Modeling Smoking and Depression Co-Morbidity and Treatment Interventions: a System Dynamics Approach

吸烟和抑郁症共病建模及治疗干预：系统动力学方法

• 批准号: 9300705
• 负责人: Jamie Pearl Tam
• 金额: $ 3.7万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9300705
• 关键词: Address; Adult; Age; Area; Biological Models; Businesses; Caring; Cessation of life; Chronic; Comorbidity; Complex; Decision Making; Depressed mood; Feedback; Future; General Population; Health; Health Status; Healthcare Systems; Incidence; Individual; Interruption; Intervention; Joints; Lead; Literature; Major Depressive Disorder; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mentally Ill Persons; Methods; Modeling; Morbidity - disease rate; Outcome; Outpatients; Patients; Policies; Population; Population Research; Predisposition; Prevalence; Process; Public Health; Randomized Clinical Trials; Recommendation; Recording of previous events; Recovery; Recurrence; Reporting; Research; Resources; Risk; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Smoking Status; System; Testing; Time; Tobacco; Tobacco use; Withholding Treatment; Youth; clinical decision-making; comorbid depression; depression model; depressive symptoms; experience; interest; mortality; population health; service utilization; smoking cessation; smoking prevalence; tobacco control; treatment as usual; treatment strategy

Project Summary Smoking and depression are leading contributors to mortality and morbidity in the U.S. They are also significantly associated with each other, with higher rates of smoking among depressed populations compared to the general population. This smoking disparity persists despite ongoing campaigns to reduce smoking in the U.S. Comorbidity of smoking and depression are subject to feedback effects, as smoking is known to predict future depression, while depression also predicts future smoking. This suggests that health interventions targeting either depression or smoking are likely to have positive effects on the other, resulting in even greater health gains. Little research has examined the impact of mental health treatment strategies on smoking outcomes. Greater use of mental health services could reduce depressive symptoms, and in so doing, reduce propensity for smoking. National organizations also recommend providing smoking cessation treatment to patients with depression. However, smoking cessation interventions in mental health settings have not been widely employed, nor has the population benefit of implementation been estimated. Systems modeling can simulate intervention scenarios that cannot be easily tested in the real world. Existing models of population smoking have yet to consider mental health status while models of depression have not accounted for smoking behaviors. This proposed study aims to develop a system dynamics model of smoking and depression comorbidity in the U.S. population—the first of its kind. The model will project future smoking prevalence by depressive state, depression prevalence, and population deaths due to tobacco or other causes over the next 50 years. The effects of two potential intervention strategies will then be analyzed: 1) integration of a smoking cessation intervention in mental health settings, and 2) increased utilization of mental health services in the population. Results from this study can be used to identify policy approaches likely to produce the largest population health gains, and guide decision-making to address mental illness and smoking disparities.

项目摘要 吸烟和抑郁症是导致美国死亡率和发病率的主要因素。 也显着相互关联，与吸烟率较高的抑郁症 与一般人口相比。这种吸烟差异持续存在，尽管目前 运动，以减少吸烟在美国吸烟和抑郁症的科摩罗受到 反馈效应，因为吸烟可以预测未来的抑郁症，而抑郁症也可以预测 未来吸烟这表明，针对抑郁症或吸烟的健康干预措施 可能会对另一方产生积极影响，从而带来更大的健康收益。小 研究已经检查了心理健康治疗策略对吸烟结果的影响。 更多地使用心理健康服务可以减少抑郁症状，这样做， 减少吸烟倾向。国家组织还建议提供吸烟 对抑郁症患者进行停药治疗。然而，戒烟干预措施， 心理健康环境尚未得到广泛利用，也没有人口受益， 估计执行情况。 系统建模可以模拟无法在真实的中轻松测试的干预场景 世界现有的人口吸烟模型尚未考虑心理健康状况， 抑郁症模型没有考虑到吸烟行为。这项研究旨在 在美国建立一个吸烟和抑郁共病的系统动力学模型。 人口-第一个同类。该模型将预测未来的吸烟流行率， 国家，抑郁症的患病率，以及未来由于烟草或其他原因造成的人口死亡 50年然后分析两种潜在干预策略的效果：1）整合 在心理健康环境中进行戒烟干预，以及2）增加对 人口心理健康服务。本研究的结果可用于确定政策 可能产生最大人口健康收益的方法，并指导决策， 解决精神疾病和吸烟的不平等问题。