慢性精神障碍与教养参与:加拿大安大略省一项基于人口的匹配病例对照研究。

IF 3.3 3区 医学 Q2 PSYCHIATRY Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie Pub Date : 2024-03-01 Epub Date: 2023-07-28 DOI:10.1177/07067437231189468
Ruchi Vijh, Fiona G Kouyoumdjian, Tomisin Iwajomo, Alexander I F Simpson, Roland Jones, Claire de Oliveira, Paul Kurdyak
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引用次数: 0

摘要

目的:慢性精神障碍患者在教养机构中的比例过高,但人们对增加参与教养风险的因素知之甚少。本研究的目的是比较从安大略省管教所释放的慢性精神病患者与患有慢性精神病但未参与管教的患者在社会人口学、临床和先前精神健康相关医疗服务使用特征方面的情况:方法:将 2010 年从安大略省管教所释放的所有慢性精神病患者与患有慢性精神病且未参与管教的安大略省居民按年龄和性别进行配对(1:2)。协变量包括社会人口(农村居住地、边缘化,如居住不稳定五分位数、物质匮乏五分位数、依赖性五分位数和种族集中五分位数)和临床(慢性精神病性障碍持续时间和合并症)特征,以及参与矫治前 1 年和 3 年的精神健康相关医疗服务使用特征(初级保健医生、精神科医生和急诊就诊以及住院治疗)。通过使用泊松回归和负二项式回归估算发病率比来衡量参与矫治与之前使用医疗服务之间的关联:与未受教养者(N = 6,393 人)相比,受教养者(N = 3,197 人)居住在物质条件较差和居住不稳定的社区,病程较短,合并心理社会疾病(如行为问题和抑郁症)较多。在对社会人口学和临床变量进行调整后,与没有参与管教的人相比,参与管教的人在参与管教之前,与精神健康相关的初级保健医生就诊率、急诊就诊率和住院率都较高,但精神科医生就诊率较低:结论:尽管患有慢性精神病性障碍并参与管教的人中,与精神健康相关的合并症较多,获得急性精神健康服务的比例也较高,但在参与管教之前看精神科医生的比例却很低。
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Chronic Psychotic Disorders and Correctional Involvement: A Population-Based Matched Case-Control Study in Ontario, Canada.

Objective: Individuals with chronic psychotic disorders are overrepresented in correctional facilities, but little is known about factors that increase the risk of correctional involvement. The objective of this study was to compare individuals with chronic psychotic disorders who were released from correctional facilities in Ontario to individuals with chronic psychotic disorders but no correctional involvement on sociodemographic, clinical, and prior mental health-related health service utilization characteristics.

Method: All individuals with chronic psychotic disorders who were released from a provincial correctional facility in Ontario in 2010 were matched (1:2) by age and sex to Ontario residents with chronic psychotic disorders and no correctional involvement. Covariates included sociodemographic (rural residence, marginalization such as residential instability quintile, material deprivation quintile, dependency quintile, and ethnic concentration quintile) and clinical (duration of chronic psychotic disorder and comorbidities) characteristics, and mental health-related health service utilization characteristics (primary care physician, psychiatrist and emergency department visits, and hospitalizations) 1 and 3 years prior to correctional involvement. The association between correctional involvement and prior health service utilization was measured by estimating incidence rate ratios using Poisson and negative-binomial regressions.

Results: Individuals with correctional involvement (N = 3,197) lived in neighbourhoods with higher material deprivation and residential instability, and had a shorter duration of illness, and more psychosocial comorbidities (e.g., behavioural issues and depression) than individuals without correctional involvement (N = 6,393). Adjusting for sociodemographic and clinical variables, individuals with correctional involvement had a higher rate of mental health-related primary care physician visits, emergency department visits, and hospitalizations but a lower rate of psychiatrist visits prior to correctional involvement, compared to individuals without correctional involvement.

Conclusions: Despite higher mental health-related comorbidities and higher rates of accessing acute mental health services among individuals with chronic psychotic disorders and correctional involvement, visits to psychiatrists prior to involvement were low.

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来源期刊
CiteScore
7.00
自引率
2.50%
发文量
69
审稿时长
6-12 weeks
期刊介绍: Established in 1956, The Canadian Journal of Psychiatry (The CJP) has been keeping psychiatrists up-to-date on the latest research for nearly 60 years. The CJP provides a forum for psychiatry and mental health professionals to share their findings with researchers and clinicians. The CJP includes peer-reviewed scientific articles analyzing ongoing developments in Canadian and international psychiatry.
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