Use of mental health and primary care services by caregivers of patients with bipolar disorder: a preliminary study
Use of mental health and primary care services by caregivers of patients with bipolar disorder: a preliminary study
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DOI：
10.1111/j.1399-5618.2004.00172.x
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发表时间：
2005-04-01
影响因子：
5.4
通讯作者：
Rosenheck, RA
中科院分区：
文献类型：
--
作者：
Perlick, DA;Hohenstein, JM;Rosenheck, RA
目的：照顾患有精神分裂症或痴呆症的亲属与照顾者负担、焦虑、抑郁症状、自评健康状况差和医疗服务使用率升高的报告有关；然而，关于双相情感障碍亲属的照顾者的可比性数据缺乏。本研究报告了双相情感障碍患者照顾者的健康、心理困扰和卫生服务利用的初步数据。此外，还评估了照顾者所报告的负担水平与他们对医疗服务的利用的关系，控制了心理困扰程度和健康状况。方法：受试者是264名符合研究诊断标准的双相情感障碍患者及其双相亲属的主要照顾者。在双相情感障碍患者住院或门诊入院前的7个月内，对照顾者的心理健康和初级保健服务使用情况进行了回顾性评估。结果：分层Logistic回归分析显示，即使在控制了照顾者的心理困扰和医疗条件后，照顾者的负担也显著增加了使用精神卫生服务的可能性(OR=13.53p<；0.001)，而焦虑和抑郁水平，而不是负担，显著增加了使用初级保健服务的可能性，控制了其他变量(OR=1.72p=0.02)。
Objectives: Caring for a relative with schizophrenia or dementia has been associated with reports of caregiver burden, symptoms of anxiety, depression, poor self-rated health, and elevated health service use; however, comparable data for caregivers of relatives with bipolar disorder are lacking. This study reports preliminary data on the health, psychological distress and health service use of caregivers of patients with bipolar disorder. It additionally evaluates the relationship of the level of burden caregivers report experiencing to their use of health services, controlling for level of psychological distress and health status.Methods: Subjects were primary caregivers of 264 patients with Research Diagnostic Criteria-diagnosed bipolar disorder and their bipolar relatives. Caregiver mental health and primary care service use were assessed retrospectively for the 7-month period prior to inpatient or outpatient admission of the bipolar patient. Caregiver depression, anxiety, medical conditions and patient symptomatology were assessed as well.Results: Hierarchical logistic regression analysis demonstrated that caregiver burden significantly increased the likelihood of mental health service use (OR = 13.53, p < 0.001) even after controlling for caregiver psychological distress and medical conditions, while anxiety and depression level, but not burden, significantly increased the likelihood of primary care service use, controlling for other variables (OR = 1.72, p = 0.02).Conclusions: Burdens experienced by family caregivers appear to increase use of health services, and presumably cost, and may be reduced by psychosocial intervention.