康症状相对严重的人。与成本相关的UMHCN与缺乏健康保险而不是服务使用显著相关。与心理健康相关的障碍在那些没有使用任何心理健康服务的人中更为常见。更高水平的社会支持是对费用和获得UMMCN的重要缓冲。10年后，暴露于WTC袭击的抑郁症或PTSD患者中有很大一部分人报告了UMMCN，而患有更严重和致残疾病的人，缺乏健康保险的人以及社会支持水平低的人尤其脆弱。
There is little current information about the unmet mental health care need (UMHCN) and reasons for it among those exposed to the World Trade Center (WTC) terrorist attacks. The purpose of this study was to assess the level of UMHCN among symptomatic individuals enrolled in the WTC Health Registry (WTCHR) in 2011–2012, and to analyze the relationship between UMHCN due to attitudinal, cost, and access factors and mental health symptom severity, mental health care utilization, health insurance availability, and social support. The WTCHR is a prospective cohort study of individuals with reported exposure to the 2001 WTC attacks. This study used data from 9,803 adults who completed the 2003–2004 (Wave 1) and 2011–2012 (Wave 3) surveys and had posttraumatic stress disorder (PTSD) or depression in 2011–2012. We estimated logistic regression models relating perceived attitudinal, cost and access barriers to symptom severity, health care utilization, a lack of health insurance, and social support after adjusting for sociodemographic characteristics. Slightly more than one-third (34.2%) of study participants reported an UMHCN. Symptom severity was a strong predictor of UMHCN due to attitudinal and perceived cost and access reasons. Attitudinal UMHCN was common among those not using mental health services, particularly those with relatively severe mental health symptoms. Cost-related UMHCN was significantly associated with a lack of health insurance but not service usage. Access-related barriers were significantly more common among those who did not use any mental health services. A higher level of social support served as an important buffer against cost and access UMHCN. A significant proportion of individuals exposed to the WTC attacks with depression or PTSD 10 years later reported an UMHCN, and individuals with more severe and disabling conditions, those who lacked health insurance, and those with low levels of social support were particularly vulnerable.
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影响因子：
3.3
作者：
DiGrande, Laura;Perrin, Megan A.;Brackbill, Robert M.
通讯作者：
Brackbill, Robert M.
影响因子：
7
作者：
Kroenke, Kurt;Spitzer, Robert L.;Loewe, Bernd
通讯作者：
Loewe, Bernd
影响因子：
3.3
作者：
Chiu, Sydney;Niles, Justin K.;Prezant, David J.
通讯作者：
Prezant, David J.
影响因子：
3.8
作者：
Mojtabai, Ramin
通讯作者：
Mojtabai, Ramin
DOI：
10.1177/070674370505001011
发表时间：
2005-09-01
影响因子：
4
作者：
Sareen, Jitender;Cox, Brian J.;Yu, Bo Nancy
通讯作者：
Yu, Bo Nancy