a prospective study of mental health care for comorbid depressed mood in older adults with painful osteoarthritis精神卫生保健的前瞻性研究共病抑郁情绪在老年人与痛苦的骨关节炎.pdfVIP

Gleicher et al. BMC Psychiatry 2011, 11:147 /1471-244X/11/147 RESEARCH ARTICLE Open Access A prospective study of mental health care for comorbid depressed mood in older adults with painful osteoarthritis 1 2,3 4,5 2,3,4,5* Yehoshua Gleicher , Ruth Croxford , Jacqueline Hochman and Gillian Hawker Abstract Background: Comorbid depression is common among adults with painful osteoarthritis (OA). We evaluated the relationship between depressed mood and receipt of mental health (MH) care services. Methods: In a cohort with OA, annual interviews assessed comorbidity, arthritis severity, and MH (SF-36 mental health score). Surveys were linked to administrative health databases to identify mental health-related visits to physicians in the two years following the baseline interview (1996-98). Prescriptions for anti-depressants were ascertained for participants aged 65+ years (eligible for drug benefits). The relationship between MH scores and MH-related physician visits was assessed using zero-inflated negative binomial regression, adjusting for confounders. For those aged 65+ years, logistic regression examined the probability of receiving any MH-related care (physician visit or anti-depressant prescription). Results: Analyses were based on 2,005 (90.1%) individuals (mean age 70.8 years). Of 576 (28.7%) with probable depression (MH score 60/100), 42.5% experienced one or more MH-related physician visits during follow-up. The likelihood of a physician visit was associated with sex (adjusted OR women vs. men = 5.87, p = 0.005) and MH score (adjusted OR per 10-point decrease in MH score = 1.63, p = 0.003). Among those aged 65+, 56.7% with probable depression received any MH care. The likelihood of receiving any MH ca