Snigdha Widge, Jacquelyn Paquet, Ling Ling, Dilini Vethanayagam
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引用次数: 0
摘要
背景:哮喘等慢性气道疾病通常与焦虑、抑郁和创伤后应激障碍等精神疾病相关,哮喘患者的精神疾病发生率是后者的1.5至2.4倍。尽管如此,这些情况仍未得到充分认识。存在各种基于问卷的筛查工具来识别这些精神疾病。本系统综述检查了现有的哮喘相关精神疾病的筛查工具,评估了它们的疗效、有效性和成本,目的是在临床实践中更广泛地实施它们。数据来源:使用MEDLINE、EMBASE、SCOPUS、CINAHL和Web of Science数据库检索2024年7月25日之前发表的所有相关研究。通过互联网搜索和/或直接沟通评估临床使用成本和版权/开放获取状态。还回顾了筛选工具的原始验证研究。研究选择:共纳入23项研究进行分析。符合条件的研究集中于筛查哮喘患者的焦虑症、抑郁症和/或创伤后应激障碍。结果:确定了8种精神病学筛查工具,每种工具在筛查各自的焦虑症、抑郁症和创伤后应激障碍方面都得到了验证和有效。这些工具有效地筛查精神疾病,包括未确诊人群。其中三种用于临床使用是免费的,另外五种需要付费。结论:考虑到多种因素,如易于给药、有效性和成本,我们推荐PHQ-9、GAD-7和PCL-5联合作为初级保健和专科诊所管理成人哮喘的精神合并症的筛查工具。其中两种工具在艾伯塔省的电子病历中可用。
Psychiatric screening tools in asthma and their barriers to clinical utilization: a systematic review.
Background: Chronic airway diseases such as asthma are often associated with psychiatric disorders like anxiety, depression, and posttraumatic stress disorder (PTSD), which occur 1.5-2.4 times more frequently in individuals with asthma. Despite this, these conditions are under-recognized. Various questionnaire-based screening tools exist for identifying these psychiatric conditions. This systematic review examines existing screening tools for asthma-related psychiatric conditions, evaluating their efficacy, effectiveness, and cost, with the goal of implementing them more broadly in clinical practice.
Data sources: A search was performed using the databases MEDLINE, EMBASE, SCOPUS, CINAHL, and Web of Science for all relevant studies published before July 25, 2024. Costs for clinical use and copyright/open access status were assessed through internet searches and/or direct communication. Original validation studies of the screening tools were also reviewed.
Study selection: A total of 23 studies were included for analysis. Eligible studies focused on screening anxiety disorders, depressive disorders and/or PTSD in individuals with asthma.
Results: Eight psychiatric screening tools were identified, each validated and effective in screening for their respective anxiety disorders, depressive disorders, and PTSD. These tools effectively screen for psychiatric disorders, including in undiagnosed populations. Three are available at no cost for clinical use, while five require a fee.
Conclusions: Considering multiple factors such as ease of administration, effectiveness, and cost, we recommend a combination of PHQ-9, GAD-7, and PCL-5 as screening tools for psychiatric comorbidity in primary care and specialty clinics managing adult asthma. Two of these tools are available in EMRs within Alberta.
期刊介绍:
Providing an authoritative open forum on asthma and related conditions, Journal of Asthma publishes clinical research around such topics as asthma management, critical and long-term care, preventative measures, environmental counselling, and patient education.