Characterizing Schizophrenia Spectrum Disorders: Results of the U.S. Mental and Substance Use Disorders Prevalence Study.

IF 3.3 3区医学 Q1 HEALTH POLICY & SERVICES Psychiatric services Pub Date : 2024-09-23 DOI:10.1176/appi.ps.20240138

Natalie Bareis, Mark Edlund, Heather Ringeisen, Heidi Guyer, Lisa B Dixon, Mark Olfson, Thomas E Smith, Lydia Chwastiak, Maria Monroe-DeVita, Marvin Swartz, Jeffrey Swanson, Elizabeth Sinclair Hancq, Paul Geiger, Noah T Kreski, T Scott Stroup

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Abstract

Objective: Current information on treatment and clinical characteristics of U.S. adults with schizophrenia spectrum disorders (i.e., schizophrenia, schizoaffective, and schizophreniform disorders) may help inform public health policy and service development for this population.

Methods: Data were from the U.S. Mental and Substance Use Disorders Prevalence Study, conducted from October 2020 to October 2022. Clinicians administered the Structured Clinical Interview for the DSM-5 for past-year psychiatric and substance use disorder diagnoses among adults ages 18-65 years. Using sampling weights, the authors examined clinical and treatment characteristics among those with schizophrenia spectrum disorders and compared sociodemographic characteristics and comorbid behavioral health conditions of individuals with or without such disorders (N=4,764).

Results: Among 114 adults with schizophrenia spectrum disorders, the most common comorbid conditions were major depressive episode (52%, 95% CI=34%-69%) and alcohol use (23%, CI=3%-43%), cannabis use (20%, 95% CI=1%-39%), and posttraumatic stress (17%, 95% CI=5%-30%) disorders. Global Assessment of Functioning scores were lower among people with than among those without schizophrenia spectrum disorders (mean±SE=44.8±2.0 vs. 77.2±0.5, p<0.01, respectively), indicating worse functioning. In the past year, 71% (95% CI=55%-87%) of adults with schizophrenia spectrum disorders received at least some mental health treatment, and 26% (95% CI=13%-38%) received minimally adequate treatment.

Conclusions: Individuals with schizophrenia spectrum disorders face substantial challenges in the United States, including high rates of comorbid mental health conditions and substance use; few received adequate treatment. A strong social safety net and active clinical interventions are required to address the socioeconomic challenges and unmet mental health service needs of this population.

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精神分裂症谱系障碍的特征：美国精神和物质使用障碍流行率研究结果》。

目的：有关美国成人精神分裂症谱系障碍（即精神分裂症、情感分裂症和精神分裂症）患者的治疗和临床特征的现有信息可能有助于为该人群的公共卫生政策和服务发展提供参考：数据来自 2020 年 10 月至 2022 年 10 月进行的美国精神和物质使用障碍流行率研究。临床医生对 18-65 岁的成年人进行了 DSM-5 结构化临床访谈，以了解他们过去一年的精神病和药物使用障碍诊断情况。作者使用抽样加权法检查了精神分裂症谱系障碍患者的临床和治疗特征，并比较了有无此类障碍患者的社会人口特征和合并行为健康状况（N=4,764）：在114名患有精神分裂症谱系障碍的成年人中，最常见的合并症是重度抑郁发作（52%，95% CI=34%-69%）、酗酒（23%，CI=3%-43%）、吸食大麻（20%，95% CI=1%-39%）和创伤后应激障碍（17%，95% CI=5%-30%）。精神分裂症谱系障碍患者的功能全面评估得分低于非精神分裂症谱系障碍患者（平均值±SE=44.8±2.0 vs. 77.2±0.5，p结论：在美国，精神分裂症谱系障碍患者面临着巨大的挑战，包括精神健康状况和药物使用的高并发率；很少有人能得到充分的治疗。要解决这一人群面临的社会经济挑战和未得到满足的精神健康服务需求，需要一个强大的社会安全网和积极的临床干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychiatric services 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.80

自引率

7.90%

发文量

295

审稿时长

3-8 weeks

期刊介绍： Psychiatric Services, established in 1950, is published monthly by the American Psychiatric Association. The peer-reviewed journal features research reports on issues related to the delivery of mental health services, especially for people with serious mental illness in community-based treatment programs. Long known as an interdisciplinary journal, Psychiatric Services recognizes that provision of high-quality care involves collaboration among a variety of professionals, frequently working as a team. Authors of research reports published in the journal include psychiatrists, psychologists, pharmacists, nurses, social workers, drug and alcohol treatment counselors, economists, policy analysts, and professionals in related systems such as criminal justice and welfare systems. In the mental health field, the current focus on patient-centered, recovery-oriented care and on dissemination of evidence-based practices is transforming service delivery systems at all levels. Research published in Psychiatric Services contributes to this transformation.