本文由小咖机器人翻译整理

期刊来源：Ann Intern Med

原文链接：https://doi.org/10.7326/M23-2824

摘要内容如下：

背景

除了COVID-19大流行带来的身体疾病负担外，人们还担心其对精神健康的不良影响。

客观

描述2018年至2021年美国成年人心理困扰和门诊精神卫生保健的趋势，并描述面对面、电话和视频门诊精神卫生保健的模式。

设计

非制度化成年人的横断面全国代表性调查。

设置

美国。

参与者

2018年至2021年纳入医疗支出小组调查家庭部分的成年人（n=86658）。

测量

用Kessler-6量表（范围为0至24，分数越高表示痛苦越严重）测量心理痛苦，13分或更高被定义为严重心理痛苦，1至12分被定义为不太严重的痛苦，0分被定义为没有痛苦。门诊精神卫生保健的使用通过计算机辅助个人访谈进行测量。

结果

2018年至2021年间，成年人严重心理困扰的比率从3.5%上升至4.2%。虽然总体上门诊心理保健的比率从11.2%上升到12.4%，但在有严重心理困扰的成年人中，这一比率从46.5%下降到40.4%。在控制年龄、性别和痛苦的情况下，观察到年轻成人（18至44岁）而不是中年（45至64岁）和老年（>65岁）成人以及就业成人而不是失业成人的门诊精神卫生保健显著增加。2021年，33.4%的心理健康门诊患者接受了至少一次视频访问，其中包括不成比例的年轻人、受过大学教育的人、高收入的人、有工作的人和城市成年人。

局限性

关于门诊心理健康服务模式（面对面、视频、电话）的信息在2021年的调查中首次完全可用。

结论

这些趋势和模式强调了将老年人、失业者和严重抑郁的成年人与门诊精神卫生保健联系起来的持续挑战，以及老年人、受教育程度较低、收入较低、失业者和农村患者在通过视频获得门诊精神卫生保健方面所面临的困难。

主要资金来源

没有。

英文原文如下：

Abstracts

BACKGROUND  In addition to the physical disease burden of the COVID-19 pandemic, concern exists over its adverse mental health effects.

OBJECTIVE  To characterize trends in psychological distress and outpatient mental health care among U.S. adults from 2018 to 2021 and to describe patterns of in-person, telephone, and video outpatient mental health care.

DESIGN  Cross-sectional nationally representative survey of noninstitutionalized adults.

SETTING  United States.

PARTICIPANTS  Adults included in the Medical Expenditure Panel Survey Household Component, 2018 to 2021 (n = 86 658).

MEASUREMENTS  Psychological distress was measured with the Kessler-6 scale (range of 0 to 24, with higher scores indicating more severe distress), with a score of 13 or higher defined as serious psychological distress, 1 to 12 as less serious distress, and 0 as no distress. Outpatient mental health care use was measured via computer-assisted personal interviews.

RESULTS  Between 2018 and 2021, the rate of serious psychological distress among adults increased from 3.5% to 4.2%. Although the rate of outpatient mental health care increased from 11.2% to 12.4% overall, the rate decreased from 46.5% to 40.4% among adults with serious psychological distress. When age, sex, and distress were controlled for, a significant increase in outpatient mental health care was observed for young adults (aged 18 to 44 years) but not middle-aged (aged 45 to 64 years) and older (aged >65 years) adults and for employed adults but not unemployed adults. In 2021, 33.4% of mental health outpatients received at least 1 video visit, including a disproportionate percentage of young, college-educated, higher-income, employed, and urban adults.

LIMITATION  Information about outpatient mental health service modality (in-person, video, telephone) was first fully available in the 2021 survey.

CONCLUSION  These trends and patterns underscore the persistent challenges of connecting older adults, unemployed persons, and seriously distressed adults to outpatient mental health care and the difficulties faced by older, less educated, lower-income, unemployed, and rural patients in accessing outpatient mental health care via video.

PRIMARY FUNDING SOURCE  None.

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