Mental health service use among individuals with traumatic brain injury: Exploring the role of social support, employment, and insurance

IF 3.3 2区 医学 Q2 PSYCHIATRY
Altaf Saadi , Mario Cruz-Gonzalez , Lulu Zhang , Margarita Alegría
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Abstract

Introduction

This study assessed 1) differences in mental health service use among those with and without traumatic brain injury (TBI), 2) whether social supports, employment, and insurance moderated the TBI-mental health service use relationship, and 3) racial and ethnic differences in these associations.

Methods

In an analytic sample of 1018 participants, we used propensity score matching and inverse probability of treatment weighting to assess differences in both lifetime and past 12-month mental health service use among those with and without TBI. We used a logistic regression model for the moderation analyses.

Results

Those with TBI reported greater depressive, anxiety, and PTSD symptoms than those without TBI, as well as higher probability of both lifetime and past 12-month mental health service use. After adjusting for the propensity score, those with TBI were about 10.5 % more likely to use mental health services compared to those without TBI. Higher levels of social support were associated with a three-fold increase in the odds of using mental health services in individuals with TBI. Employment and insurance did not significantly moderate the TBI-mental health service use relationship, but insurance was independently associated with grater odds of both lifetime and past 12-month mental health service use.

Conclusion

Greater psychiatric symptoms in individuals with TBI, along with their increased use of mental health services, highlight the need for a multidisciplinary approach to TBI care. Interventions could also target social relationships, as lower social support represents a potential pathway for differences in mental health service use for those with TBI.
创伤性脑损伤个体的心理健康服务使用:探索社会支持、就业和保险的作用
本研究评估了1)创伤性脑损伤(TBI)患者和非创伤性脑损伤患者心理健康服务使用的差异,2)社会支持、就业和保险是否调节了创伤性脑损伤与心理健康服务使用的关系,以及3)这些关联的种族和民族差异。方法在1018名参与者的分析样本中,我们使用倾向得分匹配和治疗加权逆概率来评估有和没有创伤性脑损伤的人一生和过去12个月心理健康服务使用的差异。我们使用逻辑回归模型进行适度分析。结果创伤性脑损伤患者报告的抑郁、焦虑和创伤后应激障碍症状比非创伤性脑损伤患者更严重,并且终生和过去12个月使用心理健康服务的可能性更高。在调整倾向得分后,与没有TBI的人相比,那些有TBI的人使用心理健康服务的可能性大约高出10.5%。较高水平的社会支持与TBI患者使用心理健康服务的几率增加三倍有关。就业和保险并没有显著调节tbi -心理健康服务使用关系,但保险与终生和过去12个月心理健康服务使用的更大几率独立相关。结论:创伤性脑损伤患者的精神症状更严重,同时他们越来越多地使用心理健康服务,这突出了创伤性脑损伤治疗的多学科方法的必要性。干预措施也可以针对社会关系,因为较低的社会支持代表了TBI患者在使用心理健康服务方面存在差异的潜在途径。
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
Journal of Psychosomatic Research
Journal of Psychosomatic Research 医学-精神病学
CiteScore
7.40
自引率
6.40%
发文量
314
审稿时长
6.2 weeks
期刊介绍: The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.
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