易受社会影响的炎症性肠病患者是否低估了抑郁和焦虑?

IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Jessica L Sheehan, Ariel A Jordan, Kira L Newman, Laura A Johnson, Dala Eloubeidi, Shirley Cohen-Mekelburg, Jeffrey A Berinstein, Renuka Tipirneni, Peter D R Higgins
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引用次数: 0

摘要

引言:抑郁症和焦虑症在炎症性肠病患者中非常普遍;然而,人们对健康的社会决定因素(SDOH)如何影响这一人群的心理健康诊断知之甚少。社会脆弱性指数(SVI)是一种公开可用的工具,可用于研究IBD患者的SDOH。方法:使用来自单个中心IBD患者回顾性队列的家庭地址对患者的个人普查区和相应的SVI进行地理编码。我们使用多变量逻辑回归来检验IBD患者的SVI与共病心理健康诊断之间的关系。其次,使用标准化健康问卷的数据来确定患者是否进行了充分的抑郁和焦虑筛查。结果:共纳入9644例患者;18%被诊断为抑郁症,21%被诊断为焦虑症,32%被诊断为“任何心理健康诊断”。抑郁症(比值比[OR],1.27;95%置信区间[CI],1.02-1.56)与更高的社会脆弱性水平相关,但焦虑症(OR,0.87;95%可信区间,0.71-1.06)和“任何心理卫生诊断”(OR,1.09;95%可信可信区间,0.92-1.30)与较高的社会脆弱度水平无关。然而,抑郁症和焦虑症的总体筛查率较低(分别为15%和8%),其中最易受社会影响的人群的筛查率最低(抑郁症8.2%,焦虑症6.3%)。意识到这些不公平现象是制定干预措施的第一步,以改善心理健康筛查,消除障碍和偏见,并促进转诊进行适当的心理健康管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Are Depression and Anxiety Underdiagnosed in Socially Vulnerable Patients With Inflammatory Bowel Disease?

Introduction: Depression and anxiety are highly prevalent among individuals with inflammatory bowel disease (IBD); however, little is understood about how social determinants of health (SDOH) may impact mental health diagnoses in this population. The social vulnerability index (SVI) is a publicly available tool that can be used to study SDOH in IBD patients.

Methods: Home addresses from a retrospective cohort of IBD patients at a single center were used to geocode patients to their individual census tract and corresponding SVI. We used multivariable logistic regression to examine the relationship between SVI and comorbid mental health diagnoses in patients with IBD. Secondarily, data from standardized health questionnaires were then used to determine if patients were adequately screened for depression and anxiety.

Results: In all, 9644 patients were included; 18% had a diagnosis of depression, 21% anxiety, and 32% had a composite of "any mental health diagnosis." Depression (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.02-1.56) but not anxiety (OR, 0.87; 95% CI, 0.71-1.06) nor "any mental health diagnosis" (OR, 1.09; 95% CI, 0.92-1.30) was associated with higher levels of social vulnerability. However, overall rates of screening for depression and anxiety were low (15% and 8%, respectively), with the lowest screening rates among the most socially vulnerable (depression 8.2%, anxiety 6.3%).

Conclusions: Disparities in the diagnoses of depression and anxiety for socially vulnerable patients with IBD exist. Awareness of these inequities is the first step toward developing interventions to improve mental health screening, eliminate barriers and bias, and promote referrals for appropriate mental health management.

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来源期刊
Inflammatory Bowel Diseases
Inflammatory Bowel Diseases 医学-胃肠肝病学
CiteScore
9.70
自引率
6.10%
发文量
462
审稿时长
1 months
期刊介绍: Inflammatory Bowel Diseases® supports the mission of the Crohn''s & Colitis Foundation by bringing the most impactful and cutting edge clinical topics and research findings related to inflammatory bowel diseases to clinicians and researchers working in IBD and related fields. The Journal is committed to publishing on innovative topics that influence the future of clinical care, treatment, and research.
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