Mental health outcomes

心理健康结果
  • 文章类型: Journal Article
    飓风,作为最具破坏性的自然灾害之一,显著影响公众的健康,造成身体伤害和长期心理健康问题。尽管大量研究集中在飓风相关的伤害上,这项研究旨在综合最近文献中的发现,特别评估最近的10次飓风,确定研究差距并为未来的研究提供信息。这次范围审查,根据PRISMA-Scr指南进行,来自PubMed的评估研究,CINAHL,Cochrane数据库,和截至2024年2月的Medline。资格标准侧重于检查身体和心理健康影响的研究,COVID-19效应,以及与飓风伊恩相关的紧急医疗服务(EMS)干预措施,尼古拉斯,Ida,泽塔,Delta,莎莉,劳拉,Isaias,汉娜,还有Dorian.20篇文章符合纳入标准。这些研究分为四个主题:身体伤害和死亡,心理健康影响,飓风-COVID-19相互作用,和EMS干预措施。调查结果揭示了不同的伤害和死亡机制,重大的心理健康挑战,由于COVID-19和不同的EMS战略,包括人工智能的利用和医疗服务的战略规划。解决健康的社会决定因素和评估飓风准备计划是文献中确定的两个空白。未来的研究应侧重于心理健康影响和并发危机挑战,以制定全面的灾害管理实践,以增强社区对未来飓风和公共卫生危机的抵御能力。
    Hurricanes, as one of the most devastating natural disasters, significantly impact the public\'s health, causing both physical injuries and long-lasting mental health issues. Although substantial research has focused on hurricane-related injuries, this study aims to synthesize findings from recent literature, specifically evaluating the 10 most recent hurricanes, to identify research gaps and inform future studies. This scoping review, conducted in accordance with PRISMA-Scr guidelines, assessed studies from PubMed, CINAHL, Cochrane databases, and Medline as of February 2024. Eligibility criteria focused on studies examining physical and mental health impacts, COVID-19 effects, and emergency medical services (EMS) interventions related to Hurricanes Ian, Nicholas, Ida, Zeta, Delta, Sally, Laura, Isaias, Hanna, and Dorian. Twenty articles met the inclusion criteria. The studies were categorized into four themes: physical injuries and fatalities, mental health impacts, hurricane-COVID-19 interplay, and EMS interventions. Findings revealed varied mechanisms of injuries and deaths, significant mental health challenges, compounded crises due to COVID-19, and diverse EMS strategies, including AI utilization and strategic planning for medical care delivery. Addressing the social determinants of health and evaluating hurricane readiness initiatives were two gaps in the literature identified. Future research should focus on the mental health impacts and concurrent crisis challenges to develop comprehensive disaster management practices that enhance community resilience against future hurricanes and public health crises.
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  • 文章类型: Journal Article
    背景:与未目睹此类暴力的儿童相比,目睹父母亲密伴侣暴力(IPV)的儿童更有可能出现心理健康问题。
    目的:本研究的主要目的是评估父母亲密伴侣暴力与儿童心理健康结果之间的关系。
    方法:这项横断面研究涉及548名参与者,分为两组:父母(N=304)和后代(N=244)。参与者是从基加利市(城市)的Mageragere部门招募的,以及Huye区(农村)的Mbazi和Ruhashya部门。为了评估后代报告的精神困难的差异,采用Mann-WhitneyU检验来比较父母及其子女对心理健康结果的反应。此外,采用多元线性回归分析,探讨父母亲密伴侣暴力(IPV)与其后代心理健康结局之间的关系.
    结果:结果强调了儿童心理和情感挑战的显着水平,据父母和孩子们自己报道。与父母相比,儿童中的抑郁症和青年行为问题更为普遍,而焦虑和易怒更常见于父母,而不是他们的孩子。亲密伴侣暴力被证明是后代易怒和焦虑症状的预测因子。在易怒方面,抑郁症,和青少年行为问题,他们被确定为焦虑症状的预测因素。特别是,焦虑和易怒被揭示来预测青少年行为问题。
    结论:研究表明,父母亲密伴侣暴力(IPV)对其后代的心理健康有影响。此外,据观察,IPV和不良心理健康结果之间不仅存在相关性,也是不同精神状态之间的联系,这意味着暴露于IPV的儿童更容易经历一系列的精神问题。因此,干预计划应着重于解决父母和孩子的精神障碍。
    BACKGROUND: Children who witness parental intimate partner violence (IPV) are more likely to develop mental health issues compared to those who do not witness such violence.
    OBJECTIVE: The main objective of this study is to assess the association between parental intimate partner violence and child mental health outcomes.
    METHODS: This cross-sectional study involved 548 participants divided into two groups: parents (N = 304) and offspring (N = 244). The participants were recruited from Mageragere Sector in the City of Kigali (urban), as well as Mbazi and Ruhashya sectors in Huye District (rural). To assess the difference about mental difficulties reported by the offspring, a Mann-Whitney U test was employed to compare the responses of parents and their children on mental health outcomes. Additionally, multiple linear regression analysis was conducted to explore the association between parental intimate partner violence (IPV) and the mental health outcomes of their offspring.
    RESULTS: The results highlighted significant levels of mental and emotional challenges in children, as reported by both parents and the children themselves. Depression and youth conduct problems were more prevalent among the children compared to their parents, whereas anxiety and irritability were more commonly reported by parents than by their children. Intimate partner violence showed to be a predictor of irritability and anxiety symptoms in offspring. In terms of irritability, depression, and youth conduct problems they were identified as predictors of anxiety symptoms. Particularly, anxiety and irritability were revealed to predict youth conduct problems.
    CONCLUSIONS: The study indicates that parental intimate partner violence (IPV) has an impact on the mental well-being of their offspring. Furthermore, it was observed that there is not only a correlation between IPV and poor mental health outcomes, but also a connection between different mental conditions, implying that children exposed to IPV are more prone to experiencing a range of mental issues. As a result, intervention programs should place emphasis on addressing the mental disorders of both parents and children.
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  • 文章类型: Journal Article
    背景:意外和突击枪伤(GSW)是美国1至17岁青年受伤的第二大原因,对儿科患者的心理健康功能产生显著的负面影响。尽管GSW具有重要意义,目前还没有一个综合儿科患者心理健康结局趋势的系统评价;本评价填补了这一空白.此外,本综述确定了基于证据的心理干预措施,这些干预措施在治疗普通人群中心理障碍的亚临床症状方面被证明是有效的.
    方法:使用五个数据库进行了全面搜索:美国心理学会(APA)PsycInfo,APAPsycarticles,护理和相关健康文献累积指数(CINAHL),教育资源信息中心(ERIC),和医学文献分析和检索系统在线(MEDLINE)。22篇文章符合纳入标准。
    结果:研究结果表明,与其他人相比,小儿GSW患者患精神疾病的风险显着升高-(例如,机动车碰撞)和未受伤的年轻人。疾病包括创伤后压力,破坏性行为,焦虑,抑郁症,和物质使用。基于医院的暴力干预计划,在社区中培养与成年人的支持性关系,以创伤为中心的门诊服务被确定为治疗亚临床心理症状的有效干预措施。
    结论:在提出的概念模型中描述,本研究描述了小儿GSW与随后的精神健康障碍发病之间的直接关联.这种关系通过针对亚临床症状的循证心理干预来缓冲。结果表明,简短的心理干预可以帮助治疗心理健康挑战,将重大长期问题的风险降至最低。建议进行文化适应,以增强所有患者干预措施的实用性和可及性。
    BACKGROUND: Accidental and assault gunshot wounds (GSWs) are the second leading cause of injury in the United States for youth ages 1- to 17-years-old, resulting in significant negative effects on pediatric patients\' mental health functioning. Despite the critical implications of GSWs, there has yet to be a systematic review synthesizing trends in mental health outcomes for pediatric patients; a gap the present review fills. Additionally, this review identifies evidence-based psychological interventions shown to be effective in the treatment of subclinical symptoms of psychological disorders in the general population.
    METHODS: A comprehensive search was conducted using five databases: American Psychological Association (APA) PsycInfo, APA PsycArticles, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resource Information Center (ERIC), and Medical Literature Analysis and Retrieval Systems Online (MEDLINE). Twenty-two articles met inclusion criteria.
    RESULTS: Findings suggest pediatric GSW patients are at a significantly elevated risk for mental health disorders when compared to other- (e.g., motor vehicle collision) and non-injured youth. Disorders include post-traumatic stress, disruptive behavior, anxiety, depression, and substance use. Hospital-based violence intervention programs, cultivating supportive relationships with adults in one\'s community, and trauma-focused outpatient services were identified as effective interventions for treating subclinical psychological symptoms.
    CONCLUSIONS: Depicted in the proposed conceptual model, the present study delineates a direct association between pediatric GSWs and subsequent onset of mental health disorders. This relation is buffered by evidence-based psychological interventions targeting subclinical symptoms. Results suggest brief psychological interventions can help treat mental health challenges, minimizing risk for significant long-term concerns. Cultural adaptations to enhance the utility and accessibility of interventions for all patients are recommended.
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  • 文章类型: Journal Article
    先前的研究表明,女孩/女性被诊断为比男孩/男性自闭症晚。在以后的生活中被诊断出来的人,尤其是女孩/妇女,有更大的焦虑和抑郁症状。由于纳入研究的标准狭窄,以前的研究受到限制。本研究使用两个样本-一个基于诊所,大型“真实世界”样本和另一个基于研究的样本,具有严格的自闭症诊断标准-了解诊断年龄之间的关系,出生时分配的性别,和焦虑/抑郁症状。在这两个样本中,那些后来被诊断出的人有更大的焦虑/抑郁症状,焦虑不是由性别预测的。在基于临床但非基于研究的样本中,出生时被分配给女性的人比出生时被分配给男性的人更晚被诊断出来.仅在基于诊所的样本中,出生时被分配为女性且后来被诊断的个体与被分配为男性且受益于较早诊断时机的个体相比,出现了更大的焦虑/抑郁症状.在基于研究的样本中,出生时被分配给女性的人比被分配给男性的人有更大的抑郁症状.这些发现强调了及时识别自闭症的重要性,尤其是女孩/妇女谁往往是后来诊断。需要基于社区的样本来更好地了解现实世界中基于性别和诊断年龄的心理健康差异。
    UNASSIGNED: Previous research has shown that girls/women are diagnosed later than boys/men with autism. Individuals who are diagnosed later in life, especially girls/women, have greater anxious and depressive symptoms. Previous research has been limited due to narrow inclusionary criteria for enrollment in studies. The present study uses two samples-one clinic-based, large \"real-world\" sample and another research-based sample with strict criteria for autism diagnosis-to understand the relationships between diagnostic age, sex assigned at birth, and symptoms of anxiety/depression. In both samples, those who were diagnosed later had greater anxious/depressive symptoms, and anxiety was not predicted by sex. In the clinic-based but not research-based sample, those assigned female at birth were diagnosed later than those assigned male at birth. In the clinic-based sample only, individuals assigned female at birth and who were later diagnosed experienced greater symptoms of anxiety/depression compared to those assigned male who benefited from earlier diagnostic timing. Within the research-based sample, those assigned female at birth had greater depressive symptoms than those assigned male. These findings highlight the importance of timely identification of autism, especially for girls/women who are often diagnosed later. Community-based samples are needed to better understand real-world sex-based and diagnostic age-based disparities in mental health.
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  • 文章类型: Journal Article
    背景:大量证据表明,不良的童年经历(ACE)是导致不良心理健康结果的危险因素。然而,ACEs导致精神病理学风险增加的具体机制尚不清楚.
    目的:该研究模拟了移情和感知社会支持(PSS)对混合临床和非临床人群心理健康结果的影响,在接触ACE的背景下。
    方法:总共575名参与者(包括接受治疗和基于社区的样本),18至65岁完成自我报告评估早期逆境的措施,PSS,同理心,和心理健康结果。
    方法:使用多重中介分析来调查移情和PSS是否介导了自我报告的ACE与心理健康结果之间的关系,以及情感和认知移情是否不同地影响情感忽视和心理困扰之间的联系。
    结果:结果显示,ACE通过情感移情和PSS对成人心理健康的间接影响具有统计学意义。情感忽视是唯一一种与移情两个维度均显着相关的逆境。情感忽视通过认知和情感移情对心理健康结果的间接影响也具有统计学意义。
    结论:研究结果强调了情感移情和PSS作为影响早期逆境与成人心理健康之间通路的跨诊断机制的作用,以及在设计旨在促进经历过童年逆境的人的福祉的干预措施时考虑到这些因素的重要性。
    BACKGROUND: Evidence overwhelmingly suggests that adverse childhood experiences (ACEs) is a risk factor for poor mental health outcomes. However, the specific mechanisms via which ACEs confer an increased risk of psychopathology are less well understood.
    OBJECTIVE: The study modelled the effect of empathy and perceived social support (PSS) on mental health outcomes in a mixed clinical and non-clinical population, within the context of exposure to ACEs.
    METHODS: A total of 575 participants (comprising a treatment-receiving and community-based sample), aged 18 to 65 completed self-report measures assessing early adversity, PSS, empathy, and mental health outcomes.
    METHODS: Multiple mediation analyses were used to investigate whether empathy and PSS mediated the relationship between self-reported ACEs and mental health outcomes, and whether affective and cognitive empathy affected differentially the link between emotional neglect and psychological distress.
    RESULTS: Results revealed a statistically significant indirect effect of ACEs on adult mental health through affective empathy and PSS. Emotional neglect was the only type of adversity significantly correlated with both dimensions of empathy. The indirect effect of emotional neglect on mental health outcomes via cognitive and affective empathy was also statistically significant.
    CONCLUSIONS: Study results highlight the role of affective empathy and PSS as transdiagnostic mechanisms influencing the pathway between early adversity and adult mental health, and the importance of taking these into account when designing interventions aiming to promote well-being among those who have experienced childhood adversity.
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  • 文章类型: Journal Article
    背景:超规范是指规范可接受的性别陈述的问责结构,叙事,以及反式和非二元(TNB)个体的存在方式。目的:本研究扩展了先前关于超规范性的定性研究,以开发和验证超规范性测度(TM)。方法:将最初开发的潜在项目库提交给焦点小组和三名内容专家进行审查。在研究1中(N=497),使用探索性因素分析(EFA)对假设为六因素结构的TM的69个初始项目进行了分析,并评估了结构效度和判别效度.在研究2(N=540)中,对TNB参与者的TM反应的独立样本进行验证性因子分析(CFA),不变性测试,以及结构和预测效度。最后,在研究3中(N=107),评估了TM的类间相关系数双向混合效应模型。结果:在研究1中进行的EFAs揭示了双因素结构,最适合移除50个项目。从概念上讲,包括这两个因素的项目存在相当大的重叠,因此决定应利用一个一般因素。研究1还提供了初步的结构和判别效度,这是由于TM与现有的异性恋和内在化恐惧症之间的预期关系。在研究2中,其余项目的相关测试发现四个项目高度相关并被删除。随后的CFA表明,单因素模型很好地拟合了数据。支持配置不变性,但发现度量非不变性。此外,研究2的结果通过TM与TNB社区归属感和心理健康结果之间的相关性来支持构建和预测有效性。最后,研究3为重测可靠性提供了支持。讨论:在三项研究中,TM被发现是超规范性的有效度量。
    Background: Transnormativity refers to the accountability structure that regulates the acceptable gender presentations, narratives, and ways of being of trans and nonbinary (TNB) individuals.Aims: The present research extends prior qualitative research on transnormativity to develop and validate the Transnormativity Measure (TM). Methods: The initial developed pool of potential items was presented to a focus groups and three content experts for review. In Study 1 (N = 497), the 69 initial items of the TM hypothesized to underly a six-factor structure were analyzed using Exploratory Factor Analysis (EFA) and construct and discriminant validity were assessed. In Study 2 (N = 540), an independent sample of TNB participants\' TM responses were subjected to Confirmatory Factor Analysis (CFA), invariance testing, and construct and predictive validity. Finally, in Study 3 (N = 107), an Interclass Correlation Coefficients 2-way mixed-effects model of the TM was assessed.Results: EFAs conducted in Study 1 revealed a two-factor structure as the best fit with 50 items removed. Conceptually there was considerable overlap in the items comprising the two factors and it was decided that one general factor should be utilized. Study 1 also provided preliminary construct and discriminant validity due to expected relations between the TM and existing measures of heteronormativity and internalized transphobia. In Study 2 findings from correlational tests of the remaining items revealed that four items were highly correlated and were removed. Subsequent CFA indicated that the one factor model fit the data well. Configural invariance was supported however metric noninvariance was found. Additionally, Study 2 results supported construct and predictive validity through correlations between the TM and measures of TNB community belonginess and mental health outcomes. Finally, Study 3 provided support for test-retest reliability. Discussion: Across three studies, the TM was found to be a valid measure of transnormativity.
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  • 文章类型: Journal Article
    爱尔兰岛分为北爱尔兰和爱尔兰共和国。在这两个司法管辖区,心理健康和心理能力法已经有了重要的发展,以及相关的政策和服务。这包括强调开发更全面的方法来收集成果数据,因此有机会调整这些过程,以实现跨境比较和共享学习。本文探讨了:法律和政策的发展;心理健康结果的国际方法;以及有助于收集的数据类型,以更好地了解心理健康和心理能力法的使用。有人认为,包容性战略要制定全面、收集和分析数据的综合和一致的方法将使公民受益,政策制定者和专业人士。
    The island of Ireland is partitioned into Northern Ireland and the Republic of Ireland. In both jurisdictions, there have been important developments in mental health and mental capacity law, and associated policies and services. This includes an emphasis on developing more comprehensive approaches to collecting data on outcomes and so there is an opportunity to align these processes to enable comparison and shared learning across the border. This article explores: legal and policy developments; international approaches to mental health outcomes; and the type of data that would be helpful to collect to better understand the use of mental health and mental capacity laws. It is argued that an inclusive strategy to developing a comprehensive, integrated and aligned approach to collecting and analysing data would benefit citizens, policy makers and professionals.
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  • 文章类型: Journal Article
    背景:自发性蛛网膜下腔出血(SAH)患者经常遇到认知功能障碍和心理健康问题,对健康相关生活质量(HR-QoL)产生负面影响。这里,我们的目的是描述认知缺陷的患病率,心理健康问题,SAH后1年的HR-QoL受损。
    方法:在这项前瞻性观察研究中,177例SAH患者在10年的时间内进入我们的神经重症监护病房,随后被邀请进行为期1年的现场随访,包括标准化的神经心理学测试电池。使用问卷(医院焦虑和抑郁量表;36项简式问卷)评估心理健康问题(焦虑和抑郁)和HR-QoL。使用改良的Rankin量表(mRS)评分评估功能结果。
    结果:患者年龄为54岁(四分位距47-62岁),入院时Hunt和Hess评分中位数为2分(四分位距1-3分)。大多数患者(93%)取得了良好的1年功能结局(mRS评分0-2)。71%的患者在至少一个认知领域有缺陷,记忆缺陷是最普遍的(51%),其次是执行职能赤字(36%),视觉建构(34%),注意力(21%)。即使是中脑周围SAH(18%)或功能完全恢复(mRS评分=0,46%)的患者,认知缺陷的患病率也相当(61%和60%,分别)。16%和33%的患者报告了抑郁和焦虑的症状,分别。37%的HR-QoL受损(147个中的55个)。有认知障碍(p=0.001)或心理健康问题(p<0.001)的患者更频繁地报告HR-QoL受损。
    结论:大多数SAH患者在SAH后1年存在认知障碍和心理健康问题。这些缺陷会损害患者的生活质量。
    BACKGROUND: Patients with spontaneous subarachnoid hemorrhage (SAH) frequently encounter cognitive dysfunction and mental health issues with negative effects on health-related quality of life (HR-QoL). Here, we aimed to describe the prevalence of cognitive deficits, mental health problems, and HR-QoL impairments 1 year after SAH.
    METHODS: In this prospective observational study, 177 patients with SAH admitted to our neurointensive care unit over a time span of ten years followed the invitation for an in-person 1-year follow-up, including a standardized neuropsychological test battery. Mental health issues (anxiety and depression) and HR-QoL were evaluated using questionnaires (Hospital Anxiety and Depression Scale; 36-item Short Form questionnaire). Functional outcome was assessed with the modified Rankin Scale (mRS) score.
    RESULTS: Patients were 54 years of age (interquartile range 47-62 years) and presented with a median Hunt and Hess score of 2 (interquartile range 1-3) at admission. Most patients (93%) achieved good functional 1-year outcomes (mRS score 0-2). Seventy-one percent of patients had deficits in at least one cognitive domain, with memory deficits being the most prevalent (51%), followed by deficits in executive functions (36%), visuoconstruction (34%), and attention (21%). Even patients with perimesencephalic SAH (18%) or with full functional recovery (mRS score = 0, 46%) had a comparable prevalence of cognitive deficits (61% and 60%, respectively). Symptoms of depression and anxiety were reported by 16% and 33% of patients, respectively. HR-QoL was impaired in 37% (55 of 147). Patients with cognitive deficits (p = 0.001) or mental health issues (p < 0.001) more frequently reported impaired HR-QoL.
    CONCLUSIONS: Most patients with SAH have cognitive deficits and mental health issues 1 year after SAH. These deficits impair patients\' quality of life.
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  • 文章类型: Systematic Review
    慢性疼痛(CP)和精神疾病(MI)是残疾多年的主要原因,通常同时发生。然而,目前尚不清楚现有干预措施是否能有效改善CP和MI并存患者的疼痛结局.这项系统评价综合了干预措施改善CP合并症和临床诊断MI患者疼痛结局的有效性的证据。从成立到2023年5月,共搜索了10个电子数据库。如果随机对照试验(RCT)评估了合并CP和临床诊断MI的人群中CP相关结局的干预措施,则将其包括在内。疼痛相关和心理健康结果报告为主要和次要结果,分别。纳入26项随机对照试验(2,311名参与者)。四项试验评估了认知行为疗法的有效性,6种基于正念的干预措施,1人际心理治疗,5种基于身体的干预措施,5多成分干预措施,和5检查了基于药理学的干预措施。总的来说,样本特征和干预措施存在相当大的异质性,纳入研究的质量普遍较差,报道的试验细节不足.尽管结果不一致,初步证据表明,对CP有积极影响的干预措施可能包括对抑郁症患者的认知行为治疗(效应大小为小到中等)和对物质使用障碍患者的多成分干预(效应大小为小).尽管CP和MI的发生率/负担很高,研究干预措施的RCTs相对较少,重度MI患者无干预措施.需要更严格设计的RCT来进一步支持我们的发现。观点:本系统综述提供了当前的证据,评估了对CP合并症和临床诊断MI患者的CP相关和MH结局的干预措施。我们的发现可能有助于临床医生确定最有效的治疗方法来管理这个脆弱的患者群体的这些症状。
    Chronic pain (CP) and mental illness (MI) are leading causes of years lived with disability and commonly co-occur. However, it remains unclear if available interventions are effective in improving pain outcomes in patients with co-existing CP and MI. This systematic review synthesised evidence for the effectiveness of interventions to improve pain outcomes for people with comorbid CP and clinically diagnosed MI. Ten electronic databases were searched from inception until May 2023. Randomised controlled trials (RCTs) were included if they evaluated interventions for CP-related outcomes among people with comorbid CP and clinically diagnosed MI. Pain-related and mental health outcomes were reported as primary and secondary outcomes, respectively. 26 RCTs (2,311 participants) were included. Four trials evaluated the effectiveness of cognitive-behavioural therapy, 6 mindfulness-based interventions, 1 interpersonal psychotherapy, 5 body-based interventions, 5 multi-component interventions, and 5 examined pharmacological-based interventions. Overall, there was considerable heterogeneity in sample characteristics and interventions, and included studies were generally of poor quality with insufficient trial details being reported. Despite the inconsistency in results, preliminary evidence suggests interventions demonstrating a positive effect on CP may include cognitive-behavioural therapy for patients with depression (with a small to medium effect size) and multi-component intervention for people with substance use disorders (with a small effect size). Despite the high occurrence/burden of CP and MI, there is a relative paucity of RCTs investigating interventions and none in people with severe MI. More rigorously designed RCTs are needed to further support our findings. PERSPECTIVE: This systematic review presents current evidence evaluating interventions for CP-related and MH outcomes for people with comorbid CP and clinically diagnosed MI. Our findings could potentially help clinicians identify the most effective treatments to manage these symptoms for this vulnerable patient group.
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  • 文章类型: Journal Article
    背景:许多人从焦虑和抑郁的心理治疗中获得了积极的结果。然而,不是每个人都受益,有些人可能需要额外的支持。先前的研究已经检查了开始治疗的人的人口统计学和临床特征,并确定了与不良临床结果相关的患者概况。
    目的:研究与心理治疗一起增加就业相关的支持是否与患者康复的机会更大有关。
    方法:我们分析了三种服务的302个客户,他们在接受心理治疗的同时获得了与就业相关的支持。比较接受要约的个体和拒绝要约的个体之间的临床恢复率(在焦虑和抑郁的测量方面均低于临床阈值),同时调整潜在的混杂因素。
    结果:Logistic回归显示,在控制基线焦虑和抑郁评分后,接受就业支持与临床恢复显著相关,心理治疗的次数,以及其他临床和人口统计学变量。如果客户获得就业支持,康复的几率是2.54倍;接受心理治疗和就业支持的客户中有47%被归类为康复,相比之下,只有27%的人只接受心理治疗。
    结论:在治疗的同时提供就业支持可能对属于本患者的客户特别有帮助,他们代表了大约10%的推荐给NHS焦虑和抑郁服务的谈话疗法。服务可以考虑如何增加以就业为重点的支持的提供和吸收,以提高客户的临床结果。
    BACKGROUND: Many people achieve positive outcomes from psychological therapies for anxiety and depression. However, not everyone benefits and some may require additional support. Previous studies have examined the demographic and clinical characteristics of people starting treatment and identified a patient profile that is associated with poor clinical outcomes.
    OBJECTIVE: To examine whether the addition of employment-related support alongside psychological therapy was associated with a greater chance of recovery for clients belonging to this patient profile.
    METHODS: We analysed 302 clients across three services, who were offered employment-related support alongside psychological therapy. The rate of clinical recovery (falling below clinical thresholds on measures of both anxiety and depression) was compared between individuals who accepted the offer and those who declined, while adjusting for potential confounders.
    RESULTS: Logistic regression showed that receiving employment support was significantly associated with clinical recovery after controlling for baseline anxiety and depression scores, the number of psychological treatment sessions, and other clinical and demographic variables. The odds of recovery were 2.54 times greater if clients received employment support; 47% of clients who received employment support alongside psychological therapy were classified as recovered, compared with 27% of those receiving psychological therapy only.
    CONCLUSIONS: Providing employment support alongside therapy may be particularly helpful for clients belonging to this patient profile, who represent approximately 10% of referrals to NHS Talking Therapies for Anxiety and Depression services. Services could consider how to increase the provision and uptake of employment-focused support to enhance clients\' clinical outcomes.
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