■这项研究的目的是调查种族/民族与脑震荡后心理健康之间的关系(即,抑郁,创伤后应激障碍[PTSD])和服务成员中的神经行为症状,以及这种关联是否因教育水平而异。
■研究样本包括524名来自美国多学科军事门诊治疗机构的脑震荡后症状患者。具有稳健误差方差的泊松回归被用来调查结果(即,临床上升高的抑郁症[患者健康问卷-8≥15],PTSD[PTSD清单,在这项队列研究中,DSM5≥38]和入院和最后一次随访时的神经行为[神经行为症状量表>第75百分位数]症状。按教育水平调整(低[无大学学位]与高[副学士学位或更高])被额外评估。
■种族/民族与心理健康/神经行为症状之间的关系因教育水平而异(p相互作用:抑郁症状=0.002,PTSD症状=0.035,神经行为症状=0.040)。具体来说,非白人在治疗后临床上升高的抑郁症状的患病率明显高于白人,但仅限于受过高等教育的人(PR=2.22,CI=1.37-3.59)。PTSD和神经行为症状也表现出类似的趋势。
■军事医疗可能需要增加以抑郁症为中心的治疗选择,这是种族/少数民族患者可以接受的,特别是那些受过高等教育的人,当他们从共同的创伤性脑损伤中恢复时。
UNASSIGNED: The purpose of this study was to investigate the relationship between race/ethnicity and post-concussive mental health (i.e., depressive, post-traumatic stress disorder [PTSD]) and neurobehavioral symptoms among service members, and whether this association differed by education level.
UNASSIGNED: The study sample consisted of 524 patients from a multidisciplinary US military outpatient treatment facility for post-concussive symptoms. Poisson regression with robust error variance was utilized to investigate outcome (i.e., clinically-elevated depressive [Patient Health Questionnaire-8 ≥15], PTSD [PTSD Checklist, DSM 5 ≥38] and neurobehavioral [Neurobehavioral Symptom Inventory >75th percentile] symptoms at admission and last follow-up in this cohort study. Modification by education level (low [no college degree] vs. high [associate\'s degree or higher]) was additionally evaluated.
UNASSIGNED: The relationship between race/ethnicity and mental health/neurobehavioral symptoms varied by education level (p-interaction: depressive symptoms = 0.002, PTSD symptoms = 0.035, neurobehavioral symptoms = 0.040). Specifically, non-Whites were at a significantly higher prevalence for clinically-elevated depressive symptoms post-treatment than Whites, but only among those with higher education level (PR = 2.22, CI = 1.37-3.59). A similar trend was demonstrated for PTSD and neurobehavioral symptoms.
UNASSIGNED: Military healthcare may need to increase depression-focused treatment options that are acceptable for racial/ethnic minority patients, particularly those with higher education, while they are recovering from comorbid traumatic brain injury.